Current through Register Vol. 54, No. 45, November 9, 2024
Section 411.42 - Out-of-pocket loss(a)General. The following general provisions apply to reimbursement for out-of-pocket loss.(1) OVS may make a monetary award for an out-of-pocket loss as it is defined in the act.(2) OVS may pay the service provider directly or reimburse the claimant for amounts paid, as applicable.(b)Medical expenses. The following provisions for payment of medical expenses apply:(1) OVS will pay a hospital or other licensed health care provider at the rate of 65% of the usual and customary charge for the service rendered.(2) This rate will apply to any bill for services incurred on or after December 12, 2009.(3) Forensic rape examinations. (i) OVS will reimburse a maximum of $1,000 to a hospital or other licensed health care provider, or both, for a forensic rape examination and medications directly related to the sexual offense.(ii) The reimbursement will not include expenses for analyzing collected evidence for DNA or presence of Rohypnol or other similar drugs.(iii) Claims shall be filed with OVS no later than 1 year after the date of the crime.(iv) OVS will reimburse a direct victim who is erroneously billed and subsequently pays the cost of the forensic rape examination or medications directly related to the sexual offense. The reimbursement will be subject to the $1,000 monetary limitation.(c)Funeral expenses. Except as otherwise set forth in this subsection, OVS will reimburse for expenses relating to a funeral of a direct victim or intervenor. The total reimbursement amount for funeral expenses will not exceed $6,500. (1) Funeral expenses to be reimbursed are as follows:(iii) Body preparation including embalming.(iv) Grave opening and closing.(v) Cemetery plot, tent and chairs.(vii) Viewing services and facilities.(viii) Automotive equipment, such as the hearse, limousine and flower car.(ix) Death announcements, prayer cards, register book and thank you cards.(xi) Minister, pastor, rabbi or other member of the clergy.(xiii) Floral arrangements.(xiv) Funeral or memorial meal.(xv) Clothing purchased for the deceased for the funeral or interment.(xvi) Other miscellaneous expenses, including organist, programs, death certificates, obituary notice and notice of the time and place of the funeral or burial services.(d)Replacement of personal health-related items damaged or stolen as a result of a crime. Except as otherwise set forth in this subsection, OVS will reimburse a claimant for costs for the replacement of each prosthetic device, wheelchair, cane, walker, hearing aid, eyeglasses or other corrective lenses, dental device or prescription medications. Reimbursement will not exceed $1,000 and will be subject to the following limitations:(1) Two hundred dollars for eyeglass frames.(2) One thousand dollars for replacement of all combined prescription medications stolen or damaged in a single crime incident.(3) One hundred dollars for replacement of canes.(4) Two hundred fifty dollars for replacement for walkers.(e)Counseling. OVS will pay expenses of counseling performed by or under the supervision of a psychiatrist, psychologist, licensed professional counselor or licensed social worker to claimants as follows:(1) A maximum of $10,000 in total expenses of a direct victim who was under 18 years of age upon the occurrence of the crime.(2) A maximum of $5,000 in total expenses of a direct victim who was 18 years of age or older upon the occurrence of the crime.(3) A maximum of $5,000 in total expenses of any of the following individuals affected by the homicide of a direct victim: (i) An individual responsible for the welfare of the direct victim, which includes legal guardians and foster parents.(ii) An individual related in the second degree of consanguinity or affinity to the direct victim.(iii) An individual residing in the same household with the direct victim.(iv) An individual engaged to be married to the direct victim.(4) A maximum of $2,500 in total expenses of any of the individuals described in paragraph (3) affected by a crime against a direct victim that is not a homicide.(5) A maximum of $1,500 in total expenses of an individual who:(i) Is physically present at a crime scene and witnesses a violent crime.(ii) Discovers the body in a homicide.(6) For counseling expenses relating to a homicide, OVS may not reduce the amount of the award or deny the reimbursement due to the conduct of the direct victim.(f)Relocation expenses. OVS will reimburse for expenses incurred by the temporary or permanent relocation of a direct victim and individuals residing in the direct victim's household when immediate relocation is necessary to protect their health and safety. This reimbursement will not exceed $1,000 per household for each direct victim for the following: (1) Relocation expenses to be reimbursed are as follows:(i) Lodging to a daily maximum of $75.(ii) Rental of substitute living quarters.(iii) Utility connection fees, which do not include cable.(iv) Rental of a passenger vehicle for a total daily maximum of $30.(v) Private vehicle usage at mileage rate currently paid by the Commonwealth to its own employees for travel.(vi) Common carrier fares.(vii) Moving company charges or van rental.(viii) Tolls and parking expenses.(ix) Rental of post office box.(x) Charges for storage of personal belongings.(xi) Child care expenses.(2) Reimbursement will be made only when a medical provider, human services provider or law enforcement representative, which may include a district attorney or other prosecutorial agency, verifies the immediate need for relocation.(3) OVS may consider a delay past the prescribed immediate need time period to be justified when the direct victim, intervenor or claimant is mentally or physically incapacitated, there is a fear of retaliation or other circumstances when good cause is shown by the claimant.(g)Travel expenses. OVS will reimburse expenses associated with travel necessary and reasonable as determined by OVS to obtain medical care or counseling, attend or participate in criminal justice or protection from abuse proceedings, and other circumstances when good cause is shown by the claimant. In the case of an injury that results in death, for travel in connection with making the funeral arrangements, transport of the body and attendance of funeral services as follows:(1) Meals totaling no more than $28 per day, with no more than $6 for breakfast, $6 for lunch and $16 for dinner.(2) Lodging to a daily maximum of $75.(3) Private vehicle usage at mileage rate currently paid by the Commonwealth to its own employees.(4) Vehicle rental to a daily maximum of $30.(5) Payment of a driver other than common carriers needed as result of a crime at maximum hourly rate of $8.(6) Common carrier fares in full.(7) Tolls and parking expenses.(8) Meals and lodging reimbursement, limited to trips of 50 miles or more from the eligible person's home.(9) Containers or other necessary requirements to transport the body.(10) In the case of an injury that results in death, for travel in connection with the transport of the body, making funeral arrangements and attending the funeral services not to exceed 5 days.(h)Crime scene clean up. The cost of cleaning the crime scene of a private residence up to a maximum of $500.(1) Reimbursement will be limited to the cost of cleaning supplies purchased for the purpose of cleaning the scene, the cost of any necessary equipment purchased or rented and the cost of professional labor for the purpose of cleaning the crime scene.(2) Multiple private residences may each be considered for crime scene cleanup if the sites are identified in the police report. The maximum award amount for each crime scene cleanup is $500.(3) Cleaning means to remove or attempt to remove blood and stains caused by bodily fluids, food, paint or other materials used to deface property as a direct result of the crime or other dirt or debris caused by the processing of the crime scene.(4) Stains deliberately caused by acts of vandalism and other intentional acts are property damage which is expressly excluded from the definition of "out of pocket loss" contained in the act.(i)Miscellaneous expenses. OVS may reimburse a claimant for other services reasonably necessary, including the following: (1) The purchase or rental of nonmedical remedial care or products that are needed to assist in normal, daily life functions and are prescribed or recommended by a health care provider, such as a wheel chair ramp, lifts or other special accommodations, including equipment or robotic devices needed to assist in normal, daily life functions.(2) The cost of obtaining services needed as a result of the crime such as laundering, cleaning, child care, administration of medication, food shopping and meal preparation. (i) Members of the family of the direct victim or intervenor engaged to perform the services will be paid their net loss of earnings not to exceed the average weekly wage and if not otherwise reimbursed for the loss of earnings.(ii) Individuals engaged to perform services who are not family members will be paid a maximum hourly rate of $8.(3) At the discretion of OVS, telephone and television expenses incurred in connection with inpatient care of the direct victim or intervenor due to the injury.(4) At the discretion of OVS, charges incurred for records, products or services including those for rehabilitation, rehabilitative occupational training, other remedial treatment and care, tutors and interpreters.The provisions of this §411.42 amended December 11, 2009, effective 12/12/2009, 39 Pa.B. 6980.The provisions of this §411.42 amended under section 312(3) of the Crime Victims Act (18 P. S. § 11.312(3)).