State Independent Living Council Discussion Archive

NATSILC: Centers Can Charge Consumers For Services

Posted by: Lou Diehl
Date Mailed: Friday, May 9th 2003 06:34 AM

From: ForCompliance@aol.com
Date: Thu, 20 Mar 2003 19:46:35 EST
Subject: CENTERS CAN CHARGE CONSUMERS FOR SERVICES

NEITHER REQUIRED NOR PROHIBITED FROM CONSIDERING ABILITY TO PAY IN 
DETERMINING COST

Among the little known facts about the Rehab Act is the fact that as it is
written right now, it allows states, CILs and other entities who provide
any IL services through grant or contract to charge consumers a fee, so
long as the state plan says they can do so. 

They can develop and implement a process by which their ability to pay is
ascertained. This may have been intended to cover supplemental services
aside from core services, but there is nothing in the law that so
specifies. 

Definitions for CFR Section 364 include the following:

Service provider means--

    (1) A designated State unit (DSU) that directly provides IL services
to individuals with significant disabilities; 

    (2) A center that receives financial assistance under part B or C of
chapter 1 of title VII of the Act; or

    (3) Any other entity or individual that meets the requirements of Sec.
364.43(e) and provides IL services under a grant or contract from the DSU
pursuant to Sec. 364.43(b). 

(Authority: 29 U.S.C. 711(c) and 796(e))


Sec. 364.59  May an individual's ability to pay be considered in 
          determining his or her participation in the costs of IL 
          services?

    (a) No Federal requirement or prohibition. 

    (1) A State is neither required to allow nor prohibited from allowing
service providers to charge consumers for the cost of IL services. 

    (2) If a State allows service providers to charge consumers for the
cost of IL services, a State is neither required to allow nor prohibited
from allowing service providers to consider the ability of individual
consumers to pay for the cost of IL services in determining how much a
particular consumer must contribute to the costs of a particular IL
service. 

    (b) State plan requirements. If a State chooses to allow service
providers to charge consumers for the cost of IL services or if a State
chooses to allow service providers to consider the ability of individual
consumers to pay for the cost of IL services, the State plan must--

    (1) Specify the types of IL services for which costs may be charged
and for which a financial need test may be applied; and

    (2) Assure that any consideration of financial need is applied
uniformly so that all individuals who are eligible for IL services are
treated equally. 

    (c) Financial need. Consistent with paragraph (b) of this section, a
service provider may choose to charge consumers for the cost of IL
services or may choose to consider the financial need of an individual who
is eligible for IL services. 

    (d) Written policies and documentation. If the service provider
chooses to consider financial need--

    (1) It shall maintain written policies covering the specific types of
IL services for which a financial need test will be applied; and

    (2) It shall document the individual's participation in the cost of
any IL services, including the individual's financial need. 

(Approved by the Office of Management and Budget under control number
1820-0527)

(Authority: 29 U.S.C. 711(c))




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