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Pennsylvania Code (Last Updated: April 5, 2016) |
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Title 55. PUBLIC WELFARE |
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PART VI. Mental Health/Intellectual Disability/Autism Manual |
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Subpart C. Administration and Fiscal Management |
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Chapter 4305. Liability for Community Mental Health and MentalRetardation Services |
Appendix B.
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Monthly Liability for Community Mental Health and Mental Retardation
Residential and Short-Term Inpatient Services
Adjusted
Family IncomeNumber of Dependents 1 2 3 4 5 6 7 8 9 10 500- 999 13 11 10 9 8 6 5 4 3 2 1000-1499 25 21 18 15 13 10 8 6 5 4 1500-1999 38 31 25 20 16 14 11 9 6 5 2000-2499 50 43 36 31 28 24 20 16 14 11 2500-2999 63 54 46 40 35 30 25 21 19 15 3000-3499 75 65 56 49 43 36 31 28 24 20 3500-3999 88 76 66 58 50 43 38 33 28 24 4000-4499 100 86 76 66 58 50 44 39 34 30 4500-4999 113 98 85 74 65 55 48 41 36 31 5000-5499 125 109 95 83 73 63 55 49 44 39 5500-5999 144 125 110 96 85 74 65 58 50 44 6000-6499 163 143 125 110 96 85 75 66 59 51 6500-6999 181 159 140 125 109 95 84 74 66 59 7000-7499 200 175 154 136 120 105 94 83 73 65 7500-7999 219 191 169 149 131 115 101 90 80 70 8000-8499 238 208 183 160 141 124 110 96 85 75 8500-8999 256 224 196 173 151 133 116 103 90 79 9000-9499 275 240 210 184 161 141 124 109 95 83 9500-9999 294 256 224 195 170 149 130 114 99 86 10000-10499 319 279 244 213 186 163 141 124 108 94 10500-10999 344 300 265 230 201 176 154 134 118 103 11000-11499 369 323 281 246 215 189 165 144 126 110 11500-11999 394 343 300 263 230 201 175 154 134 118 12000-12499 419 365 319 279 244 213 185 161 141 123 12500-12999 444 388 338 295 258 224 195 170 148 129 13000-13499 469 409 356 310 270 235 204 178 154 134 13500-13999 494 430 374 325 283 246 214 185 160 139 14000-14499 519 451 391 340 295 256 221 191 165 141 14500-14999 544 473 410 355 308 265 229 198 169 145 15000-15499 569 493 428 369 319 275 236 203 173 146 15500-15999 594 514 444 383 330 284 243 206 175 149 16000-16499 619 535 461 398 341 291 249 211 179 151 16500-16999 644 555 478 410 351 300 255 215 180 155 17000-17499 669 578 498 429 368 315 268 228 191 160 17500-17999 694 600 518 446 384 329 281 239 203 170 18000-18499 719 623 538 465 400 344 295 251 214 180 18500-18999 744 645 559 483 416 359 309 264 225 191 19000-19499 769 668 579 501 433 374 321 276 236 201 19500-19999 794 689 599 519 449 389 335 289 248 211 20000-20499 819 711 619 538 466 404 349 301 259 223 20500-20999 844 734 639 555 483 419 363 313 270 233 21000-21499 869 756 659 573 499 433 375 325 281 243 21500-21999 894 779 679 591 515 448 390 339 294 254 22000-22499 919 801 699 610 531 463 403 350 305 264 22500-22999 944 824 719 628 548 478 416 363 315 275 23000-23499 969 846 739 646 564 493 430 375 328 285 23500-23999 994 869 759 664 580 508 444 388 339 295 24000-24499 1019 891 779 681 596 523 456 400 350 306 24500-24999 1044 914 800 700 614 538 470 413 361 316 25000-25499 1069 936 820 719 630 551 484 425 373 326 Formulae if Adjusted Family Income Exceeds $25,499
The liability for 1 dependent is adjusted family income times 0.0420 The liability for 2 dependents is adjusted family income times 0.0368 The liability for 3 dependents is adjusted family income times 0.0321 The liability for 4 dependents is adjusted family income times 0.0281 The liability for 5 dependents is adjusted family income times 0.0246 The liability for 6 dependents is adjusted family income times 0.0215 The liability for 7 dependents is adjusted family income times 0.0188 The liability for 8 dependents is adjusted family income times 0.0165 The liability for 9 dependents is adjusted family income times 0.0144 The liability for 10 dependents is adjusted family income times 0.0126 The liability for 11 dependents is adjusted family income times 0.0110
Cross References This appendix cited in 55 Pa. Code § 4305.41 (relating to liability); 55 Pa. Code § 4305.42 (relating to more than one client receiving service); and 55 Pa. Code § 4305.43 (relating to client receiving more than one service).