Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 5598 (August 31, 2024).

55 Pa. Code § 187.81. Policy.

SUPPORT PROVISIONS FOR MA
FOR THE MEDICALLY NEEDY


§ 187.81. Policy.

 Support from LRR’s. Policy regarding support from the LRR’s will be as follows:

   (1)  Legally responsible relatives will be limited to the spouse of the applicant and the natural or adoptive parent or parents of an unemancipated minor child. However, there will be no relative responsibility by the relatives of the following children for MA purposes:

     (i)   Adoptive or natural parents of a child, regardless of age, adopted under the provisions of the act of June 13, 1967 (P. L. 31, No. 21) (62 P. S. § §  771—774) known as the Adoption Opportunities Act. The adoptive parents of children adopted under the provisions of the Adoption Opportunities Act will be issued a ‘‘Certificate of Subsidized Adoption’’ card, CY 931, by the Child Welfare Office, which will be sufficient proof of adoption under the terms of this act.

     (ii)   Parents of a child, 18 to 21 years of age, when the child received MA services in a MH/MR facility.

     (iii)   Parents of a child, regardless of age, or a spouse when the child or spouse is receiving SSI payments. The parent or spouse will be liable in determining MA eligibility and payment until the child or spouse received SSI benefits, at which time, the child or spouse will be categorically needy on the basis of SSI eligibility and there will be no further relative liability for MA purposes.

   (2)  A finding of financial ability to contribute to the applicant group will be made for each such relative except that a relative over 60 years of age will be excluded.

   (3)  Parent will include the father of a child born out of wedlock only if paternity has been legally established.

   (4)  The court alone will have the authority to decide that a spouse or parent must provide support and to what extent. If there is an existing court order, or, where appropriate, the Revenue Agent has determined the amount to be paid, no further determination will be needed. The amount of the order that is being paid will be considered as the income of the person.

   (5)  For cases where there is no existing order, or where an established court order is not being met, the Department has developed regulations for determining the amount a spouse or parent might be expected to contribute towards meeting the cost of the MA care received.

   (6)  The findings of the Department on the financial ability of a spouse or parent will be exclusively for the purpose of determining the amount of the monthly income in excess of the amount the Department believes is reasonable for the support of himself and others dependent on him.

   (7)  If the applicant is otherwise eligible and if an immediate finding cannot be made of the financial ability of a legally responsible relative to help meet the medical care costs of his spouse or unemancipated minor children, the client will be eligible for medical assistance for a temporary period, not to exceed such time as a decision can be reached as to the availability of funds from the legally responsible relative.

   (8)  A determination of ability to support will be made at each redetermination. If it is necessary to determine the LRR’s ability to pay before 6 months have passed since the last application of redetermination, the amount the LRR has already paid or has obligated himself to pay since the contribution was last determined will be deducted from the amount arrived at in §  187.84 (relating to procedures) to determine the amount by which the LRR continues to be a resource. If the case was referred to the Claim Settlement Area Office for court action, before the County Office makes a new determination of ability to support and the amount of support expected, it will request the Area Office to report the amount collected and any other pertinent information.

   (9)  The liability of a parent for children receiving MA services in a mental health or mental retardation facility will be limited to children under 18 years of age.

Source

   The provisions of this §  187.81 adopted August 4, 1977, effective August 5, 1977, 7 Pa.B. 2180.



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