subchapter 71s service cost-sharing

 

SECTION .0100 PURPOSE

 

10A NCAC 71S .0101 PURPOSE OF CONSUMER CONTRIBUTIONS

(a) As used in this Subchapter, the following definitions shall apply:

(1) Consumer Contributions a monetary amount voluntarily given to the service provider by the service recipient or the designated representative toward the cost of the service received.

(2) Recommended Contribution Schedule a listing of income ranges and corresponding recommended contribution percentages for use with clients whose incomes are above the Federal poverty level. The Recommended Contribution Schedule is available at http://www.dhhs.state.nc.us/aging/arms/csupdat2.htm and is determined as follows:

 

Percent of Poverty

Suggested Percentage of the Cost of Service

100%

10%

125%

20%

150%

30%

175%

40%

200%

50%

225%

60%

250%

70%

275%

80%

300%

90%

350%

100%

 

(b) The purpose of consumer contributions is to extend the availability of services which are subject to consumer contributions administered by the Division of Social Services by providing the opportunity for each client to voluntarily contribute toward the cost of the service(s) received. Revenue collected from clients shall be retained by the service provider.

 

History Note: Authority G.S. 143B-153;

Eff. March 1, 1994;

Amended Eff. September 1, 2005;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 20, 2017.

SECTION .0200 ‑ SERVICE COST SHARING REQUIREMENTS

 

10A NCAC 71s .0201 SERVICES SUBJECT TO CONSUMER CONTRIBUTIONS

(a) The following services, when provided by funds administered by the Division of Social Services, shall be subject to consumer contributions:

(1) Adult Day Care;

(2) Adult Day Health;

(3) Housing and Home Improvement (Renovations or Repair and Furnishings or Appliance Purchases only);

(4) In‑Home Aide Services;

(5) Personal and Family Counseling;

(6) Preparation and Delivery of Meals.

(b) When any of the services specified in Paragraph (a) of this Rule are provided to adults or children as part of a Protective Services Plan, these individuals shall be excluded from, consumer contributions, from the beginning of the provision of services until protective services are no longer needed or for 12 months, whichever comes first. Consumer contributions shall not apply to children in foster care, children who have been approved to receive adoption assistance, persons receiving Work First assistance, or federally administered Supplemental Security Income (SSI) applicants or recipients.

 

History Note: Authority G.S. 143B‑153;

Eff. March 1, 1994;

Amended Eff. September 1, 2005;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 20, 2017.

 

10A NCAC 71S .0202 INITIAL AND ANNUAL REVIEWS

(a) Upon the initiation of the provision of the service(s) subject to consumer contributions and at least annually thereafter, the agency shall review with each client determined eligible to receive services subject to consumer contributions the following information:

(1) that the contribution is entirely voluntary and that there is no obligation to contribute;

(2) that all contributions collected shall be used to expand the service(s);

(3) that information about the client's participation in consumer contributions shall be confidential;

(4) who should be contacted, including the telephone number, if the client has questions regarding consumer contributions;

(5) the total cost of the service (actual or per unit); and

(6) that services shall not be reduced or terminated for failure to contribute.

(b) The agency shall provide a copy of the Recommended Contribution Schedule from the North Carolina Division of Aging and Adult Services to a client whose income is above the Federal poverty level. The agency shall not provide the Recommended Contribution Schedule to clients whose incomes are at or below the Federal poverty level.

(c) The agency shall document in the client's file that the above information has been shared with the client or the designated representative.

 

History Note: Authority G.S. 143B‑153;

Eff. March 1, 1994;

Amended Eff. September 1, 2005;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 20, 2017.

 

10A NCAC 71S .0203 ANNUAL REVIEW

 

History Note: Authority G.S. 143B-153;

Eff. March 1, 1994;

Repealed Eff. September 1, 2005.

 

10A NCAC 71S .0204 INCOME DETERMINATION

Income may be self‑declared by the client or his designated representative or may be verified at county option.

 

History Note: Authority G.S. 143B‑153;

Eff. March 1, 1994;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 20, 2017.

 

10A NCAC 71S .0205 SERVICE COST SHARING FORM

10A NCAC 71S .0206 SERVICE COST SHARING SCHEDULE

 

History Note: Authority G.S. 143B‑153;

Eff. March 1, 1994;

Amended Eff. November 1, 1994;

Repealed Eff. September 1, 2005.

 

10A NCAC 71S .0207 COLLECTION OF CONSUMER CONTRIBUTIONS REVENUE

(a) Service providers shall have written procedures to collect, account for, and safeguard all contributions.

(b) When the county department of social services directly provides a service subject to consumer contributions, the county department of social services shall collect and account for these revenues.

(c) When a service subject to consumer contributions is provided by an agency other than a county department of social services or an individual through a purchase of service contract, that provider or the county department of social services shall be responsible for collecting and accounting for the revenue. When the provider is responsible for collecting and accounting for consumer contributions revenue, this must be specified in the contract for purchase of services.

(d) When a service subject to consumer contributions is purchased through a local or state‑level contract, the county department of social services shall furnish the provider current information in writing as to the amount of the consumer contributions the client has agreed to contribute. The county department of social services or the provider shall collect the contribution from the client. The county department of social services shall furnish the provider in writing any change in the amount of consumer contributions. No consumer contributions amounts other than those identified shall be collected.

 

History Note: Authority G.S. 143B‑153;

Eff. March 1, 1994;

Amended Eff. September 1, 2005;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 20, 2017.

 

10A NCAC 71S .0208 TERMINATION

Service(s) to the client shall not be terminated for failure to contribute to the cost of service(s) rendered.

 

History Note: Authority G.S. 143B‑153;

Eff. March 1, 1994;

Amended Eff. September 1, 2005;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 20, 2017.