651 CMR, § 5.14 - Financial Eligibility and Costs for Certain Services
(1) Protective Services Casework shall be
provided to Eligible Elders regardless of income.
(2)
Costs and Eligibility of
Other Protective Services.
(a)
Home Care Services that may be provided under the Commonwealth's Home Care
Program shall be subject to the financial eligibility and Cost Sharing Program
requirements set forth in
651
CMR 3.00: Home Care
Program.
(b) Home Care
Services that may be provided under the Commonwealth's Home Care Program shall
be subject to the criteria established by the Home Care Program as set forth in
651
CMR 3.00: Home Care
Program.
(c) Home Care
Program Respite Services shall be subject to the Respite Care Program
requirements and copayment criteria set forth in
651
CMR 3.00: Home Care
Program.
(3) An
Eligible Elder whose Protective Services plan requires Home Care Services and
whose annual gross income is above the Cost Sharing Program income limits for
the Home Care Program shall be assisted with private payment arrangements with
private providers of the needed services.
(4) In situations in which the Protective
Services Caseworker and the Protective Services Supervisor have determined that
private payment arrangements will have an adverse effect on the provision of
Protective Services to the Elder, the executive director of the Home Care
Program may approve Home Care Program Services subject to the following
requirements:
(a) The Eligible Elder shall be
charged the full cost of those services.
(b) Reasonable efforts shall be made to
implement private payment arrangements.
(5) No Eligible Elder shall be required to
reimburse the Department for all or part of the cost of Protective Services
unless she/he has been notified prior to the start of services that a
reimbursement will be charged.
(6)
If in the judgment of the Department or a Protective Services Agency,
discussion of financial eligibility and/or payment of fees would have an
adverse effect upon the provision of Protective Services, no such discussion
shall be required and no bill shall be sent to the Eligible Elder subject to
the following requirements:
(a) Supervisory
approval of the determination of adverse effect shall be documented in the case
record.
(b) Reasonable efforts to
discuss financial eligibility and to collect such copayments or charges shall
be made on a monthly basis following the provision of services.
(7) Services other than Protective
Services Casework, Home Care Services and/or Respite Care shall be provided or
arranged for by a Protective Services Agency subject to appropriation, and
subject to the financial and other eligibility criteria of the government
agency or private organization providing such service(s).
Notes
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