Wis. Admin. Code Department of Health Services DHS 1.065 - Children's long-term support parental payment limits

(1) AUTHORITY, PURPOSE AND SCOPE.
(a) This section establishes a parental payment limit for certain children's long-term support services identified in this subsection. These provisions apply to all county administrative agencies that administer the services to which this section applies.
(b) This section applies to children's services of a type that may be reimbursed under a waiver under the disabled children's long-term support program as defined in s. 46.011 (1g), Stats., regardless of whether those services are actually reimbursed under that program, under the community integration program waivers under s. 46.275, 46.277 or 46.278, Stats., or otherwise with federal, state or county funds.
(c) This section applies to services for children under the children's community options program under s. 46.272, Stats.
(2) DEFINITIONS. In this section:
(a) "County administrative agency" means the county department designated to administer and provide or contract for children's services covered by this section in that county.
(b) "Service plan" means a written plan for providing services covered by this section.
(3) DETERMINING PARENTAL PAYMENT LIMITS. The county administrative agency shall determine the parental payment limit for each child receiving services covered by this section. The county administrative agency shall determine the parental payment limit for services covered by this section in the following manner:
(a) Determine the annual parental income. If the parents live in separate households and the child receiving services covered by this section resides in both households, determine a separate parental payment limit for each household.
(b) Subtract the higher of the following:
1. The department's standard disability allowance.
2. Allowable medical or dental expenses claimed for the child on schedule A of the parent's most recent internal revenue service tax form 1040 that was filed with the internal revenue service.

Note: The Internal Revenue Service (IRS) has a web-based guide to assist in identifying which expenses may be claimed to Schedule A of the 1040 form for allowable medical and dental expenses that would qualify as itemized deductions. Please see IRS Publication 502 at the following address http://www.irs.gov/publications/p502/index.html

Note: The Department's standard disability allowance can be found on the Department's website at http://www.dhs.wisconsin.gov/children/clts/ppl/index.htm.

(c) Determine the federal poverty level based on current federal poverty guidelines for the family size. If the parents live in separate households and the child resides in both households, determine the family size and federal poverty level for each household.
(d) Determine whether the income, adjusted as provided in under par. (b) is at or above 330% of the federal poverty level and identify the percentage of the annual service plan costs owed based on the most current Children's Long-term Support Parental Payment Limit Worksheet provided by the department. Use Table DHS 1.065 to determine the percentage of service plan costs for which the parents may be liable.

Adjusted Gross Income (% of FPL)

Percentage of Service Plan Cost

Less than 300% FPL

0.0%

330%

to less than

355%

1.0%

355%

to less than

380%

1.8%

380%

to less than

405%

2.6%

405%

to less than

430%

3.4%

430%

to less than

455%

4.2%

455%

to less than

480%

5.0%

480%

to less than

505%

5.8%

505%

to less than

530%

6.6%

530%

to less than

555%

7.4%

555%

to less than

580%

8.2%

580%

to less than

605%

9.0%

605%

to less than

630%

9.8%

630%

to less than

655%

10.6%

655%

to less than

680%

11.4%

680%

to less than

705%

12.2%

705%

to less than

730%

13.0%

730%

to less than

755%

13.8%

755%

to less than

780%

14.6%

780%

to less than

805%

15.4%

805%

to less than

830%

16.2%

830%

to less than

855%

17.0%

855%

to less than

880%

17.8%

880%

to less than

905%

18.6%

905%

to less than

930%

19.4%

930%

to less than

955%

20.2%

955%

to less than

980%

21.0%

980%

to less than

1005%

21.8%

1005%

to less than

1030%

22.6%

1030%

to less than

1055%

23.4%

1055%

to less than

1080%

24.2%

1080%

to less than

1105%

25.0%

1105%

to less than

1130%

25.8%

1130%

to less than

1155%

26.6%

1155%

to less than

1180%

27.4%

1180%

to less than

1205%

28.2%

1205%

to less than

1230%

29.0%

1230%

to less than

1255%

29.8%

1255%

to less than

1280%

30.6%

1280%

to less than

1305%

31.4%

1305%

to less than

1330%

32.2%

1330%

to less than

1355%

33.0%

1355%

to less than

1380%

33.8%

1380%

to less than

1405%

34.6%

1405%

to less than

1430%

35.4%

1430%

to less than

1455%

36.2%

1455%

to less than

1480%

37.0%

1480%

to less than

1505%

37.8%

1505%

to less than

1530%

38.6%

1530%

to less than

1555%

39.4%

1555%

to less than

1580%

40.2%

1580% and above

41.0%

Note: The federal poverty guidelines are adjusted yearly by the federal Office of Management and Budget under 42 USC ยง 9902 (2) and are published annually in the Federal Register. The federal poverty guidelines and the CLTS Parental Payment Limit Worksheet are distributed annually by the Department to counties for use in calculating the parental payment limit. To receive the current federal poverty guidelines and the CLTS Parental Payment Limit Worksheet, contact the Division of Medicaid Services, P.O. Box 7851, Madison, WI 53707-7851, or visit the Department's website at http://www.dhs.wisconsin.gov/children/clts/ppl/index.htm.

(e) Compute the annual cost of the child's service plan. Subtract administrative and support and service coordination functions.
(f) For families with an income over 330% of the federal poverty level, multiply the percentage established in par. (d) by the amount established in par. (e).
(3m) AMENDING CALCULATED PAYMENT LIMITS.
(a) The parental payment limit is the amount calculated under sub. (3) (f).
(b) If a parent refuses to provide financial information to the administering agency, then their parental payment limit shall be 41% of the annual cost of the child's service plan.
(c) A county may consider a family's financial hardship when determining the parental payment limit.
(4) NOTIFICATION OF PARENTAL FINANCIAL OBLIGATION. The county administrative agency shall provide written notice to the parents of the amount of annual parental financial obligation due before the service plan is implemented, or as soon thereafter as administratively possible, that includes all of the following:
(a) The date of the implementation of the parental financial obligation, which is the start date on the service plan.
(b) The annual amount due, with a breakdown of monthly minimum requirements.
(c) Procedures offered by the county administrative agency for reconsideration of the parental financial obligation.

Notes

Wis. Admin. Code Department of Health Services DHS 1.065
CR 08-017: cr. Register June 2008 No. 630, eff. 7-1-08. Amended by, corrections in (1) (c) (note) made under s. 13.92(4) (b) 7, Stats., Register February 2017 No. 734, eff. 3/1/2017 Amended by, CR 19-020: am. (1) (c) Register December 2019 No. 768, eff. 1/1/2020 Amended by, CR 23-046: am. (1) (b), (3) (intro.) Register April 2024 No. 820, eff. 5-1-24; correction in (1) (b) made under s. 35.17, Stats., Register April 29 No. 820, eff. 5/1/2024

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