Any payments from the State of N.D. or Medicaid toward the in-kind support and maintenance
(ISM) received by the recipient are excluded per the provision in SI 00815.050. That POMS section essentially explains that in-kind income provided by a governmental
medical or social services program is not income.
In some instances, recipients may move from a semi-private room to a private room,
and a friend or relative pays the additional cost. Such payments are also excluded.
North Dakota State law provides that the payment for the additional cost of a private
room "must come from sources other than a resident's monthly income." Simply stated,
the N.D. law specifically says a recipient pays all income (less $60.00) for the cost
and care and specifically precludes the recipient from paying for the additional in-kind
shelter cost associated with a private room. This State law limiting the maximum amount
a recipient can pay toward room and board is analogous to "rent control" laws in some
locations which limit the amount of rent an individual can legally pay. In "rent control"
situations, SSI policy in SI 00835.380 provides that ISM will not be charged as income if the current market rental value
(CMRV) exceeds the amount of rent the individual is paying as long as that payment
equals the allowed amount in the "rent control" situation. Although third party payments
for shelter are a different type of ISM than rental subsidies when CMRV exceeds the
rent payment, both "rent control" and N.D. law limit the recipient's payment toward
food and shelter. Since ISM is not counted in "rent control" situations, ISM is similarly
not counted in N.D. basic care facilities when a third party pays for the additional
cost of a private room.