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02.42A.04.01 Background and Fee
1. Section 4-217(d), of Health-General Article, Annotated Code of Maryland authorizes each county local health department to set and collect a fee for processing and issuing a death certificate that covers the administration cost of providing this service. The fee set by the local health department for processing and issuing a death certificate as determined by the Health Officer.
2. Section 2-42A(e), Montgomery County Code, as amended, requires that fees for Department of Health and Human Services services be established by the County Executive who may from time to time change them in an amount not to exceed the cost of the services provided.
3. The fee to be charged for the preparation of a death certificate will be determined by the Health Officer based on the determination of the actual cost of processing and issuing a death certificate.
02.42A.04.02 Effective Date
This regulation takes effect thirty (30) calendar days after the deadline for comments published in the Register.
(Administrative History: Reg. No. 19-20 (Method 1); Orig. Dept.: Health and Human Services; Supersedes: Reg. No. 61-92)
*Editor's note—This regulation also implements Md. Code, Health-General Article, § 16-201.
The Maryland State Department of Health periodically issues an Ability to Pay Schedule for Clinic and Outpatient Services in accordance with its responsibilities under Section 16-201, Health-General Article, Annotated Code of Maryland. The amount of the authorized service fee to be paid by a client is determined by referring to the Ability to Pay Schedule. No client is denied services due to inability to pay.
(Administrative History: Reg. No. 19-20 (Method 1); Orig. Dept.: Health and Human Services; Supersedes: Reg. No. 1-95, which superseded Reg. No. 62-93)
02.42A.06.01 Definitions
1.1 In this regulation, unless more specifically defined, the following words have the meanings stated:
(a) Applicant means a child’s parent, guardian, or custodian who applies for benefits.
(b) Case worker means the Department of Health and Human Services staff person assigned to work directly with the applicant or client to determine eligibility.
(c) Certification period means the time period for which benefits have been approved. Certification is the process through which an applicant is officially approved to receive benefits.
(d) Child care means care for less than a 24 hour day, for which compensation is paid to a child care center or family child care home licensed or registered by the Maryland Department of Human Resources.
(e) Child care center means a facility providing child care in Maryland that is:
(1) licensed under COMAR 07.04.02 by the Maryland Department of Human Resources;
(2) operated under a letter of compliance issued by the Maryland Department of Human Resources; or
(3) licensed by any branch of the military under applicable military child care regulations.
(f) Client means a person who has been approved to receive benefits. In a two- parent household the term client refers to both parents.
(g) Director means the director of the Department of Health and Human Services or the director’s designee.
(h) Family child care home means a residence, other than the child’s home, that is:
(1) registered under COMAR 07.04.02 to provide child care by the Maryland Department of Human Resources;
(2) operated under a letter of compliance issued by the Maryland Department of Human Resources; or
(3) registered by any branch of the military under applicable military child care regulations.
(i) Gross income means total household income, taxable and nontaxable, from all sources, whether or not reported on a federal or state income tax return.
(1) Gross income includes, but is not limited to:
(A) wages and tips received as compensation for employment or services rendered before taxes and other deductions;
(B) commissions, bonuses, and incentives;
(C) interest and dividends from all financial accounts;
(D) benefits under the Social Security Act, or the Railroad Retirement Act;
(E) bequests and inheritances;
(F) child or spousal support payments, which include:
(i) amounts paid directly to the applicant or client;
(ii) third party payments on behalf of the applicant or client; or
(iii) court ordered payments;
(G) recurring monetary gifts and loans, excluding student loans, made to the household by other persons not living in the household to assist with living expenses;
(H) strike benefits which do not include employee contributions;
(I) pensions and annuity benefits, including veterans, railroad, and mine worker benefits;
(J) unemployment compensation benefits;
(K) trust fund disbursement;
(L) capital gains;
(M) net profits from business and property rentals;
(N) workers compensation benefits;
(O) stipends for educational or research fellowships for living expenses, excluding that portion that covers tuition and required fees; and
(P) net income from self-employment.
(2) Gross income does not include:
(A) losses from business, rental, or capital transactions;
(B) other third-party payments for which the applicant or client has no discretion over the use of the funds;
(C) employment income of household members under 18 years old, unless emancipated;
(D) loans and grants, such as scholarships, obtained and used under conditions that preclude their use for current living costs;
(E) grants or loans to an undergraduate student for educational purposes made or insured under a program administered by the Commissioner of Education under the Higher Education Act;
(F) loans with established payment plans;
(G) Medicare payments deducted from social security benefits;
(H) Supplemental Security Income (SSI), Temporary Cash Assistance (TCA), and foster care benefits;
(I) Nazi restitution payments to victims of Nazi persecution; or
(J) military basic allowance for housing.
(3) For the purpose of determining eligibility, the following will be deducted from gross income:
(A) extraordinary necessary medical expense payments that exceed 7 percent of household gross income when the applicant or client provides documentation that the household makes regular payments;
(B) out-of-pocket child care expenses paid for child care during additional approved activities when the applicant or client provides documentation that the household makes regular payments;
(C) child support payments made by a non-custodial parent for a child not residing in the applicant’s or client’s household;
(D) $5,000 of a household’s annual gross income per child for adults with physical custody of a child, as defined in Section 1.1(n). This amount may change as determined by the state program in COMAR 07.04.06.02.B(23)(c)(iii), or its replacement; and
(E) $5,000 of household gross income per child in child care when the minor parent lives with their parent(s) and attends public school full time. This amount may change as determined by the state program in COMAR 07.04.06.02.B(23)(c)(iv), or its replacement.
(j) Household means an applicant or client and all of the following residing in the applicant’s or client’s home:
(1) the applicant’s or client’s spouse;
(2) another parent of any of the applicant’s or client’s children;
(3) the applicant’s or client’s children; and
(4) the spouse’s children.
(k) Metropolitan area median income means the most recently published metropolitan area median income from the United States Department of Housing and Urban Development, unless lower than the previous year, then income limits will remain the same.
(l) OCSE means an office of child support enforcement in any jurisdiction.
(m) Parent means a child’s natural parent, adoptive parent, or parent surrogate.
(n) Parent surrogate means an adult, other than a parent, including a caretaker relative, who has legal guardianship and assumes day-to-day responsibility for a child’s care and welfare.
(o) Provider means an individual who is responsible for the operation of a family child care home or child care center.
(p) Program administrator means the section chief for child care subsidy programs responsible for implementation of WPA regulations and procedures.
(q) Recertification means the process through which the eligibility of a client whose certification period is ending is reviewed to determine continued eligibility.
(r) State program means Maryland’s Purchase of Child Care Program as administered by the Montgomery County Department of Health and Human Services.
(s) Statement of Responsibility means a written agreement between the provider, parent and WPA that outlines the type of care provided, the monthly subsidy amount approved for each child, and the terms and conditions for participation. Both the parent and the provider must sign the agreement to acknowledge the terms and conditions of participation and to verify the type of care, child’s start date and provider’s average monthly fee.
(t) Supervisor means the person responsible for WPA daily operations and for reviewing eligibility decisions made by WPA case workers.
(u) Temporary disability means a physical, mental, or emotional impairment that substantially limits the applicant or client for no more than 6 months. The applicant or client must submit a statement of condition of disability from a physician which verifies that the applicant or client temporarily cannot work and cannot care for the child(ren).
(v) Voucher means a coupon given to a client to purchase child care from a provider. The voucher states the child’s name, month of service, expiration date, type of child care, and the authorized subsidy amount.
(w) WPA means the Working Parents Assistance Program, administered by the County Department of Health and Human Services.
2.1 General Eligibility
(a) A parent or parent surrogate may apply for benefits.
(b) A child must be under the age of 14 to be eligible for benefits. A child under the age of 19 may be eligible if a documented disability precludes self care.
(c) An applicant or client cannot receive benefits if eligible for the state program unless there is a state program waiting list.
(d) An applicant or client must be a citizen or legal resident of the United States, or have a child who is a United States citizen, and reside in Montgomery County.
(e) Pursuit of child support
(1) The applicant or client must be receiving or actively pursuing child support for all children in the household, if the applicant or client is not living with the other parent of the children. Actively pursuing child support means:
(A) receiving child support that is court ordered through a legal separation agreement or divorce decree;
(B) receiving child support that is court ordered through any OCSE;
(C) submitting an application for child support to the Montgomery County OCSE with enough identifying information for the Montgomery County OCSE or WPA to make a determination regarding cooperation from the custodial parent;
(D) enforcing through an OCSE an existing court order for child support where support is not being paid or payment is less than the court order; or
(E) cooperating with an OCSE by providing accurate and updated information regarding any absent parent.
(2) The program administrator may waive the child support requirement for good cause. Good cause means circumstances in which cooperation of the applicant or client in pursuit of child support may be contrary to the interest of the child for whom support is being sought. These circumstances are:
(A) when cooperation is reasonably anticipated to result in physical or emotional harm to an identifiable person;
(B) when the child was conceived as a result of incest or rape;
(C) when legal proceedings for the child's adoption are pending before a court of competent jurisdiction; or
(D) when the applicant or client is currently being assisted by a public or licensed private social service agency to resolve the issue of whether to keep the child or relinquish the child for adoption and the discussions have not gone on for more than three months.
(3) The applicant or client may refuse to cooperate in pursuing child support only by showing good cause.
(A) The applicant or client is responsible for providing evidence necessary to support a claim of good cause.
(B) The case worker is responsible for reviewing a claim of good cause and making a recommendation to the program administrator.
(4) Evidence to support a claim of good cause includes, but is not limited to:
(A) a birth certificate or medical or law enforcement record indicating that the child was conceived through incest or rape;
(B) a court document or other records showing that legal proceedings for adoption are pending before a court of competent jurisdiction;
(C) a court, medical, criminal, child protective services, psychological, social services or law enforcement record which indicate that the absent parent might inflict physical or emotional harm on an indentifiable person;
(D) a medical record showing the emotional health history and the present emotional health status of an indentifiable person;
(E) a written statement from a mental health professional indicating a diagnosis or prognosis of the emotional health of the child or the applicant or client;
(F) a written statement from a public or licensed private social service agency that the agency is helping the applicant or client to resolve the issue of the child’s adoption and that these discussions have not continued for more than three months; or
(G) sworn statement from individuals other than the applicant or client with knowledge of the circumstances providing the basis for a claim of good cause.
(f) Income
(1) Applicants or clients with households of 2, 3, and 4 persons are eligible if household income does not exceed 60 percent of metropolitan area median income for that household size.
(2) Applicants or clients with households of 5 or more persons are eligible if household income does not exceed 60 percent of metropolitan area median income for a household of 5 persons.
(g) Work Activity
(1) The applicant or client must be:
(A) working for wages or self-employment income at least 30 hours a week;
(B) attending a job training program and engaged in related work or study at least 30 hours a week;
(C) attending school to receive a high school diploma or equivalent and engaged in related work or study at least 30 hours a week;
(D) attending college to receive a first undergraduate degree, carrying at least 12 credit hours and maintaining at least a 2.0 grade point average for the semester most recently completed; or
(E) engaged in any combination of work, school, and job training at least 30 hours a week.
(2) If the applicant’s or client’s spouse or another parent of any child in the household lives in the applicant’s or client’s home, this parent must be:
(A) working for wages or self-employment income at least 30 hours a week;
(B) attending a job training program and engaged in related work or study at least 30 hours a week;
(C) attending school to receive a high school diploma or equivalent and engaged in related work or study at least 30 hours a week;
(D) attending college to receive a first undergraduate degree, carrying at least 12 credit hours and maintaining at least a 2.0 grade point average for the semester most recently completed;
(E) engaged in any combination of work, school, and job training at least 30 hours a week; or
(F) physically or mentally incapable of engaging in a work activity or providing ongoing child care, as documented by a physician.
(3) Eligibility while in school or job training full-time is limited to 2 years, or 4 years if working half-time and attending school half-time.
(4) When an applicant, client or the other parent has a temporary disability which precludes meeting the activity requirement, the applicant or client must provide proof of such disability as defined in Section 1.1(u).
(h) The applicant or client must not be engaged in any activities as defined in 02.42A.06.07.
(i) The applicant or client must be in good standing with the state program as defined by COMAR 07.04.06.
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