An individual residing in an ICF/ID may have income and a payment toward the cost of care. The CAO will apply the provisions of Chapter 468, Determining MA Eligibility and Payment Toward the Cost of Care, except for the treatment of earnings from a sheltered workshop or other therapeutic activity arranged by the institution. The CAO will allow the following personal care allowance deductions from those earnings:
1. In addition to the basic PNA, an amount of $20 a month for an individual who has sheltered workshop earnings or other earnings from therapeutic activities arranged by the institution which do not exceed $50.00 gross per month.
2. In addition to the basic PNA, an amount of $40 a month for an individual who has sheltered workshop earnings or other earnings from therapeutic activities arranged by the institution totaling $50.01- $90.00 gross per month.
3. In addition to the basic PNA, an amount of $80 a month for an individual who has sheltered workshop earnings or other earnings from therapeutic activities arranged by the institution totaling $90.01- $150.00 gross per month.
4. In addition to the basic PNA, an amount of $80 a month plus 50% of the difference between the actual gross earnings and $150.01 for an individual who has sheltered workshop earnings or other earnings from therapeutic activities arranged by the institution which exceed $150 gross per month.
NOTE: The total PNA may not exceed the one person SSI limit
Example: Ms. Smith has a retirement pension of $225.00 per month plus Social Security income of $750.00 per month and sheltered workshop earnings of $200.00 per month. Ms. Smith has a PNA of:
$200.00 (Total sheltered workshop earnings)
- $150.01
$ 49.99
$ 25.00 (50% of the remainder)
+$ 80.00
$105.00 (Additional PNA)
$105.00 (Additional PNA)
+$ 45.00 (Basic PNA)
$150.00 (Total PNA)
$150.00 is the total deducted from the gross income of $1,175.
Reminder: Earnings from a sheltered workshop or other therapeutic activities arranged by the institution must be entered as income code 07 in the Client Information System (CIS). Only income coded as 07 on the CAWAGE screen will signal CIS to determine an addition to the basic PNA. Only individuals residing in an ICF/ID, ICF/ORC, State Mental Hospital equivalent to an Institution for Mental disease (IMD) or State Intellectual Disabilities Center equivalent to an ICF/ID are entitled to the additional PNA. Individuals residing in a Long-Term Care (LTC) facility are not entitled to the additional PNA. 55 Pa. Code ยง 4310.9
Updated August 27, 2013 Issued May 1, 2012