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 4310.7 - Determining client monthly liability
Universal Citation: 55 PA Code ยง 4310.7
Current through Register Vol. 54, No. 44, November 2, 2024
The extent of a client's liability for costs of services provided over and above that paid by third-party payors, other agencies, or LLR's is determined as follows:
(1) During the first six months of care, clients have their liability determined in the following manner:
(i) The client's
liability is all income less $60 per month personal use monies, except when the
client is maintaining a home to which he plans to return on discharge from the
facility. A liability exemption to maintain a home is allowable six months from
the date service began.
(A) The home could be
owned by the client or rented from a landlord. If rented, the client must
continue to pay the rent, utilities, and other expenses associated with
maintaining a property or rental property. The roomer or roomer/boarder
situation would also be included if the client continues to pay the landlord to
hold the room during the period of hospitalization, not to exceed 6
months.
(B) If the home maintenance
exemption is applied, the client's liability is all income less the home
maintenance exemption and $60 a month personal use monies.
(ii) If the client is responsible for paying
insurance premiums obtained prior to institutionalization, the amount of these
premiums are exempted. Liability would be all income less the insurance
premiums and $60 per month personal use monies.
(iii) If the client is receiving a veteran's
benefit for which an institutional award request has been acted upon by the
Veteran's Administration, the amount exempted for personal use is that portion
specified by the Veteran's Administration.
(2) Following the first 6 months of care, all income is considered available to meet the cost of care except:
(i) $60 monthly income for personal care
items.
(ii) Veteran's benefits for
which an institutional award request has been acted upon by the Veteran's
Administration. The amount exempted is that portion of the benefit the
Veteran's Administration specifies is to be reserved for the beneficiary's
personal use.
(iii) Health
insurance or life insurance premiums, or both, obtained prior to
hospitalization.
(iv) The patient's
resident property, household furnishings, clothing, personal effects.
(v) $1,500 combined value of other real or
personal property or both. "Other" includes accumulated reserves in
institutional representative payee/guardian or client accounts or both that are
not legally restricted for the patient's personal future needs. If these limits
are exceeded, any amount over the limit is available to meet the costs of
service.
Disclaimer: These regulations may not be the most recent version. Pennsylvania may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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