Subpart 1.
Services exempted from financial participation.
Regardless of
an eligible individual's family income, SSB must not require eligible
individual financial participation for the following services:
A. diagnostic assessment services except
those services provided under an extended evaluation or trial work experience
that are not diagnostic in nature;
B. vocational rehabilitation counseling and
other adjustment to blindness services;
C. job-related services;
D. referral services;
E. interpreter and note-taking
services;
F. low vision services,
including closed circuit televisions, up to a cumulative value of
$500;
G. communication center
services;
H. maintenance or
transportation services needed by an eligible individual to obtain adjustment
to blindness services;
I. reader
services;
J. rehabilitation
technology, other than technology which can be classified as low vision aids,
up to a cumulative value of $3,000; and
K. postemployment services consisting of the
services identified in this subpart.
Subp. 2.
Services subject to financial
participation.
Based on an eligible individual's family income, an
eligible individual may be required to participate in paying the cost of all
rehabilitation services not exempted from financial participation under subpart
1.
Subp. 3.
Basis for determining the
degree of financial participation required.
The degree of financial
participation required of an eligible individual is determined on the basis of
the eligible individual's monthly and annual family income in relation to the
most recent estimate of Minnesota median income levels as adjusted for family
size using the adjustment methodology specified in the Code of Federal
Regulations, title 45, section 96.85. This estimate is published annually by
the United States Department of Health and Human Services in the Federal
Register. The applicable sections of the Federal Register are incorporated by
reference.
Subp. 4.
No required financial participation.
The following eligible
individuals are exempt from financial participation:
A. an eligible individual whose monthly
family income is equal to or less than the state median monthly income as
adjusted for family size;
B. an
eligible individual who has been determined eligible for Social Security
benefits based on the individual's own disability under Title II or XVI of the
Social Security Act consistent with Code of Federal Regulations, title 34,
section 361.54(b)(3)(ii); or
C. an
eligible individual who had been determined eligible for an individual or
family means-tested public assistance program of the Department of Human
Services.
Subp. 5.
Financial participation required.
An eligible individual
whose monthly family income is more than the state median monthly income as
adjusted for family size must pay for rehabilitation services provided under
the eligible individual's IPE an amount equal to the percentage by which the
eligible individual's family income exceeds the adjusted median income.
Example: If an eligible individual's monthly family income exceeds the state
median monthly income adjusted for the eligible individual's family size by ten
percent, the eligible individual must pay ten percent of the cost of
rehabilitation services provided under the eligible individual's IPE; SSB would
pay 90 percent.
Subp. 6.
[Repealed, 36 SR 33]
Subp. 7.
Variance.
An eligible individual who is unable to pay for
rehabilitation services to the extent required by subparts
4 and
5 because of unusual
financial circumstances in relation to family income may apply to the director
for a variance in the determination of the eligible individual's required
financial participation as follows:
A.
A request for a variance must be submitted in writing by the eligible
individual or the eligible individual's designated representative. The request
must provide the director with evidence describing the eligible individual's
unusual financial situation. If additional information is required by the
director to determine eligibility for a variance, SSB must, within 15 calendar
days after receiving the written request, inform the eligible individual in
writing of the specific additional information required.
B. The director must determine whether the
eligible individual is eligible for a variance and notify the eligible
individual of the determination in writing within 30 calendar days after the
director receives all the information required under item A. The written
notification must:
(1) specify whether the
eligible individual is eligible for a variance;
(2) indicate the reasons for the
determination;
(3) specify the
amount of the variance, if any;
(4)
inform the eligible individual of review and appeal rights under part
3325.0478; and
(5) be signed and dated by the
director.
C. The
director must grant a variance only if the eligible individual demonstrates
that it would be impossible for the eligible individual to make the cost
contributions required under subparts
5 and
6 without using the eligible
individual's savings because of:
(1) court
ordered financial obligations of the eligible individual;
(2) legal financial obligations incurred by
the eligible individual prior to being found eligible to receive rehabilitation
services from SSB; or
(3)
extraordinary expenditures for necessities such as food, shelter, clothing, or
medical care the eligible individual is required to make because of illness or
disability.
D. The
director must determine the amount of an eligible individual's variance by:
(1) calculating the sum of the eligible
individual's financial obligations and extraordinary expenditures identified in
item C which make it impossible for the eligible individual to make the cost
contributions required under subparts
5 and
6; and
(2) subtracting that sum from the financial
participation amount the eligible individual would have to pay without the
variance.
E. An eligible
individual who receives a variance must immediately notify the director in
writing if the eligible individual's financial situation improves.
F. The director may review the financial
situation of an eligible individual who receives a variance at any time to
determine whether the eligible individual's financial situation continues to
justify the variance.
Subp.
8.
Income verification.
If an eligible
individual's employment plan includes or is expected to include rehabilitation
services other than those identified in subpart
1, the eligible individual
must provide SSB with written verification of the eligible individual's most
recent annual family income and sources of income.
Subp. 9.
Annual
redetermination.
SSB must redetermine at least annually, the
financial need of each eligible individual.
Subp. 10.
One source payments;
conditions and reimbursement.
If purchasing services for an
eligible individual who is subject to financial participation from a vendor
that requires payment from one source (e.g., any Visa purchase) SSB must
authorize for the full amount after first receiving the eligible individual's
required financial participation.
