(a) The department
will not pay a cost under the program for children with disabilities unless, in
addition to exhausting alternate resources, the child and the child's family
agree to pay costs of treatment during each year that the child participates in
the program for children with disabilities in an amount determined by use of
the table in (1) of this subsection, and adjusted as provided in (2) - (5) of
this subsection, as follows:
STATE OF ALASKA
PROGRAM FOR CHILDREN WITH DISABILITIES
FAMILY PARTICIPATION AMOUNT GUIDE FOR
TREATMENT SERVICES
YEARLY Family Size ADJUSTED INCOME
1 2 3 4 5 6 7 8 9 10 11 12 -0- - 9,000 -0- 9,001 - 10,200
60 -0- 10,201 - 11,400 150 80 -0- 11,401 - 12,600 190 170 100 -0- 12,601 -
13,800 220 190 170 140 -0- 13,801 - 15,000 260 230 200 180 160 -0- 15,001 -
16,200 300 270 240 210 180 160 -0- 16,201 - 17,400 340 310 280 250 220 190 160
-0- 17,401 - 18,600 380 350 320 290 260 230 200 170 -0- 18,601 - 19,800 420 390
360 330 300 270 240 210 180 -0- 19,801 - 21,000 470 440 410 380 350 320 290 260
230 200 -0- 21,001 - 22,200 520 480 450 420 380 350 320 280 250 220 180 -0-
22,201 - 23,400 570 530 500 460 430 400 360 330 290 260 220 190 23,401 - 24,600
620 590 550 510 480 440 410 370 340 300 270 230 24,601 - 25,800 680 640 600 570
530 490 460 420 380 350 310 270 25,801 - 27,000 730 700 660 620 580 540 510 470
430 390 360 320 27,001 - 28,200 790 750 710 680 640 600 560 520 480 440 400 370
28,201 - 29,400 850 810 770 730 690 650 610 580 540 500 460 420 29,401 - 30,600
920 880 830 790 750 710 670 630 590 550 510 470 30,601 - 31,800 980 940 900 860
810 770 730 690 650 610 560 520 31,801 - 33,000 1050 1010 960 920 880 830 790
750 710 660 620 580 33,001 - 34,200 1120 1070 1030 990 940 900 850 810 770 720
680 640 34,201 - 35,400 1190 1140 1100 1050 1010 960 920 880 830 790 740 700
35,401 - 36,600 1260 1220 1170 1130 1080 1030 990 940 900 850 800 760 36,601 -
37,800 1340 1290 1240 1200 1150 1100 1060 1010 960 920 870 820
(2) The department will adjust the family
participation amount determined under (1) of this subsection according to the
election district in which the custodial parent or guardian of the child has
his or her residence for voting purposes. The department will multiply the
family participation amount by the following factors:
Residence in Election District Factor District 1 1.45 2
1.15 3 1.40 4 1.40 5 1.40 6 1.15 7 - 15 1.50 16 1.40 17 1.20 18 - 21 1.40 22
1.00 23 1.05 24 1.00 25 1.10 26 1.05 27 1.25
(3) If family size exceeds 12 members, the
department will calculate the yearly participation amount by reducing adjusted
income by $1,200 for each additional member and using the participation amount
for a family of 12 with the reduced adjusted income;
(4) If adjusted income exceeds $37,800, the
department will calculate the yearly participation amount as follows:
(A) for a household with one member, by
multiplying the adjusted income of the family by
(i) four percent for adjusted incomes that
exceed $37,800 but that do not exceed $50,000;
(ii) an additional two percent for each
$5,000 in excess of $45,001;
(B) for a household of more than one, by
subtracting $1,200 from the adjusted income of the family for each additional
member of the household and multiplying the remainder as described in (A) of
this paragraph; however, if application of this formula produces an income of
$37,800 or less, family income amount will be calculated from the chart at (1)
of this subsection rather than by multiplication as described in (A) of this
paragraph;
(5) If more
than one child in a family is eligible for services under this chapter, the
family participation amount is the same as it would be if there were only one
eligible child.
(b) The
department will determine a family's yearly adjusted income by
(1) counting all income for the 12-month
period ending with the date of application, whether earned or unearned, from
any source, including the fair market value of in-kind payments, but excluding
payments made under the Alaska Native Claims Settlement Act;
(2) subtracting all of the family's
unreimbursed expenditures for medical and dental services, and medical
insurance, including necessary transportation and temporary housing;
(3) subtracting child support and alimony
payments made by a member of the family, unless those payments were paid to or
for another family member;
(4)
subtracting child care payments that were necessary to permit a parent to work
or to meet the specialized needs of a child with a disability, unless those
payments are made to another family member;
(5) subtracting housing and travel expenses
of the child and of one other person that were incidental to securing medical
care; and
(6) subtracting any
losses of tangible personal property by the family due to fire, automobile
accident, or other casualty in excess of $5,000 in value for the 12-month
period.
(c) In
determining a family's yearly adjusted income, and in determining if
alternative resources have been exhausted, the department will consider the
income and resources of
(1) the
child;
(2) each of the child's
parents;
(3) the spouse of a
custodial parent if that person claims or has claimed, in the last year, the
child as a dependent for state or federal income tax purposes; and
(4) any other person that is financially
responsible for the child's care.
(d) Upon request of the child, of a parent of
the child, or of an applicant, and in its discretion, the department will
disregard the income resources and expenses of a parent if it finds that the
parent cannot be located or has abandoned the child, or has refused to
contribute to the support of the child. However, the department reserves the
right to recover from the parent who abandoned the child or who has refused to
contribute, any and all amounts paid as a result of the operation of this
subsection, together with any costs and interest allowed by law.
(e) The department will consider a payment by
a child or the child's family to be a payment of all or part of the family's
participation amount only if the cost paid was for a service that meets the
requirements of
7
AAC 23.150. Except as otherwise provided in this
subsection, the department will pay a cost only after the applying family has
paid the entire applicable family participation amount. In the discretion of
the department, and if the applicant agrees to a plan of financial
participation, the department will pay costs before the entire participation
amount is paid. A plan of financial participation must provide for payment by
the applying family of the entire yearly participation during the current
enrollment period of the child and must demonstrate by clear and convincing
evidence that the applying family will meet its obligations under the
plan.
(f) The department will
reduce or waive the participation amount calculated in this section if the
department, based on clear and convincing evidence, finds that the child would
otherwise die or suffer permanent, severe disability, or that the family would
suffer extreme and life-threatening privation if it met the prescribed
participation amount. The department reserves the right to recover from the
child, or the child's parent or parents, the amount of any and all benefits
paid as a result of the operation of this subsection, together with any costs
and interest prescribed by law.
(g)
The department will recalculate the family participation amount annually, and
at any time that
(1) the family's adjusted
income for a calendar quarter, determined as described in (b)(1) - (b)(6) of
this section, varies by more than 25 percent from that of the same calendar
quarter of the previous year; or
(2) the department requests that a new
financial report form be completed.
