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COMMONWEALTH OF PENNSYLVANIA

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Pennsylvania Code



CHAPTER 123. DEFINITIONS

TANF/GA INTAKE AND REDETERMINATION
DEFINITIONS

Sec.


123.22.    Definitions.

MA INTAKE AND REDETERMINATION DEFINITIONS
FOR THE CATEGORICALLY NEEDY


123.72.    Definitions.

MA INTAKE AND REDETERMINATION DEFINITIONS
FOR THE MEDICALLY NEEDY


123.82.    Definitions.

TANF/GA INTAKE AND REDETERMINATION DEFINITIONS


§ 123.22. Definitions.

 The following words and terms, when used in this chapter and Chapters 125, 133 and 141 (relating to application process; redetermining eligibility; and general eligibility provisions), have the following meanings, unless the context clearly indicates otherwise:

   AMR—Agreement of Mutual Responsibility

     (i)   A written individualized document that, based on an assessment of the individual’s skills and abilities, sets forth the responsibilities and obligations to be undertaken by the individual to achieve self-sufficiency, including participation in approved work and work-related activities.

     (ii)   The AMR includes the time frames within which each obligation is to be completed, the penalties for failure to comply, and the services to be provided by the Department to support the individual’s efforts.

   Applicant—An individual who submits an application for cash assistance for himself or on behalf of another. The individual remains an applicant until a decision on eligibility or ineligibility is made.

   Application—A signed form approved by the Department which contains the name and address of the applicant, unless the applicant is homeless, and is filed with the CAO. The applicant applying for himself or others shall sign and file the application for himself or through a representative authorized by guardianship or power of attorney. If an individual is unable to apply for himself, he may apply through an authorized representative or another person who has authority to act for him. An application will continue in effect until a decision on eligibility is made. The transfer of a budget group from GA to TANF is an application. The addition of a person who is not required to be a member of an existing budget group is an application.

   Application interview—A personal interview between an applicant and an eligibility worker, to gather and record information and to secure verification needed to establish eligibility.

   Authorization date of cash assistance—The date on which a decision of eligibility is made.

   Inquiry—An inquiry differs from an application in that the person is seeking information only, and does not wish to file an application for cash assistance. When a person asks for cash assistance or some other service on behalf of a competent adult, the Department will consider the request an inquiry unless it is known that the person asking for cash assistance on behalf of another is doing so with the knowledge and consent of the latter.

   Monthly assistance payment—The amount of money issued monthly that is based on the family size allowance plus, if applicable, a special need allowance, reduced by the net income of the budget group.

   Personal interview—A meeting or discussion between an applicant or recipient and an eligibility worker, in person, by telephone or by other means approved by the Department.

   Reapplication—A completed, signed form approved by the Department which is filed with the CAO by a recipient and used for a complete redetermination of continued eligibility of a budget group.

   Redetermination—A periodic review by a CAO worker of eligibility factors subject to change. If all factors subject to change are reviewed, the review is a complete redetermination, otherwise the review is a partial redetermination.

   Screening interview—A personal interview between the applicant and an eligibility worker which includes a review of the application to assure that information necessary to determine eligibility is provided prior to determining a person ineligible or prior to scheduling an application interview.

Authority

   The provisions of this §  123.22 amended under sections 201(2), 403(b), 405, 405.1, 405.3 and 432 of the Human Services Code (62 P.S. § §  201(2), 403(b), 405, 405.1, 405.3 and 432); Titles I and III of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Pub.L. No. 104-193) (PRWORA), creating the Temporary Assistance for Needy Families (TANF) Program, and amending 42 U.S.C.A. § §  601—619, 651—669(b) and 1396u-1; and the Federal TANF regulations in 45 CFR 260.10—265.10.

Source

   The provisions of this §  123.22 amended through July 16, 1982, effective July 17, 1982, 12 Pa.B. 2286; amended October 4, 1991, effective October 5, 1991, apply retroactively to November 1, 1989, 21 Pa.B. 4643; amended September 13, 2002, effective September 14, 2002, 32 Pa.B. 4435; amended April 22, 2022, effective April 23, 2022, 52 Pa.B. 2548. Immediately preceding text appears at serial pages (290879) to (290880) and (349775).

Cross References

   This section cited in 55 Pa. Code §  108.17 (relating to Agreement of Mutual Responsibility (AMR)); 55 Pa. Code §  121.2 (relating to definitions); and 55 Pa. Code 125.1 (relating to policy).

MA INTAKE AND REDETERMINATION DEFINITIONS FOR
THE CATEGORICALLY NEEDY


§ 123.72. Definitions.

 The definitions of applicant, application and inquiry as set forth in §  123.82 (relating to definitions) shall apply to Categorically Needy MA.

Source

   The provisions of this §  123.72 amended April 27, 1979, effective August 30, 1978, 9 Pa.B. 1041. Immediately preceding text appears at serial page (33075).

MA INTAKE AND REDETERMINATION DEFINITIONS FOR
THE MEDICALLY NEEDY


§ 123.82. Definitions.

 The following words and terms, when used in this section, have the following meanings, unless the context clearly indicates otherwise:

   Applicant—An adult or emancipated minor who indicates to the county office, either in person, or through someone acting in his behalf, that he wants his eligibility for MA determined. The adult with whom an unemancipated minor lives, or the guardian or trustee of that adult, will be the applicant in the behalf of the child. For a child in foster care, the child welfare agency supervising the care will be the applicant. For a child who is a resident in an institution, an official of the institution will be the applicant.

   Applicant group—A person living alone or the following persons living together: spouses, parents and their unemancipated minor children and any other unemancipated minor children who are related by blood or marriage, or any other adults or emancipated minor children living in the household who consider themselves to be dependent upon the head of the household and who do not wish to apply on their own behalf. If a person who would have been included with other persons as a member of an applicant group dies within 90 days of the date of application, he will be considered to be a member of the applicant group insofar as being eligible for the services he received within the 90 days before the date of application.

   Application—Application shall include the following:

     (i)   An action by which a person requests that the county office determine his eligibility for medical assistance.

     (ii)   A separate application for MA will not be required when a person has been found to be needy that is, a money payment or nonmoney payment recipient.

     (iii)   An application may be made for any kind of medical care provided by the program. It will not be necessary to apply for any one kind of care or for different kinds of care in a sequence.

     (iv)   The date of a request for MA, as distinguished from an inquiry, is the date the eligibility form, Form PA 743, is completed and signed. The applicant must be living at the time this request is made.

     (v)   A reapplication will be considered an application.

     (vi)   A request for MA by an adult or emancipated minor, or on behalf of an unemancipated minor, will be considered an application even though the person is added to an existing applicant group.

     (vii)   When a categorically needy recipient, whether money payment or nonmoney payment, is no longer eligible as a categorically needy person because he has sufficient resources to meet his basic needs, but he is eligible as a medically needy only person, it will not be necessary to complete a Form PA 743.

     (viii)   If a person who has been found ineligible for MA should request a County or State appeal hearing, the request will be considered an application.

     (ix)   An application will continue in effect until disposed of.

   Inquiry—An inquiry differs from a request in that the person making the inquiry is seeking information only and not MA. When a person asks for information intended for the use of someone other than himself, the Department will consider the request as an inquiry unless or until it knows that the person is, in actuality, requesting MA on behalf of another person and is doing so with the knowledge and consent of the latter.

Cross References

   This section cited in 55 Pa. Code §  123.72 (relating to definitions); and 55 Pa. Code §  125.84 (relating to procedures).



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