The CAO will review the EMC budget group's information in the fourth month and the seventh month.
The CAO will use any information given by the individual in the fourth-month review to cover the next three months. Information for month six, which the individual can give on the SAR form, will be used in the seventh-month review to cover the rest of the EMC period.
NOTE: Although the individual does not turn in a SAR form after month seven the individual must let the CAO know of any changes in the budget group’s number of individuals, employment or income.
If the budget group is not eligible for EMC, the CAO will decide whether they can get MA in other categories.
NOTE: If the budget group includes a pregnant woman or an eligible child under age one, the CAO must continue NMP benefits for the pregnant woman and the eligible child. (See Chapter 338, Medical Assistance Benefits.)
The CAO will send an advance notice to close the EMC budget before the end of the EMC eligibility period if:
The budget group does not report and prove needed information by the 21st day of the fourth month.
The budget group does not turn in a completed SAR form in the seventh month.
The budget group does not complete a twelve-month renewal.
NOTE: The twelve-month renewal is on time if it is completed by the end of that month, no matter what day the end of the month actually falls on.
Example: An EMC case was opened on October 15, the renewal due date is October 31 of the next year.
Important: EMC budgets are entitled to a full 12 calendar months of eligibility.
NOTE: The CAO must accept any information from the individual as proof for the fourth month.
EMC specific closing reason codes are available on CIS or e-CIS with the proper text. The codes are:
|
624 |
A |
Expiration of 12-month eligibility |
|
625 |
A |
Failure to provide information |
|
626 |
A |
Excess income |
|
627 |
A |
Failure to maintain employment |
|
628 |
A |
No dependent child |
The review in month four is to confirm that a TANF qualified child is still in the budget group.
The review in month seven is to confirm continued employment and that the earned income is within the EMC limit (185% of the FPIG; see Appendix A).
The individual must submit the SAR form in month seven, reporting the income of month six only. If that month’s income is more than 185 % of the FPIG, the caseworker will find out the budget group’s income and child care payments for months four and five and compare the average for the three months with the 185% FPIG limit.
The CAO will:
Count the countable gross earned income of all EMC budget group members, including LRRs who return to the home. Gross earned income includes wages, tips, salaries, commissions and bonuses from work. 55 Pa. Code § 140.51
Count the profit from self-employment. See Cash Assistance Handbook, Chapter 152, Self-Employment Income to determine profit.
If an LRR returns home in the first six-month period, the CAO does not have to count income, as the only rule is to have a TANF qualified child in the household. However, if the LRR returns to the home in the second six-month period, the CAO must count the latest month of income from the household and the LRR’s last 30 days of income.
Example:
EMC is approved for a mother and her child. Later, in month nine of the EMC period, her husband (the father of the child) returns to the home. He is eligible for EMC benefits and is included in the EMC household.
If the father has a job, his pay is included when deciding on continued EMC eligibility for the household. EMC eligibility is found as follows:
|
|
Mother’s income (Month 8) |
Father’s income (Last 30 days) |
|
Gross monthly wages |
$1,100 |
$1,300 |
|
Child care |
-100 |
|
|
|
$1,000 + $1,300 = $2,300 |
|
Because $2,300 is less than 185% of the FPIG for three individuals, the family is still eligible for EMC.
NOTE: If the combined income in month eight is over the limit, the CAO will ask for the family’s income and child care expenses in the two previous months (months six and seven). If the average monthly amount for the three months is under the 185% limit for three individuals, the family is still eligible.
The CAO should not count the following: 55 Pa. Code § 140.441
Earned income that is excluded (see Cash Assistance Handbook, Chapter 150, Income, and Medical Assistance Eligibility Handbook, Chapter 350, Income).
Earned income related to the gross earnings of a child (see Medical Assistance Eligibility Handbook, Chapter 350, Income).
The Earned Income Credit (EIC).
The income of others living in the household but not included in the EMC budget group. 55 Pa. Code § 140.481
The income of any individual who left the budget group during the quarter being reviewed.
The CAO will deduct dependent care costs paid by the EMC budget group if the following conditions are met:
The costs are for the care of dependent children or incapacitated individuals living in the home of the EMC budget group.
NOTE: The individuals receiving the care do not have to be members of the EMC budget group.
The dependent care costs are reported.
NOTE: Failure to report dependent care costs may cause ineligibility if the costs are needed to meet the income limit.
The costs are related to an EMC budget group member’s work.
The amount paid is proven.
Dependent care services are not needed when an unemployed biological or adoptive parent, specified relative, or legal guardian of the child is living in the home, unless: 55 Pa. Code § 140.481(b)
The individual is physically or mentally incapable of providing care.
The individual is involved in work-related activities, such as education, training or a job search.
The child is at risk because of suspected child abuse.
The CAO will count income as follows:
Subtract the child or dependent care costs of month six from the gross monthly earnings of month six to find the countable net income.
Compare the net monthly income to 185% of the FPIG for the family size. (See Appendix A.)
Reminder: The individual must turn in the SAR form in month seven, reporting the income and child care expenses of month six only.
Example:
Sara Smith and her two TANF-qualified children receive EMC and report gross monthly earnings and allowable child and dependent care costs as follows:
|
Month |
Income |
Child Care |
|
April (4) |
$500 |
$30 (Not reported on SAR form) |
|
May (5) |
$700 |
$50 (Not reported on SAR form) |
|
June (6) |
$750 |
$60 (Reported on SAR form) |
Income for June: $750 - $60 = $690
Because $690 is less than 185% of the FPIG for three individuals, the family is still eligible for EMC.
NOTE: If the combined income in month six is over the limit, the CAO will ask for the family’s income and child care expenses in the two previous months (months four and five). If the average monthly amount for the three months is under the limit for three individuals, the family is still eligible.
NOTE: An individual who left the budget group during the quarter is not counted in the budget group size for the 185% test.
If the monthly income is more than 185% of the FPIG, the CAO will take the following actions: 55 Pa. Code § 140.513(2)(i)
Review eligibility for other MA categories. If eligible, approve benefits effective the day after the EMC stop date.
NOTE: If the budget group includes a pregnant woman, continue NMP benefits through the 60-day period following birth for the pregnant woman. The newborn remains eligible for one year. Set the renewal due date of one year from the birth date.
Let the budget group know the reason for stopping EMC, and give it them information about eligibility for other MA categories.
NOTE: If the recipient reports income on time and correctly, and the income after deductions for child or dependent care is more than 185% of the FPIG, the CAO must stop EMC. No overpayment referral is made. The recipient is ineligible for the rest of the twelve-month EMC period.
The budget group remains eligible for EMC for the second six-month period as long as a specified relative in the budget group keeps a job and meets the income limits. The condition of keeping a job is met if: 55 Pa. Code § 140.513(2)(ii)
A specified relative worked in each of the three previous months and is working at the end of the last month of the quarter.
An unemployed specified relative gets a job offer and will begin work in the first month of the third or fourth quarter.
The unemployment is due to involuntary loss of work, illness or good cause. (See Cash Assistance Handbook, Chapter 135, Employment and Training).
NOTE: EMC can continue for the second six-month period even if the specified relative is not working and has no job offer, as long as the loss of work was due to reasons beyond the control of the client, such as plant closing, layoff, illness, or good cause.
If the budget group doesn’t meet the job rules, the CAO will send an advance notice telling them that EMC will be stopped.
The CAO will ask if:
The budget group still includes a TANF-qualified child.
The SSI child who qualified the specified relative for TANF is still in the household.
When counting income and family size for EMC, the SSI child must be excluded. Child care costs for the SSI child is an allowable deduction.
If the CAO determines that there is no child who meets one of these conditions, the budget group is no longer eligible for EMC.
Updated February 14, 2012, Replacing March 28, 2008