Section 152-12-4 - ELIGIBILITY DETERMINATION1.Identification of Disability EligibilityA.Communication Equipment Fund Program for People with Disabilities: Persons who are disabled to the extent that they cannot use the telephone for expressive or receptive communications, as verified by a signed form from any of the following licensed professionals: physician, audiologist, optometrist, physical therapist, occupational therapist, or speech pathologist are eligible for assistance from the fund. A copy of a signed audiogram or a copy of a diploma from a school for the deaf or blind or documentation of qualifying disability from another State program is acceptable in place of a doctor's signature.B.Telecoil technology/hearing aid Program disability eligibility: Persons whose hearing ability in both ears is below 40 decibels pure tone average, as verified by a licensed audiologist or copy of a signed audiogram and are age 65 or older.2. Identification of Income EligibilityA. Lending Program1)General Income Guideline for Communication Equipment Fund Program for People with Disabilities.The initial application for services will contain a section for a declaration of reported family gross annual income. An applicant whose family gross annual income is below 220% of U.S. Department of Agriculture National Poverty Guidelines adjusted for family size will be eligible for the Lending Program for equipment.2)Persons seeking telecoil technology/hearing aids through the Communication Equipment Fund Program. An applicant whose family gross annual income is below 135% of the U.S. Department of Agriculture National Poverty Guidelines adjusted for family size will have first priority for telecoil technology/hearing aids available at that time through the Communication Equipment Fund Program.B. For purposes of this Chapter, Family Gross Annual Income is defined as the sum of all income of family members in the household (not including dependent children), before taxes, received during the 12 month period prior to the date of application. Income shall include: 1) Wages, salaries, commissions or fees before deductions;2) Net earnings from self-employment, partnership or business;6) Contributions from persons outside the household;7) Pensions or annuities;8) Government benefits: public assistance, welfare payments, social security, SSI, unemployment;9) Workers' compensation; 12) Other cash income withdrawn from savings or investments and other resources available to the family.D. The following items are not included in determining gross annual income:- proceeds from sale of property, house or car, tax refunds, scholarships or training stipends.E. Consideration may be given in special circumstances, including but not limited to, exorbitant medical costs.3.Certification of Eligibility or IneligibilityA.Notification of Eligibility.A letter will be mailed to each individual determined eligible for services. The letter will state their eligibility and be signed and dated by Program staff.B.Notification of Ineligibility.For all applications in which the Program staff determines that an applicant for or recipient of services does not meet the requirements for eligibility as listed in this Chapter, a letter stating the reasons for ineligibility shall be mailed to each applicant found ineligible, dated and signed by Program Staff, along with a statement of Rights of Appeal.4.Order of SelectionA.General Order of Selection.At any time services cannot be provided to all eligible individuals, the Order of Selection procedures must be implemented. Under these circumstances individuals shall be served in the following priority order. Those eligible individuals who are:1) aged 62 or older living alone;3) adults, with one family member under age 12;4) adults, with one adult family member;5) teenagers or children.B.Telecoil Technology/Hearing Aids Order of Selection. 1) Aged 75 or older living alone;2) Aged 70-75 and living alone;C. For purposes of this regulation, "living alone" means living without any roommate, spouse, child, or other assistance in a housing unit, whether that housing unit is a private home, apartment, assisted living facility, group housing or nursing home.12-152 C.M.R. ch. 12, § 4