1. .05 Criteria for Eligibility for Cancer Treatment ​Services.
   
2. A. A local click here for the desert picture health department or a Statewide academic health center shall use the following financial eligibility criteria for cancer treatment services under the Cancer Prevention, Education, Screening and Treatment Program:
   
3. (1) The basis for determining financial eligibility shall be the gross annual household income;
   

• (2) An applicant with a gross annual household income above 250 percent of the federal poverty level is not eligible to receive cancer treatment services;
  
• (3) Written documentation required for determination of the gross annual household income shall include:
  
• (a) The household’s most recent federal income tax return; or
  
• (b) If a household income tax return was not filed, the following:
  

(i) The most recent W-2 statement;

(ii) Pay stubs from two consecutive pays;

(iii) A Social Security entitlement letter; or

(iv) A notarized letter from the applicant stating that the applicant is not working and does not have any income;​