55 Pa. Code § 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.
Notes
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