Section 20.23. Income

(a) Income limits.

(1) Caregivers whose household income exceeds 380% of poverty level are not eligible for the benefits and services under this chapter.

(2) Caregivers whose income exceeds 200% of poverty level and does not exceed 380% of poverty level are required to share in the costs of reimbursable items and services under this chapter as provided under § 20.41 (relating to general reimbursement).

(b) Income inclusions. Income includes the following:

(1) Salaries.

(2) Wages.

(3) Bonuses.

(4) Commissions.

(5) Net income from self-employment or partnership income.

(6) Alimony.

(7) Support money.

(8) Cash Public Assistance and relief.

(9) The gross amount of pensions or annuities, including Railroad Retirement benefits.

(10) The gross amount of cash benefits received under the Social Security Act (42 U.S.C.A. § § 301—1397e), except Medicare benefits.

(11) Benefits received under State unemployment insurance laws.

(12) Veteran’s disability payments.

(13) Interest, including interest received from the Federal government, State government or an instrumentality or political subdivision thereof.

(14) Realized capital gains except as provided in subsection (c).

(15) Rental income.

(16) Workmen’s compensation benefits and the gross amount of loss of time insurance benefits, except those benefits granted under section 306(c) of the Workmen’s Compensation Act (77 P. S. § 513).

(17) Life insurance benefits and proceeds, except as provided in subsection (c).

(18) Gifts or bequests of cash or property converted to cash, other than transfers by gift between members of a household, in excess of $300.

(19) Any amount of money or the net cash realized from the sale of a prize, such as an automobile or a trip won in a lottery, contest or by a form of gambling.

(20) Royalties.

(21) Dividends.

(c) Income exclusions. Income does not include the following:

(1) Surplus food or other noncash relief, including food stamps, supplied by a government agency.

(2) Property tax rebate payments and rent rebate payments, received under the Senior Citizens Rebate and Assistance Act (72 P. S. § § 4751-1—4751-12).

(3) Medicare benefits.

(4) The first $5,000 of the total of death benefit payments received upon the death of each person from whom the benefits may be due.

(5) The difference between the purchase price of a person’s residence and its selling price, to the extent that the person uses the proceeds from the sale of the residence to purchase a different residence within 2 years of the sale of the former residence.

(6) The amount of damages received, whether by civil suit or settlement agreement, due to personal injuries. Damages received means an amount received through prosecution of a legal suit, action or other claim based on tort or tort type rights, or through a settlement agreement entered into in lieu of litigation, except to the extent that the amount duplicates reimbursements previously received. Damages include black lung benefits and benefits granted under section 306(c) of the Workmen’s Compensation Act.

(7) Payments provided to eligible low income households under the Low Income Home Energy Assistance Program.

(8) That portion of client payments received by home providers in the Domiciliary Care Program administered by the Department under Chapter 21 (relating to domiciliary care services for adults), which, for any specific income year, does not exceed the actual expenses of providing domiciliary care services.

(d) Documentation of income.

(1) Except as provided in paragraph (2), a primary caregiver seeking benefits under this chapter shall document through copies of the applicable Federal income tax returns, or other acceptable documentation, the total annual household income for the calendar year immediately preceding the year in which the caregiver is assessed or reassessed for participation in the Program.

Example—A primary caregiver applies to participate in the Program on August 16, 1992. The caregiver shall provide copies of the tax returns which reflect the total annual household income for the previous year, which is calendar year 1991. Accordingly, the caregiver shall provide tax returns which document household income received from January 1, 1991, up to and including December 31, 1991.

(2) If the caregiver believes that recent changes in income have resulted in a lower household income which would affect the caregiver’s eligibility or the level of cost sharing required, the caregiver may provide the area agency on aging with documentation of current annual income. The area agency on aging will determine what documentation is necessary and the period of time for which the documentation is needed in order for the agency to determine an accurate calculation of current annual household income.

(3) The failure to provide truthful information with respect to this section will subject the caregiver to the penalties provided under § 20.45 (relating to Program violations and penalties).

(e) Acceptable documentation of income. The following are examples of documents, photocopies of which may be provided as acceptable documentation of income under subsection (d):

(1) Federal, State or local income tax returns.

(2) Pension checks, annuity checks or checks from other sources of income. When the checks are issued monthly, or on some other less-than-annual basis, a photocopy of the check for a single month, or other applicable period, will suffice. United States Treasury checks may not be photocopied.

(3) Statements from a financial institution where direct deposit is made for the applicant or claimant or statements from a government agency, such as the Social Security Administration or the Railroad Retirement Board.

(4) Documents that clearly verify the type and amount of income or a recent change in previous annual income.

Notation

Cross References

This section cited in 6 Pa. Code § 20.2 (relating to definitions); 6 Pa. Code § 20.21 (relating to eligibility for Program benefits); and 6 Pa. Code § 20.22 (relating to conditions of participation).