Illinois Administrative Code › Title 59 - MENTAL HEALTH › Part 299 - SEXUALLY VIOLENT PERSONS › Subpart I - REIMBURSEMENTS › Section 299.1030 - Determination of Ability to Pay Services Charges

Current through Register Vol. 48, No. 28, July 12, 2024
a) The Department, in determining the ability
				of the person to pay services charges, will assemble any necessary information
				pertaining to his/her financial status and will then set the amount for which
				the person will be held liable. The person must furnish financial information
				on admission or as soon thereafter as possible to enable the Department to make
				a proper determination of the sources available for reimbursement of the cost
				of services charges. The Department will require the person to update his/her
				financial information on not less than an annual basis. The liability for
				payment of services charges shall be based on information available at the time
				of determination. (The data may include savings, trusts, wills, evidence of
				indebtedness, evidence of court-ordered payments, and the like.) Each person
				for whom a determination has been made shall be issued a Notice of
				Determination, notifying the person of his/her liability. The notice shall be
				issued even when current determined liability is $0.00.
b) When there is a demonstrated ability to
				pay, payment for services is an obligation, established by Section 90 of the
				Act, against the person, guardians, trustees and/or payees.
c) Subsequent review may be initiated by the
				recipient prior to the annual redetermination due to changes in ability to pay
				or as a result of an administrative hearing. Service recipients have a duty to
				inform the Department of any changes in their financial status.
d) The determination of the ability to pay
				and amount of liability of the person for services charges, up to the
				prevailing maximum rate, shall be based on all assets and income of the person.
				After considering the person's legal dependent's financial needs (see
				subsection (h)), all resources and assets are reduced to the allowable reserve
				exemption in accordance with subsection (e).
e) The allowable reserve exemption is
				determined by the amount of assets owned at the time of initiation of services,
				except that the allowable reserve exemption from all sources cannot exceed that
				established by HFS (see 89 Ill. Adm. Code
				120.382 ). The
				service recipient's allowable reserve exemption can only be increased by the
				unused portions of the monthly personal and clothing allowance or unspent
				workshop or other monetary incentive funds, such as living skills program
				funds. Amounts to be paid by the service recipient for services charges may not
				be deferred to build a reserve to the maximum amount allowed.
f) If the person becomes eligible and is
				approved for Medicaid, 42 CFR 430 (2016) and HFS rules at 89 Ill. Adm. Code
				120.382 govern
				the allowable reserve and personal and clothing allowance.
g) The Department shall allow deductions from
				income for a community spouse maintenance needs allowance and a family
				maintenance needs allowance for each dependent family member who does not have
				enough income to meet his/her needs. Family members include dependent children
				under age 21, dependent adult children, dependent parents, or dependent
				siblings of either spouse, who are living with the community spouse. To
				determine the amount of the deduction:
1) The
				deduction for the community spouse maintenance needs allowance, as set forth in
				89 Ill. Adm. Code
				120.61(d),
				is equal to the community spouse maintenance needs standard less any non-exempt
				monthly income of the community spouse. The deduction is allowed only to the
				extent that income of the spouse who is receiving services at a
				Department-operated facility is contributed to the community spouse. However,
				the deduction for the community spouse maintenance needs allowance shall not be
				less than the amount ordered by the court for support of the community spouse
				or the amount determined as the result of the fair hearing.
2) The deduction for the family maintenance
				needs allowance for each dependent family member is equal to one-third of the
				difference between the family maintenance needs standard and any non-exempt
				income of the family member as set forth in 89 Ill. Adm. Code
				120.61(d).