Code of Maine Rules › 14 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 197 - OFFICE OF AGING AND DISABILITY SERVICES › Chapter 11 - CONSUMER-DIRECTED PERSONAL ASSISTANCE SERVICES › Section 197-11-09 - CONSUMER PAYMENTS (MAJOR SUBSTANTIVE RULE)

Current through 2024-29, July 17, 2024
(A)
Consumer Payments.
The
				authorized agency will use a Department of Health and Human Services approved
				form to determine income and liquid assets and calculate the monthly payment to
				be made by the consumer. The agency may require the consumer and his or her
				spouse to produce documentation of income and liquid assets. A consumer need
				not complete a financial assessment if he or she pays the full cost of services
				received. His or her payments, as determined by an annual financial assessment
				may not exceed the total cost of services provided.
(B)
Definitions.
The following
				definitions apply to this Section.
(1)
Dependent Allowances.
Dependents and dependent allowances are
				defined and determined in agreement with the method used in the MaineCare
				program. The allowances are changed periodically and cited in the MaineCare
				Eligibility Manual, Chart II, AFDC Related Income Limits. Dependents are
				defined as individuals who may be claimed for tax purposes under the Internal
				Revenue Code and may include a minor or dependent child, dependent parents, or
				dependent siblings of the consumer or consumer's spouse. A spouse may not be
				included.
(2)
Disability-related expenses:
Disability-related expenses are
				out-of-pocket costs incurred by the consumer's for their disability, which are
				not reimbursed by any third-party sources. They include:
(a)Home access modifications: ramps,
				tub/shower modifications and accessories, power door openers, shower
				seat/chair, grab bars, door widening, environmental controls;
(b)Communication devices: adaptations to
				computers, speaker telephone, TTY, Personal Emergency Response
				Systems;
(c)Wheelchair (manual or
				power) accessories: lab tray, seats and back supports;
(d)Vehicle adaptations: adapted carrier and
				loading devices, one communication device for emergencies (limited to purchase
				and installation), adapted equipment for driving;
(e)Hearing Aids, glasses, adapted visual
				aids;
(f)Assistive animals
				(purchase only);
(g)Physician
				ordered medical services and supplies;
(h)Physician-ordered prescription and over
				the counter drugs;
(i)Medical insurance premiums, co-pays and
				deductibles-.; and
(j)Unemployment
				and workers compensation expenses related to employing the PA.
(3)
Household
				members:
means the consumer and the spouse
.
(4)
Household members income
				includes:
(a) Wages from work,
				excluding state and Federal taxes and employer mandated or court ordered
				withholdings of the consumer and the spouse;
(b) Benefits from Social Security,
				Supplemental Security Income, pensions, insurance, independent retirement
				plans, annuities, and Aid and Attendance;
(c) Adjusted gross income from property
				and/or business, based on the consumer's most recent Federal income
				tax;
(d) Interest and
				dividends.
(e) Regularly occurring
				payments received from a home equity conversion mortgage.
Not included are benefits from: the Home Energy Assistance
				  Program, Food Stamps, General Assistance, Property Tax and Rent Refund,
				  emergency assistance programs, or their successors.
(5)
A liquid asset
is
				something of value available to the consumer that can be converted to cash in
				three months or less and includes:
(a) Bank
				accounts;
(b) Certificates of
				deposit
(c) Money market and mutual
				funds;
(d) Life insurance
				policies;
(e) Stocks and
				bonds;
(f) Lump sum payments and
				inheritances; and
(g) Funds from a
				home equity conversion mortgage that are in the consumer's possession whether
				they are cash or have been converted to another form.
Funds which are available to the consumer but which carry a
				  penalty for early withdrawal will be counted minus the penalty. Exempt from
				  this category are mortuary trusts and lump sum payments received from insurance
				  settlements or annuities or other such assets named specifically to provide
				  income as a replacement for earned income. The income from these payments will
				  be counted as income.