Section 141.61. Policy

(a) Conditions of eligibility. The following relates to eligibility for GA:

(1) An individual is eligible for GA under the requirements established in subsection (d) and if the appropriate eligibility conditions in the following chapters are met:

(i) Chapter 145 (relating to age).

(ii) Chapter 147 (relating to residence).

(iii) Chapter 149 (relating to citizenship and alienage).

(iv) Chapter 161 (relating to persons in institutions).

(v) Chapter 163 (relating to guardians and trustees).

(vi) Chapter 165 (relating to road to economic self-sufficiency through employment and training (RESET) program).

(vii) Chapter 177 (relating to resources).

(viii) Chapters 125 and 127 (relating to application process; and reserved).

(ix) Chapter 255 (relating to restitution).

(x) Chapter 257 (relating to reimbursement).

(xi) Furthermore, eligibility for GA requires that the person is not receiving SBP or SSI. However, a person receiving SSI, but who is receiving less than the maximum SSI payment may receive assistance to supplement his SSI. Refer to § § 297.1(e)(4) and 297.3(n) (relating to policy; and requirements).

(xii) Furthermore, eligibility for GA requires that the person be ineligible for TANF and Extended TANF because of failure to meet TANF and Extended TANF definitive conditions. An applicant or recipient who does not qualify for TANF or Extended TANF solely because of a refusal or failure, without good cause, to establish eligibility for TANF or Extended TANF is ineligible for GA. A person meeting definitive conditions but ineligible for TANF because of income, resources or participation in a strike is not eligible for GA. A person who refuses without good cause to cooperate in establishing paternity or support as required in the TANF or Extended TANF program is ineligible for GA. A family in which an adult refuses or fails, without good cause, to cooperate in establishing and maintaining eligibility for Extended TANF as provided in § § 141.53—141.56 is also ineligible for GA.

(xiii) Furthermore, a full-time student at a college or university is not eligible as a categorically needy person for General Assistance—cash grant (GA) or Medical Assistance (PD)—unless he has participated in a Federally subsidized program for dependent children—TANF—within the previous 5 years.

(xiv) A GA cash assistance applicant is ineligible for 30 days after the termination of employment if the applicant voluntarily terminates the employment without good cause. Good cause includes the circumstances beyond a person’s control specified § 165.52(a) (relating to good cause).

(2) Before authorizing GA to a family with dependent children, a thorough determination shall be made as to whether the family meets the definitive conditions for TANF or Emergency Assistance (EA—Family Cash Assistance). For GA cases with dependent children, the case narrative shall substantiate that the TANF and EA categories were considered and include the reason the case was not eligible for one of these three categories.

(3) Otherwise eligible families with children under the age of 21 who do not qualify for TANF shall be authorized EA—Family Cash Assistance because an emergency situation has caused the family’s need for financial help. The family shall qualify for EA—Family Cash Assistance for up to 30-consecutive days within a 12-month period. To authorize EA—Family Cash Assistance, procedures in § 289.4(b) (relating to procedures) for applicant/recipient families with children under 21 who do not qualify for TANF shall be applied. EA—Family Cash Assistance shall never be granted concurrently with GA.

(4) Only the Executive Director, or District Supervisor in districted counties, shall approve GA authorizations of cases with dependent children under § 227.24(j)(5)(viii) (relating to procedures).

(b) Social Security number required. A Social Security number is required for each family member for whom assistance is to be granted or is being received. If a Social Security number is needed and no application has been made, it is the responsibility of the CAO to complete and submit the SSA-5 application form.

(c) Determining GA categorical eligibility. An applicant for, or recipient of, GA is determined to be eligible in accordance with the following:

(1) A person is eligible to receive GA for an indeterminate period due to medical, social or related circumstances. Persons who may qualify for GA are limited to the following:

(i) A child who is under age 18; or who is 18 through 20 years of age and is attending a secondary or equivalent vocational or technical school full-time and may reasonably be expected to complete the program before reaching 21 years of age. Age, school enrollment and attendance shall be verified.

(ii) Parents residing in a two-parent household with their child who is under 13 years of age or their child who is under 21 years of age and who has a disability. The age, residence and disability (if applicable) of the child shall be verified. Both parents as well as the child shall be included in the application. If the family is ineligible under this provision, either parent or child may qualify under another criterion.

(iii) A person who has been assessed by a physician or psychologist as having a temporary or permanent disability which precludes him from working in any gainful employment. The following conditions apply:

(A) Documentation which demonstrates the relationship between the disability and the inability to work shall be provided by the client during the application interview for cash assistance or, in the case of recipients, within 30-calendar days after the date of the redetermination.

(B) With the exception of documentation under subclause (II), documentation shall be on a form provided by the Department and completed by a physician or a psychologist.

(I) The CAO’s medical consultant may be used in those cases that the IMU worker is unable to establish the inability to work based on the disability.

(II) The verification may also be provided by sources including, but not limited to, the SSA indicating approval for disability benefits or on a disability determination of 50% or greater made by the Department of Veterans Affairs (DVA). A medical certification of disability provided by the Department’s Medical Review Team (MRT) is also acceptable documentation of illness or disability. Documentation from sources other than the SSA, DVA or MRT is also acceptable if it clearly states the relationship between the disability and the person’s employability. In addition, this documentation shall be less than 6 months old at the time of application or redetermination unless the condition to which it refers is permanent or chronic. The verification of 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.

(C) An applicant or recipient who claims a physical or mental disability which temporarily or permanently precludes the applicant or recipient from any gainful employment but who does not have the documentation at the application or within 30 days of the redetermination interview shall be determined ineligible for GA until the documentation is presented to the CAO. The CAO shall determine eligibility for the MNO Program to cover the cost of the employability assessment only for persons who allege eligibility based on a physical or mental disability. Reasonable accommodations to assist a person to secure documentation during this period shall be provided to a person who is prevented from cooperating due to a physical or mental disability.

(D) A person who has a serious physical or mental disability which prevents employment and which is documented in accordance with this subparagraph may be authorized as GA even if the person is undergoing active treatment or has undergone treatment for substance abuse in a drug or alcohol treatment program. Eligibility for GA on the basis of having a serious physical or mental disability 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.

(E) A person who has a disability solely related to substance abuse that prevents employment and which has been documented in accordance with this subparagraph may be authorized as GA. Eligibility for GA on this basis is contingent upon accepting and participating in available drug or alcohol treatment services.

(F) An applicant or recipient who has a verified physical or mental disability which is temporary shall seek appropriate treatment as a condition of eligibility.

(iv) A nonparental caretaker of a child under 13 years of age or a caretaker of an individual who is ill or disabled. The caretaker shall reside with the individual for whom he provides care and his presence must be required. A caretaker’s presence in the home will not be considered as required if there is another person in the home who is able to provide the care without the need for GA. The caretaker shall provide documentation of the age of the child or the illness or disability of the individual needing care.

(v) A person who is undergoing active treatment for substance abuse in a drug or alcohol treatment program licensed or approved by the Department of Health or administered by an agency of the Federal government as long as the treatment precludes the person from engaging in any form of employment. Eligibility under this criterion is limited to a maximum of 9 months in the lifetime of the person regardless of whether or not treatment is continuing upon expiration of the 9-month time limit.

(vi) A pregnant woman whose pregnancy has been medically verified and who is ineligible for TANF.

(vii) A person who is a victim of domestic violence or another abusive living situation and is receiving protective services. It is not necessary that the service be continuous or rendered on a daily, weekly or monthly basis. Eligibility under this criterion is limited to a maximum of 9 months in the lifetime of the person, regardless of whether or not protective services are continuing upon expiration of the 9-month time limit. The person shall verify that the person is receiving one of the following protective services, or is involved in one of the following activities:

(A) Residing in an emergency shelter or emergency housing for abused persons.

(B) Receiving supportive counseling from a professional counseling source.

(C) Receiving social services to prevent further potential abuse.

(D) Receiving social services necessary to enable the person to remain in his own home.

(E) Filing of assault or battery or other charges with a law enforcement agency related to seeking protection from the abuser.

(F) Obtaining a restraining order or peace bond against the abuser.

(G) Receiving services from any branch of government (including the courts or the police) or agency meant to counsel or protect the individual from abuse. Information provided by or on behalf of a victim of abuse is confidential and subject to Chapter 105 (relating to safeguarding information).

(2) GA recipients are eligible for the MNO level of benefits. In addition, these persons receive coverage for prescribed medications. GA recipients eligible for Federally-funded MA receive additional benefits under the MA Program. Children under age 21, pregnant women, migrants, refugees eligible for MA up to 8 months from date of entry into the United States, as specified in 45 CFR 400.90 (relating to basis and scope), repatriated nationals and persons who have applied for or been referred to the SSA for Social Security or SSI disability benefits qualify for Federally-funded MA.

The provisions of this § 141.61 adopted August 4, 1977, effective August 5, 1977, 7 Pa.B. 2180; amended January 13, 1978, effective January 1, 1978, 8 Pa.B. 141; amended July 28, 1978, effective July 1, 1978, 8 Pa.B. 2105; amended December 29, 1978, effective August 24, 1978, 8 Pa.B. 3815; March 7, 1980, effective March 8, 1980, 10 Pa.B. 983; corrected March 23, 1980, effective March 8, 1980, 10 Pa.B. 1304; implemented July 11, 1980, effective May 15, 1980 for new applicants and effective June 1, 1980 for currently active applicants, 10 Pa.B. 2980 and 3102; amended November 21, 1980, effective May 15, 1980, 10 Pa.B. 4426; amended June 25, 1982, effective June 26, 1982, 12 Pa.B. 1940; amended August 26, 1988, effective November 1, 1988, 18 Pa.B. 3893; amended August 26, 1988, effective November 1, 1988, 18 Pa.B. 3921; amended October 2, 1992, effective upon publication and apply retroactively to October 1, 1989, 22 Pa.B. 4875; amended July 28, 2000, the disability verification provision under subsection (d)(iii)(B)(II) effective retroactive to July 17, 1993, the provisions under Act 49 effective retroactive to September 1, 1994, the provisions under Act 20 effective retroactive to July 1, 1995, the provisions under Act 35, effective retroactive to June 17, 1996, the effective date of the disability verification provision under § 141.61(d)(1)(iii)(B)(II) is retroactive to July 17, 1993, 30 Pa.B. 3779; amended September 13, 2002, effective retroactively to March 3, 1997, with the exception of subsection (c) which becomes effective September 14, 2002, 32 Pa.B. 4435; amended October 11, 2002, subsection (a)(1) effective March 3, 1997, and subsection (c) effective September 14, 2002, 32 Pa.B. 5048. Immediately preceding text appears at serial pages (290932) to (290937).

Notation

Authority

The provisions of this § 141.61 amended under sections 201(2), 401(a), 403(b), 405, 405.1, 405.3, 432, 432.12 and 432.21(a) of the Public Welfare Code (62 P. S. § § 201(2), 401(a), 403(b), 405, 405.1, 405.3, 432, 432.12 and 432.21(a)); sections 402(a)(7)(A)(iii) and (B) and 408(a)(7)(A) and (C) of the Social Security Act (42 U.S.C.A. § § 602(a)(7)(A)(iii) and (B) and 608(a)(7)(A) and (C)); 45 CFR 264.1(c); the act of May 16, 1996 (P. L. 175, No. 35); and the Domestic Relations Code, 23 Pa.C.S. 4301—4381, 5103, 7101—7901 and 8101—8418).

Notes of Decisions

Chronically Needy Person

Subsection (d)(1)(viii) requires that employment be verified for the purpose of determining eligibility for ‘‘chronically needy’’ status. Fisher v. Department of Public Welfare, 475 A.2d 873 (Pa. Cmwlth. 1984); reversed 501 A.2d 617 (Pa. 1985).

Where an applicant seeks to qualify for general assistance benefits as a ‘‘chronically needy’’ person, but fails to submit medical documentation until after ‘‘transitionally needy’’ benefits have been terminated due to expiration of the 90-day period provided for in subsection (d)(1)(iii)(c)(I), the regulation does not require retroactive payment for the period after termination and prior to classification as ‘‘chronically needy.’’ Sheets v. Department of Public Welfare, 496 A.2d 65 (Pa. Cmwlth. 1985).

A chiropractor’s statement is insufficient documentation for purposes of establishing ‘‘chronically needy’’ status under subsection (d)(1)(iii)(B). Hardy v. Department of Public Welfare, 473 A.2d 1138 (Pa. Cmwlth. 1984).

Equal Protection

Since there is no constitutional right to receive public welfare or a college education, and since denial of general welfare assistance to full-time college students with no previous history of family need is rationally related to the legitimate state goals of preserving fiscal integrity and eliminating undeserving individuals from the welfare rolls, § 141.61(a)(1)(xiii), implementing 62 P. S. § 403(d), is not an unconstitutional denial of equal protection. Walker v. O’Bannon, 487 F. Supp. 1151 (W. D. Pa. 1980); affirmed 624 F.2d 1092 (3rd. Cir. (Pa.) 1980).

Form

The regulation requiring that proof of disability for general assistance be on a Department of Public Welfare form was upheld as in accordance with the legislative intent. Zamattio v. Department of Public Welfare, 625 A.2d 746 (Pa. Cmwlth. 1993).

Full-time College Student

Full-time college students who have not participated in a Federally subsidized program for dependent children within the previous 5 years are not eligible for general assistance; this section does not violate the legislative intent set forth at 62 P. S. § 401 in that the prohibition is clear and free from all ambiguity. Yanushko v. Department of Public Welfare, 543 A.2d 1277 (Pa. Cmwlth. 1988).

Ineligibility for AFDC

The requirement that to be eligible for general assistance an applicant be ineligible for AFDC is reasonable and in keeping with the purpose of the general assistance program in that it ensures maximum allocation of scarce state resources to those most needy. Snyder v. Department of Public Welfare, 492 A.2d 124 (Pa. Cmwlth. 1985).

Initial Application

55 Pa. Code § 141.81(g)(1) (relating to policy) is reasonable and is clear and unambiguous, and an exception to its application is not warranted even though a private insurance carrier alters its stated coverage after tentatively agreeing to cover the expenses, since the insurance carrier gave notice of its revised coverage before the end of the 90-day period. Berry v. Department of Public Welfare, 401 A.2d 602 (Pa. Cmwlth. 1979).

Cross References

This section cited in 55 Pa. Code § 108.7 (relating to requirements subject to waiver); 55 Pa. Code § 141.21 (relating to policy); 55 Pa. Code § 141.71 (relating to policy); and 55 Pa. Code § 145.64 (relating to procedures).