Pennsylvania Code › Title 55 - HUMAN SERVICES › Part VI - Mental Health/Intellectual Disability/Autism Manual › Subpart C - Administration and Fiscal Management › Chapter 4305 - LIABILITY FOR COMMUNITY MENTAL HEALTH AND INTELLECTUAL DISABILITY SERVICES › MENTAL HEALTH CLIENT FEE SCHEDULES › Appendix B

Current through Register Vol. 54, No. 28, July 13, 2024
Monthly Liability for Community Mental Health and
						Intellectual Disability Residential and Short-Term Inpatient Services
Adjusted Family Income
Number of Dependents
1
2
3
4
5
6
7
8
9
10
500- 999
13
11
10
9
8
6
5
4
3
2
1000-1499
25
21
18
15
13
10
8
6
5
4
1500-1999
38
31
25
20
16
14
11
9
6
5
2000-2499
50
43
36
31
28
24
20
16
14
11
2500-2999
63
54
46
40
35
30
25
21
19
15
3000-3499
75
65
56
49
43
36
31
28
24
20
3500-3999
88
76
66
58
50
43
38
33
28
24
4000-4499
100
86
76
66
58
50
44
39
34
30
4500-4999
113
98
85
74
65
55
48
41
36
31
5000-5499
125
109
95
83
73
63
55
49
44
39
5500-5999
144
125
110
96
85
74
65
58
50
44
6000-6499
163
143
125
110
96
85
75
66
59
51
6500-6999
181
159
140
125
109
95
84
74
66
59
7000-7499
200
175
154
136
120
105
94
83
73
65
7500-7999
219
191
169
149
131
115
101
90
80
70
8000-8499
238
208
183
160
141
124
110
96
85
75
8500-8999
256
224
196
173
151
133
116
103
90
79
9000-9499
275
240
210
184
161
141
124
109
95
83
9500-9999
294
256
224
195
170
149
130
114
99
86
10000-10499
319
279
244
213
186
163
141
124
108
94
10500-10999
344
300
265
230
201
176
154
134
118
103
11000-11499
369
323
281
246
215
189
165
144
126
110
11500-11999
394
343
300
263
230
201
175
154
134
118
12000-12499
419
365
319
279
244
213
185
161
141
123
12500-12999
444
388
338
295
258
224
195
170
148
129
13000-13499
469
409
356
310
270
235
204
178
154
134
13500-13999
494
430
374
325
283
246
214
185
160
139
14000-14499
519
451
391
340
295
256
221
191
165
141
14500-14999
544
473
410
355
308
265
229
198
169
145
15000-15499
569
493
428
369
319
275
236
203
173
146
15500-15999
594
514
444
383
330
284
243
206
175
149
16000-16499
619
535
461
398
341
291
249
211
179
151
16500-16999
644
555
478
410
351
300
255
215
180
155
17000-17499
669
578
498
429
368
315
268
228
191
160
17500-17999
694
600
518
446
384
329
281
239
203
170
18000-18499
719
623
538
465
400
344
295
251
214
180
18500-18999
744
645
559
483
416
359
309
264
225
191
19000-19499
769
668
579
501
433
374
321
276
236
201
19500-19999
794
689
599
519
449
389
335
289
248
211
20000-20499
819
711
619
538
466
404
349
301
259
223
20500-20999
844
734
639
555
483
419
363
313
270
233
21000-21499
869
756
659
573
499
433
375
325
281
243
21500-21999
894
779
679
591
515
448
390
339
294
254
22000-22499
919
801
699
610
531
463
403
350
305
264
22500-22999
944
824
719
628
548
478
416
363
315
275
23000-23499
969
846
739
646
564
493
430
375
328
285
23500-23999
994
869
759
664
580
508
444
388
339
295
24000-24499
1019
891
779
681
596
523
456
400
350
306
24500-24999
1044
914
800
700
614
538
470
413
361
316
25000-25499
1069
936
820
719
630
551
484
425
373
326
Formulae if Adjusted Family Income Exceeds
						$25,499
The liability for 1 dependent is adjusted family income
						times 0.0420
The liability for 2 dependents is adjusted family income
						times 0.0368
The liability for 3 dependents is adjusted family income
						times 0.0321
The liability for 4 dependents is adjusted family income
						times 0.0281
The liability for 5 dependents is adjusted family income
						times 0.0246
The liability for 6 dependents is adjusted family income
						times 0.0215
The liability for 7 dependents is adjusted family income
						times 0.0188
The liability for 8 dependents is adjusted family income
						times 0.0165
The liability for 9 dependents is adjusted family income
						times 0.0144
The liability for 10 dependents is adjusted family
						income times 0.0126
The liability for 11 dependents is adjusted family
						income times 0.0110
The provisions of this Appendix B amended under
						  sections 201(2) and (8) and 202 of the Mental Health and Intellectual
						  Disability Act of 1966 (50 P.S. §§
														4201(2) and
						  (8) and
						  4202).
This appendix cited in 55 Pa. Code §
													4305.41 (relating to liability);
						  55 Pa. Code §
													4305.42 (relating to more than one
						  client receiving service); and 55 Pa. Code §
													4305.43 (relating to client
						  receiving more than one service).