Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VI - Mental Health/Intellectual Disability/Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 4310 - CLIENT LIABILITY-STATE MH/ID FACILITIES › DETERMINING LIABILITY AND ASSESSMENTS › Section 4310.13 - Determining legally liable relative monthly liability

Current through Register Vol. 54, No. 28, July 13, 2024
The extent of a LLR's liability for costs of services
						provided to clients over and above that paid by third-party payors, other
						agencies, or the client is based on discretionary income and determined from
						the table in Appendix A. The monthly LLR liability is determined by the
						following assessment method. The assessment must be completed on the PW-833.
(1)
Determining gross
					 income.
(i) Income must be verified
					 using the most recent Federal tax 1040 forms. If Federal tax forms are not
					 available, the W-2 or three recent pay stubs may be used. However, LLR's are
					 required to present their Federal Income 1040 tax forms at the next Federal
					 income tax filing period.
(ii)
					 Determine the total annual earned income of the household. To the earned income
					 figures, add any interest, dividends, benefits, alimony, or child support
					 payments received by the LLR during the preceding 12 months. The sum of all
					 earned and nonearned income is the gross annual income. The following policies
					 apply to the determination of gross income:
(A) Earned income is the sum of all wages,
					 salaries, fees, commissions, tips, bonuses, net rental income before deductions
					 for taxes, insurance, tax sheltered annuities or other income.
(B) Interest income includes interest
					 received from accounts with banks, money market funds, credit unions or bonds
					 that are paid to the LLR.
(C)
					 Dividends received from corporate stock holdings or life insurance policies are
					 counted as income.
(D) Capital
					 gains from any source.
(E) Benefits
					 including, but not limited to, unemployment compensation, OASDI payments,
					 pensions, black lung benefits, railroad retirement, and the like, are counted
					 as income.
(F) Benefits of a LLR
					 that are specifically restricted to his own personal use, such as veteran's
					 pensions or Social Security benefits shall be considered only for his own
					 support and must be disregarded for the purpose of supporting the
					 client.
(iii) Alimony and
					 support payments are counted as income when determining gross income.
(A) If there is a court-supervised settlement
					 or agreement regarding payment for medical care costs for the client, liability
					 is only assessed against the spouse or parent having responsibility for these
					 costs.
(B) If the court order
					 specified that the first spouse or parent is liable for medical costs up to a
					 given dollar amount, the second spouse or parent remains liable up to the
					 second spouse's or parent's maximum liability, but liability may not exceed the
					 amount assessed the first spouse or parent under court order.
(C) If there is no court-supervised
					 separation or divorce agreement, the income of both spouses or parents is
					 considered assessable up to the maximum liability. If a child is a client and
					 if the parent with whom the child is not residing refuses to provide
					 information or income amounts, liability of the parent with whom the child
					 resides is limited to the maximum liability based on the one parent's income.
					 The other parent refusing to provide information or income amounts is liable
					 for the full cost of care up to the maximum liability over and above the
					 charges paid by the parent with whom the child resides.
(D) Services may not be discontinued to a
					 child because of nonpayment by the noncustodial parent.