RULES AND REGULATIONS
Title 55--PUBLIC WELFARE
DEPARTMENT OF PUBLIC WELFARE
[55 PA. CODE CHS. 101, 125, 133, 141, 145, 166, 175, 177, 178, 181 AND 183]
Public Assistance
[30 Pa.B. 3779] The Department of Public Welfare (Department), by this order, adopts the final-form rulemaking to read as set forth in Annex A, under the authority of sections 201(2) and 403(b) of the Public Welfare Code (62 P. S. §§ 201(2) and 403(b)).
Notice of proposed rulemaking is omitted in accordance with section 204(1)(iv) of the act of July 31, 1968 (P. L. 769, No. 240) (45 P. S. § 1204(1)(iv)), known as the Commonwealth Documents Law (CDL), and 1 Pa. Code § 7.4(1)(iv) because the administrative regulations relate to Commonwealth grants and benefits. Additionally, notice of proposed rulemaking is omitted for good cause as unnecessary and contrary to the public interest in accordance with section 204(3) of the CDL (45 P. S. § 1204(3)) and 1 Pa. Code § 7.4(3).
The amendments, except for the amendment pertaining to allowable medical expense income deductions, are a result of Federal and State statutory mandates allowing for no administrative discretion. These amendments, except the amendment pertaining to allowable medical expense income deductions, have been implemented through Notices of Rule Change (NORCs) published at 24 Pa.B. 4425 (August 27, 1994), effective September 1, 1994; 25 Pa.B. 2762 (July 8, 1995), effective July 1, 1995; 26 Pa.B. 2865 (June 15, 1996), effective June 17, 1996; and 27 Pa.B. 1092 (March 1, 1997), effective March 3, 1997. Additionally, these amendments include a discretionary provision which benefits applicants and recipients and was implemented through a NORC published at 23 Pa.B. 3433 (July 17, 1993), effective July 17, 1993.
The amendment pertaining to allowable medical expense income deductions is a result of section 1902(a)(17) of the Social Security Act (42 U.S.C.A. § 1396a(a)(17)(D)), as clarified by the Health Care Financing Administration (HCFA), which defines what states may use as allowable medical expense income deductions when determining eligibility for Federally-funded categories of Medically Needy Only (MNO)-Medical Assistance (MA). This amendment applies to the Federally-funded categories of MNO-MA and will also be applied to the General Assistance (GA)-related MNO-MA category. This amendment was implemented on February 1, 1999, through written procedural instructions.
These amendments conform State regulations with State statute, reduce State costs, streamline the GA program and ensure that needy individuals of this Commonwealth are assisted in their efforts to become self-sufficient in accordance with legislation enacted by the General Assembly.
Purpose
The purpose of these amendments is to incorporate eligibility requirements for GA, GA-related MA, Federal Temporary Assistance for Needy Families (TANF--which replaced the Aid to Families With Dependent Children [AFDC] Program), TANF-related MA and MNO-MA. These amendments are mandated by State and Federal law as discussed in the following section.
Background
The act of June 16, 1994 (P. L. 319, No. 49) (Act 49) amended the Public Welfare Code by making significant changes to the GA Program that had been largely untouched by reform measures since the passage in 1982 of Act 1982-75 (Act 75). Act 75 introduced time-limited cash grants and a distinction between Transitionally Needy (TN-employable) and Chronically Needy (CN) GA recipients. Act 49 reduced the eligibility period for TN benefits, imposed a 60-day residency requirement on TN and CN clients, tightened eligibility requirements under the CN component and reduced MA services available to both TN and CN clients. The legislative mandates of Act 49 were implemented effective September 1, 1994, through a NORC published at 24 Pa.B. 4425 (August 27, 1994). Effective December 9, 1997, the Department stopped applying the 60-day durational residency requirement for GA (62 P. S. § 432.4(a)) added by section 6 of Act 49. The United States District Court for the Western District of Pennsylvania, in the case of Warrick et al. v. Snider et al., C.A. No. 94-1634, U.S.D.C., W.D., Pa., ruled that section 432.4(a) of the Public Welfare Code (62 P. S. § 432.4(a)) is unconstitutional. See 2 F. Supp. 2d 720. That decision was affirmed by the U. S. Court of Appeals for the Third Circuit, at C.A. No. 98-3010, August 17, 1999. See 191 F. 3rd 446. Consequently, no regulations will be promulgated to implement the 60-day residency portion of 62 P. S. § 432.4(a).
The act of June 30, 1995 (P. L. 129, No. 20) (Act 20) further amended the Public Welfare Code by eliminating the TN component of the GA Program and deleting or replacing references to the CN component with the phrase ''General Assistance'' as applicable. Categorical eligibility for the GA program is now determined using criteria formerly referred to as CN criteria. These provisions were implemented through a NORC published at 25 Pa.B. 2762 (July 8, 1995) effective July 1, 1995.
Thereafter, the act of May 16, 1996 (P. L. 175, No. 35) (Act 35) again amended the Public Welfare Code by further tightening GA eligibility criteria. These provisions were implemented through a NORC effective June 17, 1996 published at 26 Pa.B. 2865 (June 15, 1996). Act 35 also imposed a 12-month residency requirement on GA and a 90-day residency requirement on MA applicants and redefined categorical eligibility for the GA-related MNO Program. Based upon the advice of the Attorney General of Pennsylvania, the Department is not implementing the Act 35 12-month durational residency requirement for GA (62 P. S. § 432.4(a)), added by section 11 of Act 35, the 90-day durational residency requirement for MA (62 P. S. § 442.1(a)(1), added by section 15 of Act 35), and the prohibition against granting assistance to noncitizens (62 P. S. § 432.22), added by section 14.1 of Act 35), and will not be promulgating regulations to implement these provisions.
In addition to the State welfare reform acts, Federal welfare reform under Title I of the Federal Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub.L. No. 104-193) (PRWORA) was enacted on August 22, 1996. PRWORA eliminated the AFDC Program under Part A of Title IV of the Social Security Act, established the TANF Program (42 U.S.C.A. §§ 601--619) and mandated the implementation of the TANF requirements no later than July 1, 1997. Although the TANF Program replaces the AFDC Program, most of the rules and procedures under which the Department administered AFDC, including those for the Job Opportunities and Basic Skills (JOBS) Training Program, will continue in effect as part of the new TANF Program.
This rulemaking contains only the provision of PRWORA that changes the name of the Federal cash assistance program from AFDC to TANF. That change was implemented through a NORC published at 27 Pa.B. 1092 (March 1, 1997) effective March 3, 1997. The remaining provisions of PRWORA will be promulgated at a later date under a separate rulemaking package. All references to AFDC found within 55 Pa. Code, Handbooks, Bulletins or NORCs published in the Pennsylvania Bulletin are to be read and considered as applicable to TANF or to a TANF applicant or recipient, unless doing so would be inconsistent with the TANF State Plan published at 27 Pa.B. 342 (January 18, 1997) effective March 3, 1997, the TANF NORC or with this rulemaking.
In addition to the legislative mandates, this rulemaking contains a requirement beneficial to applicants and recipients which was implemented effective July 17, 1993 through the NORC published at 23 Pa.B. 3433 (July 17, 1993). Verification requirements for disability were revised to permit the acceptance of physical or mental disability determinations based on documentation provided by sources such as the Social Security Administration, the Department of Veterans Affairs or the Department's Medical Review Team (MRT), in addition to the Department's standard verification forms. This revision was not mandated by State or Federal legislation but is included in this rulemaking since it relates to the sections of the Pennsylvania Code amended by Acts 49 and 35.
In addition to the changes announced in the NORCs, the Department is amending § 181.14 that defines an allowable medical expense income deduction when determining eligibility for MNO-MA. A clarification through instructions to Departmental staff was issued on February 1, 1999, expanding allowable medical expense income deductions. By request of the Independent Regulatory Review Commission (IRRC), this regulation was amended to support the clarification that had been issued. Medical and remedial expenses paid by a public program on behalf of an individual are allowable deductions from income when determining eligibility for MNO-MA. The public program must be wholly financed by funds from the State or political subdivision. Political subdivision includes, but is not limited to, township, county or district. Medical expenses paid by a public program that receives Federal funds are not permissible deductions from income. This regulation is beneficial to applicants/recipients applying for, or receiving, MNO-MA.
Need for Rulemaking
The Department is required to comply with Federal and State statutes. This rulemaking is needed for consistency between Department regulations and legislative changes.
Summary of Amendments
This summary of new, revised or deleted requirements is organized according to the act which mandated the requirements and the eligibility group which is affected by them.
I. Act 49
A. The following are nonfinancial eligibility requirements that apply to GA (cash) applicants and recipients:
1. Section 141.21(r)--Subsection (r) is added to specify that three or more GA recipients residing together will not receive more cash assistance than a comparable AFDC (now TANF) household with the same number of members. (62 P. S. § 403(b))
2. Section 141.61(a)(1)(xii)--Subparagraph (xii) is revised to specify that a person refusing to apply for or cooperate in establishing eligibility for AFDC (now TANF) for himself or for a child in his care will not be eligible for GA. (62 P. S. § 432.8))
3. Section 141.61(a)(1)(xiv)--Subparagraph (xiv) is added to specify that an applicant who terminates a job without good cause is ineligible for GA until 30 days after the job termination. (62 P. S. § 403(f))
4. Section 141.61(d)(2)--Paragraph (2) is amended to specify that GA recipients are eligible, at a minimum, for MNO-MA benefits plus coverage for prescribed medications. There are GA cash recipients who are eligible to receive additional MA benefits. The Department receives Federal funding for the MA benefits received by these recipients. These recipients include children under age 21, pregnant women, migrants, refugees eligible for MA up to 8 months from date of entry into the United States, repatriated nationals and persons who have applied for or are referred to the Social Security Administration for Social Security or Supplemental Security Income disability benefits.
B. The following are nonfinancial eligibility requirements that apply to TANF and GA (cash) applicants and recipients:
1. Section 177.21(a)(11)--Paragraph (11) is added to specify that a savings account established in a bank or other financial institution and restricted for payment of educational expenses is not considered in determining eligibility. The moneys deposited and the interest earned are exempt as long as the account is designated for educational expenses. Funds withdrawn from the restricted account and used for purposes other than educational expenses will be added to the total resources of the budget group to determine eligibility in the month of withdrawal and subsequent months. (62 P. S. § 408(2))
2. Section 177.21(a)(12)--Paragraph (12) is added to specify that a savings account established under the Tuition Account Program and bonds purchased under the Tuition Account Program and College Savings Bond Act (24 P. S. §§ 6901.101--6901.509) are not considered in determining eligibility. (62 P. S. § 408(2))
Note: These exemptions were implemented in the TANF program effective March 3, 1997. When Act 49 was enacted in 1994, the TANF Block Grant Program was not yet in place. These exemptions could not be applied to AFDC, TANF's predecessor program, without a Federal waiver which the Commonwealth did not receive. The Department is including these TANF provisions in this pre-TANF regulation upon the recommendation of IRRC.
C. The following are nonfinancial eligibility requirements that apply to persons who qualify for GA (cash) or GA-related Nonmoney Payment (NMP) MA:
1. Section 141.61(d)(1)(ii)--The original provision of subparagraph (ii) is deleted and new language is added to specify that parents residing in a two-parent household with their child who is under 18 years of age are eligible for GA or GA-related NMP-MA. Eligibility under this criterion does not apply if the child qualifies for AFDC (now TANF). Both parents as well as the child must be included in the application for GA benefits. (62 P. S. § 432(3)(i)(B))
Note: The provisions of this subparagraph became effective September 1, 1994, but were superseded by a requirement of Act 35 that permits parents residing with their child to receive GA only if the child is under age 13 unless the child is disabled. (See III.D.1., the section relating to GA cash and GA-related MA Program requirements, § 141.61(d)(1)(ii).) The provision of Act 35 became effective June 17, 1996. The language in Annex A reflects current requirements.
2. Section 141.61(d)(1)(vi)--The original provision of subparagraph (vi) is deleted and new language is added to specify that a pregnant woman whose pregnancy is medically verified and who has been determined ineligible for AFDC (now TANF) is eligible for GA. (62 P. S. § 432(3)(i)(F))
3. Section 141.61(d)(1)(vii)--The original provision of subparagraph (vii) is deleted and new language is added to specify that victims of domestic violence are eligible for GA or GA-related NMP-MA. The individual must be receiving protective services as defined in this section. Eligibility for GA under this criterion is limited to 9 months over the recipient's lifetime. (62 P. S. § 432(3)(i)(G))
D. The following are requirements that apply to persons who are eligible for GA (cash) or GA-related NMP-MA under modified criteria:
1. Section 141.61(d)(1)(i)--Subparagraph (i) is revised to specify that a child who is under age 18 or is age 18-20 is eligible for GA if the child does not qualify for AFDC (now TANF) and is attending a secondary or equivalent vocational or technical school full-time and is expected to graduate or complete the program before reaching age 21. (62 P. S. § 432(3)(i)(A))
2. Section 141.61(d)(1)(iii)--Throughout subparagraph (iii) the term ''handicap'' is replaced by the term ''disability'' as used in Act 49. The term ''disability'' is also used throughout the Federal Americans with Disabilities Act.
3. Section 141.61(d)(1)(iii)(B)(II)--Subclause (II) is added to specify that a person whose disability is established by the Social Security Administration or a person with a 50% or more disability as established by the Department of Veteran's Affairs (DVA) is eligible for GA or GA-related NMP-MA.
4. Section 141.61(d)(1)(iii)(D)--Clause (D) is added to clarify that a person who has been assessed by a physician or psychologist as having a verified disability that temporarily or permanently precludes any gainful employment is eligible for GA or GA-related NMP-MA. Eligibility for GA under this criterion is not contingent upon participation in a drug or alcohol treatment program as long as the person remains disabled after the substance abuse is successfully treated. (62 P. S. § 432(3)(i)(C))
5. Section 141.61(d)(1)(iii)(E)--Clause (E) is added to clarify that persons who have a verified disability solely related to substance abuse that prevents any employment are eligible for GA or GA-related NMP-MA. Eligibility is contingent upon accepting and participating in an available treatment program. (71 P. S. § 1690.109(d))
6. Section 141.61(d)(1)(iv)--Subparagraph (iv) was revised under Act 49 to specify that nonparental caretakers of children under age 18 may be eligible for GA or GA-related NMP-MA. Act 49 added a provision that the child or disabled person for whom care is provided must reside in the home with the caretaker. (62 P. S. § 432(3)(i)(D))
Note: The provisions of this subparagraph became effective September 1, 1994, but were superseded by a requirement of Act 35 that permits nonparental caretakers of a child to receive GA only if the child is under age 13 and there is no other person in the home capable of providing the care without the need for GA. (See III.D.4., the section relating to GA cash and GA-related MA program requirements, §§ 141.61(d)(1)(iv) and 141.71.) The Act 35 provision became effective June 17, 1996. The language in Annex A incorporates all of these changes.
7. Section 141.61(d)(1)(v)--Subparagraph (v) was revised under Act 49 to clarify that a person receiving active treatment for substance abuse in a program administered by an agency of the Federal government is eligible for GA or GA-related NMP-MA. Eligibility under this criterion continues to be limited to 9 months in a person's lifetime. (62 P. S. § 432(3)(i)(E))
Note: The provisions of this subparagraph became effective September 1, 1994, but were superseded by a requirement of Act 35 that permits a person undergoing active treatment in an approved drug or alcohol treatment facility to receive GA only if the treatment precludes any form of employment. (See III.D.5., the section relating to GA cash and GA-related MA program requirements, §§ 141.61(d)(1)(v) and 141.71.) The Act 35 provision became effective June 17, 1996. The language in Annex A reflects current requirements.
8. Section 141.61(d)--Under Act 49, the period of eligibility for TN assistance was reduced to 60 days in a 24-month period. (62 P. S. § 432(3)(iii))
Note: The provisions of this paragraph which became effective July 1, 1994, were subsequently superseded by a requirement of Act 20 that eliminated the TN component of the GA Program and deleted references to TN and CN within the Public Welfare Code. (See II., the section labeled Act 20.) The Act 20 provision became effective July 1, 1995.
9. Sections 145.63(c)(1), (3)(ii) and 145.64(b)(1)--These sections are revised to specify that the age limit for a student attending secondary school is changed from under age 19 to under age 21. (62 P. S. § 432(3)(i)(A))
10. Section 166.23(c)(2)--Paragraph (2) is revised to delete the prohibition against assigning an individual 45 years of age or older to a Community Work Experience Program project.
E. The following nonfinancial requirements no longer apply as a basis for eligibility and these provisions are being deleted:
1. A person 45 years of age or older is no longer eligible for GA or GA-related NMP-MA on the basis of age. This language is deleted from § 141.61(d)(1)(ii).
2. A person who is employed 30 or more hours per week whose earned income after deductions is below the monthly assistance grant level is no longer eligible for GA. This language is deleted from § 141.61(d)(1)(vi).
3. A person who is ineligible for Unemployment Compensation (UC) and whose income falls below the assistance grant level as the result of a natural disaster is no longer eligible for GA under this criterion. This language is deleted from § 141.61(d)(1)(vii).
4. A person who maintained full-time employment defined as at least 30 hours per week for a verified minimum of 48 months out of the 8 years prior to application and has exhausted his UC benefits is no longer eligible for GA. Section 141.61(d)(1)(viii) is therefore deleted.
5. Recipients who did not meet CN criteria were permitted to receive CN assistance from April 8, 1982, through December 31, 1982. Since this provision became obsolete effective January 1, 1983, § 141.61(d)(1)(ix) is deleted.
F. For GA-related MA, the following provisions are changed:
1. Section 141.71(c)(2) is revised to clarify the level of MA benefits associated with the receipt of GA cash assistance. Children under age 21, pregnant women, migrants, refugees eligible for MA up to 8 months from date of entry into the United States, repatriated nationals and persons who have applied for or are referred to the Social Security Administration for Social Security or Supplement Security Income disability benefits qualify for additional MA benefits under Federally-funded MA, if otherwise eligible.
2. Section 141.81(c)(3)(v)(A) is revised to clarify the categories of MA that qualify for Federally-funded MA and specify persons who may be eligible for MNO-MA under the TD category.
3. Section 178.11(4)(i) and (6) is revised to clarify the category of MA eligibility for children and GA eligibles who do not receive cash assistance.
4. Sections 178.11(7), 178.12(7), 181.41(4)(i), 181.41(7) and 181.42(8) are revised to reflect the change in eligibility conditions, the age limits and type of MA coverage provided under Act 49.
Note: The provisions of §§ 178.11(7), 178.12(7), 181.41(7) and 181.42(8) which became effective September 1, 1994, were superseded by changes to these provisions in Act 20 which was effective July 1, 1995. (See II., the section labeled Act 20. The language in Annex A reflects current requirements.
G. For GA-related MA, the following eligibility criterion is added:
* Section 178.165--An education savings account established in a financial institution and specifically designated for payment of educational expenses is disregarded in determining eligibility. A savings account established under the Tuition Account Program and bonds purchased under the Tuition Account Program and College Savings Bond Act are also disregarded in determining eligibility.
II. Act 20
A. The following sections are revised to reflect the elimination of the GA-TN component, the elimination of references to the CN component and elimination of references to the now obsolete GA-TN-related MA categories:
1. Sections 133.23(a)(2)(ii)(L), 141.61(a)(1), (d), (d)(1), (d)(1)(ii), (d)(1)(v) and 141.71(c)(2)--References to TN and CN are deleted.
2. Sections 141.61(d)(1)(iii)(C)(I) and (II)--Subclauses (I) and (II) are deleted because the TN program is eliminated and there is no longer a distinction between CN and TN recipients. Persons now eligible for GA on the basis of disability are not referred to the Employment and Training Program.
3. Section 141.61(d)(2)--This paragraph is deleted because the TN program is eliminated.
4. Section 141.61(d)(3)--Paragraph (3) is deleted because parents and children who qualify for GA are no longer designated TN and CN recipients.
5. Section 178.11(7)--Paragraph (7) is deleted because it described a person eligible for the TN component of GA which is eliminated.
6. Section 178.12(7)--Paragraph (7) is rescinded and the section has been renumbered because it described a person eligible for the TN component of GA which is eliminated.
7. Section 181.1(d)(1) and (2)--References to the PK and TK (TN-related) categories are deleted because the TN component of GA is eliminated.
8. Section 181.2--The definitions of PK and TK categories are deleted because the TN component is eliminated.
9. Section 181.41(6)--The reference to PK category is deleted because the TN component of GA is eliminated.
10. Sections 181.41(7) and 181.42(8)--These paragraphs are deleted because they described persons eligible for the TN component of GA which is eliminated.
III. Act 35
A. The following requirements, enacted under Act 35 and permitted by PRWORA, apply to the TANF Program, and GA cash and related NMP-MA programs:
1. Sections 125.21(b)(1), 125.24(c)(1) and (7)(v), 181.11(a) and 183.104a(a)(3)--The provisions of these sections are revised to specify that initial authorization of assistance will occur when all factors of eligibility are verified unless verification is pending from a third party and the client has cooperated in the verification attempt or unless certification of cooperation is pending with the domestic relations section of the Court of Common Pleas. Initial authorization of cash assistance will not be delayed more than 30 days after application. If the applicant establishes eligibility, assistance will be authorized effective with the date that all conditions of eligibility are verified. (62 P. S. § 432.19)
Note: The NORC published at 26 Pa.B. 2865 (June 15, 1996) incorrectly identified § 125.74 as a section that would incorporate the previous requirement specified. It has been incorporated into § 181.11.
2. Sections 177.2 and 183.2--These sections are revised to amend the definition of budget group to read ''one or more related or unrelated individuals who occupy a common residence or would occupy a common residence if they were not homeless and whose needs and eligibility are considered together in determining eligibility for cash assistance under one category of assistance.'' This revised definition essentially copies the statutory definition of assistance group which was added to section 402 of the Public Welfare Code under Act 35. (62 P. S. § 402)
B. The following requirements apply to the TANF and GA cash assistance programs:
* Section 141.21(s) and (t)--Subsections (s) and (t) are added to specify that an applicant or recipient of AFDC (now TANF) or GA who has been convicted of violating section 481(a) of the Public Welfare Code (62 P. S. § 481(a)), that is, has been convicted of securing or attempting to secure, or aiding or abetting or attempting to aid or abet any person in securing cash assistance, MA or Federal food stamps by means of a willfully false statement or misrepresentation, or by impersonation or by willfully failing to disclose a material fact regarding eligibility either prior to, or at the time of, or subsequent to the application for assistance, a crime commonly referred to as welfare fraud, is ineligible for cash assistance for 6 months from the date of a first conviction, for 12 months from the date of a second conviction, and permanently from the date of a third conviction. (62 P. S. § 481(f))
C. The following requirement applies to the GA cash assistance program:
* Section 175.23(d)--Subsection (d) is added to specify that cash assistance granted shall be reduced by amounts obtained by cashing an assistance check at a gambling casino, racetrack, bingo hall or other establishment that derives more than 50% of its gross revenues from gambling. (62 P. S. § 434)
Note: The NORC published at 26 Pa.B. 2865 (June 15, 1996) provided an incorrect citation (§ 175.24(f)) for this requirement. The citation is correct as specified previously.
D. The following requirements apply to the GA cash and the GA-related MA programs:
1. Section 141.61(d)(1)(ii)--Subparagraph (ii) is revised to specify that persons eligible for GA and GA-related NMP-MA include persons who are parents residing in a two-parent household with their child who is under 13 years of age or their child under age 21 who has a verified disability. The requirement supersedes the provision of Act 49 which permitted two parents residing in a household with their child who was under age 18 to receive GA. (62 P. S. § 432(3)(i)(B))
2. Section 141.61(d)(1)(iii)--Subparagraph (iii) is revised to specify that a person who has been assessed by a physician or psychologist as having a verified physical or mental disability which causes a permanent or temporary disability that precludes gainful employment shall provide verification of the disability in a form prescribed by the Department and completed by a physician or psychologist. The verification of the physical or mental disability shall be based on acceptable clinical and laboratory diagnostic techniques rather than a statement of symptoms by the applicant or recipient. (62 P. S. § 432(3)(i)(C))
3. Section 141.61(d)(1)(iii)(F)--Clause (F) is added to specify that an applicant or recipient who has a verified mental or physical disability which is temporary must seek and comply with appropriate treatment as a condition of eligibility. (62 P. S. § 432(3)(i)(C))
4. Sections 141.61(d)(1)(iv) and 141.71--These sections are revised to specify that persons eligible for GA and GA-related NMP-MA include the nonparental caretaker of a child under 13 years of age. Assistance will not be granted to a person under this criterion if there is another adult in the household who is capable of providing the care without GA being required. This requirement supersedes the provision of Act 49 which allowed nonparental caretakers of children under age 18 to receive GA. (62 P. S. § 432(3)(i)(D))
5. Sections 141.61(d)(1)(v) and 141.71--These sections are revised to specify that a person undergoing active treatment for substance abuse in an approved drug or alcohol treatment program qualifies for GA or GA-related NMP-MA only if the treatment precludes the person from engaging in employment. The 9-month lifetime limitation remains unchanged. This requirement supersedes the provision of Act 49 which allowed a person undergoing active treatment for substance abuse to receive GA regardless of whether the treatment precluded the person from engaging in gainful employment. (62 P. S. § 432(3)(i)(E))
E. The following requirements apply to the MA program:
1. Section 141.81(a)(1)--Paragraph (1) is revised to specify that a person applying for MNO-MA shall meet the standards of both financial and nonfinancial eligibility. Additional revisions are made as editorial corrections and do not reflect a change in the policy. (62 P. S. § 442.1(a)(2)).
Note: The NORC published at 26 Pa.B. 2865 (June 15, 1996) provided an incorrect citation (§ 125.74) for this requirement. The citation is correct as previously specified.
2. Section 141.81(c)(3)(ii)(C)--Clause (c) is revised to add a pregnant woman as a person who may be eligible for MNO-MA under the TC category. (62 P. S. § 442.1(a)(3)(ii)(E))
3. Section 141.81(c)(3)(iv)--Subparagraph (iv) is revised to specify that a person with a disability who is receiving Social Security disability benefits, who has been referred to the Social Security Administration for a determination of eligibility for Supplemental Security Income disability benefits or who is under review for disability by the Department based upon Social Security disability criteria, may be eligible for MNO-MA under the TJ category. (62 P. S. § 442.1(a)(3)(ii)(F))
4. Section 141.81(c)(3)(v)--Subparagraph (v) is revised to specify that a person who is a custodial parent of a dependent child under age 21, a person age 59 or older, or a person who is employed 100 hours per month earning at least the minimum wage, may be eligible for MNO-MA under the TD category. (62 P. S. § 442.1(a)(3)(ii)(B), (C) and (G))
5. Sections 181.1(b) and 181.12--This section and subsection are revised to specify that in determining eligibility for retroactive MNO-MA, income received or expected to be received in a 6-month period is used, even if the person requests MA coverage for less than 6 months. The 6-month period can include both retroactive and prospective months. Medical coverage can continue as long as the need exists, but no longer than the consecutive 6-month period from which income is counted. (62 P. S. § 442.1(c))
IV. PRWORA
1. Section 101.1 is revised to incorporate references to the Federal TANF program that replaced the AFDC program and to include a statement that most of the rules that were in effect under the AFDC program remain in effect under TANF.
V. Federal Legislation--42 U.S.C.A. § 1396a(a)(17)(D)
1. Section 181.12(c)(2) is revised to amend the cross reference to include the addition of medical and remedial expenses paid by a public program as allowable medical expense income deductions when determining eligibility for retroactive MNO-MA.
2. Sections 181.14(d)(3), (e)(6) and (7)--These paragraphs are revised to expand allowable medical expense income deductions when needed for a determination of eligibility for MNO-MA. Individuals may qualify for MNO-MA without the deduction of medical expenses if total net countable income does not exceed the MNO-MA income limit. If the net income exceeds the limit, allowable medical expenses may be used as deductions to spend down the income that exceeds the limit. Allowable medical expenses include expenses incurred by an applicant who is liable to pay the expense. Medical expenses paid by a third party are not deductible from an individual's income. However, section 1902(a)(17) of the Social Security Act (42 U.S.C.A. § 1396a(a)(17)), as clarified by HCFA, permits states to expand the definition of allowable medical expense income deductions. Therefore, these revisions allow medical and remedial expenses paid by a public program funded by a state or political subdivision on behalf of an individual as allowable medical expense income deductions. The public program may not be financed in whole or in part by Federal funds. This is the sole exception to the requirement that medical expenses paid by a third party are not permissible deductions from income.
Affected Individuals and Organizations
This rulemaking affects applicants and recipients of TANF, GA and MA. Providers of medical and psychological services are also affected due to the reduction or termination of compensable services under certain GA-related MA programs as well as the more stringent verification requirements imposed on persons who state that they are either temporarily or permanently disabled.
Accomplishments/Benefits
Implementation of the regulations by various NORCs has had the effect of bringing regulations into compliance with State law, reducing State costs, streamlining the GA program and ensuring that needy individuals of this Commonwealth are assisted in their efforts to become self-sufficient in accordance with legislation enacted by the General Assembly.
Fiscal Impact
Commonwealth:
The savings for the current year include $111.178 million for Act 49; $28.136 million for Act 20; and $214.679 million for Act 35. These estimates reflect prior year budget projections. This is due to an inability to separately identify the effect of changes which have been implemented in prior years.
Public Sector:
There will be no costs or savings incurred by the public sector.
Private Sector:
There will be no costs or savings incurred by the private sector.
Paperwork Requirements
Revisions to the GA disability requirements under Act 35 precipitated the development of the following forms:
* PA 1663--Employability Assessment Form
* PA 1664--Employability Reassessment Form
* PA 1671--Health Sustaining Medication Assessment Form
* PA 1672--Drug and Alcohol Treatment Information Form
Effective Date
The effective date of the provisions found in §§ 141.21, 141.61, 141.71, 141.81, 145.63, 145.64, 166.23, 177.21, 178.11, 178.12, 178.165, 181.41 and 181.42, as amended by Act 49, when published as final-form rulemaking in the Pennsylvania Bulletin are retroactive to September 1, 1994. The effective date of the savings for education exemption found in § 177.21, applicable to the TANF program, is retroactive to March 3, 1997.
The effective date of the regulations found in §§ 133.23, 141.61, 141.71, 178.11, 178.12, 181.1, 181.2, 181.41 and 181.42, as amended by Act 20, is retroactive to July 1, 1995.
The effective date of the regulations found in §§ 125.21, 125.24, 141.21, 141.61, 141.71, 141.81, 175.23, 177.2, 181.1, 181.11, 181.12 and 183.2 and the Statement of Policy found in § 183.104a, as amended by Act 35, is retroactive to June 17, 1996.
The effective date of the regulation found in § 101.1, as amended by PRWORA, is retroactive to March 3, 1997.
The effective date of the disability verification provision under § 141.61(d)(iii)(B)(II) is retroactive to July 17, 1993; and the expansion of allowable medical expense income deductions found in §§ 181.12 and 181.14 is retroactive to February 1, 1999.
Sunset Date
There is no sunset date. The Department conducts periodic reviews of the GA Program in accordance with section 403(e) of the Public Welfare Code. TANF and MA regulations are also reviewed through the Department's Quality Control and Corrective Action review process.
Public Comments
Although these amendments are being adopted without prior notice, interested persons are invited to submit their written comments within 30 days from the date of this publication for consideration by the Department as to whether the regulations should be revised. Comments should be sent to the Department of Public Welfare, Edward Zogby, Director, Bureau of Policy, Room 431, Health and Welfare Building, Harrisburg, PA 17120, (717) 787-4081.
Persons with a disability may use the AT&T Relay Service by calling (800) 654-5984 (TDD users) or (800) 654-5988 (Voice users).
Regulatory Review Act
Under section 5.1(c) of the Regulatory Review Act (71 P. S. § 745.5a(c)), on May 17, 2000, the Department submitted a copy of these final-omitted regulations to the Chairpersons of the House Committee on Health and Human Services and the Senate Committee on Public Health and Welfare. On the same date, the final-omitted regulations were submitted to the Office of the Attorney General for review and approval under the Commonwealth Attorneys Act (71 P. S. §§ 732-101--732-506).
In accordance with section 5.1(d) of the Regulatory Review Act, these final-form regulations were deemed approved by the Committees on July 3, 2000. These final-form regulations were approved by IRRC on July 13, 2000.
Findings
The Department finds that:
(1) Public notice of intention to adopt the administrative regulations by this order is omitted because the regulations relate to Commonwealth grants and benefits and is unnecessary and contrary to public interest under section 204(1)(iv) and (3) of CDL and the regulations thereunder, 1 Pa. Code §§ 7.4(1)(iv) and (3).
(2) The adoption of these amendments in the manner provided in this order is necessary and appropriate for the administration and enforcement of the Public Welfare Code.
Order
The Department, acting under the Public Welfare Code, orders:
(a) The regulations of the Department, 55 Pa. Code Chapters 101, 125, 133, 141, 145, 166, 175, 177, 178, 181 and 183, are amended by amending §§ 101.1, 101.2, 125.21, 125.24, 133.23, 141.21, 141.61, 141.71, 141.81, 145.63, 145.64, 166.23, 175.23, 177.2, 177.21, 178.11, 178.12, 181.1, 181.2, 181.11, 181.12, 181.14, 181.41, 181.42, 183.2 and 183.104a and by adding § 178.165 to read as set forth in Annex A with ellipses referring to the existing text of the regulations.
(b) The Secretary of the Department shall submit this order and Annex A to the Office of the Attorney General and the Office of General Counsel for approval as to legality and form as required by law.
(c) The Secretary of the Department shall certify this order and Annex A and deposit them with the Legislative Reference Bureau as required by law.
(d) This Order shall take effect upon publication in the Pennsylvania Bulletin as follows: The effective date of the regulations found in §§ 141.21, 141.61, 141.71, 141.81, 145.63, 145.64, 166.23, 177.21, 178.11, 178.12, 178.165, 181.41 and 181.42, as amended by Act 49, when published as final rulemaking in the Pennsylvania Bulletin are retroactive to September 1, 1994. The effective date of the savings for education exemption found in § 177.21, applicable to the TANF program, is retroactive to March 3, 1997. The effective date of the regulations found in §§ 133.23, 141.61, 141.71, 178.11, 178.12, 181.1, 181.2, 181.41 and 181.42, as amended by Act 20, is retroactive to July 1, 1995. The effective date of the regulations found in §§ 125.21, 125.24, 141.21, 141.61, 141.71, 141.81, 175.23, 177.2, 181.1, 181.11, 181.12 and 183.2 and the Statement of Policy found in § 183.104a, as amended by Act 35, is retroactive to June 17, 1996. The effective date of the regulation found in § 101.1, as amended by PRWORA, is retroactive to March 3, 1997. The effective date of the disability verification provision under § 141.61(d)(iii)(B)(II) is retroactive to July 17, 1993; and the expansion of allowable medical expense income deductions found in §§ 181.12 and 181.14 is retroactive to February 1, 1999.
(Editor's Note: For the text of the order of the Independent Regulatory Review Commission, relating to this document, see 30 Pa.B. 3872 (July 29, 2000).)
Fiscal Note: 14-467. No fiscal impact; (8) recommends adoption.
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