110 Mass. Reg. 4.08A
No fee will be charged to any family whose income is at or below 150% of the federal poverty level as revised annually and published by the United States Department of Health and Human Services in the Federal Register. When determining whether a family's income falls at or below 150% of the federal poverty level the federal poverty levels for each size family will be used.
The fee for substitute care services will be calculated as follows:
Commentary. This commentary is to provide examples where the actual and reasonable expenses directly attributable to the child in placement exceed 25% of the child's SSI benefit.
Family A is composed of two parents and two children, a son and a daughter. The daughter is in residential care but returns to the family home on weekends and vacations. The family is able to demonstrate through bills, receipts; etc., that the actual expenses of the clothing, food and recreational activities for their daughter is $ 200.00 per month and that those expenses are reasonable. The daughter's SSI benefit is $ 350.00 per month. The family may receive a partial waiver of the fee by $ 112.50, the difference between $ 87.50 (an amount equal to 25% of the child's SSI benefit) and the actual cost of the child's care and expenses.
Family B is composed of a mother and her son. The son is placed in a residential program and spends weekends and vacations with his mother. When the son visits his mother a nurse is required to assist in the child's care. The nurse costs $ 75.00 per weekend for a total cost of $300.00 per month. The son receives $400.00 per month in SSI benefits. Under the Department's regulations, the mother would have paid $300.00 to DSS and would have retained an amount equal to $100.00 for the child's expenses. Upon request, the mother would receive a partial waiver of her fee by $200.00 as well as an amount equal to any other documented expenses which are reasonable and directly attributable to the child, such as those set forth in Family A.
Family C is composed of a father and a thirteen year old daughter. The daughter receives $ 375.00 in SSI benefits per month. The father uses a portion of that money to pay for a two bedroom apartment for his daughter and himself. The daughter is placed in a residential program through the Department. The father must maintain a two bedroom apartment for those times when his daughter visits on weekends and holidays. The father is able to demonstrate that the rental difference between a one bedroom and a two bedroom apartment is $150.00. Under the Department's regulations the father is requested to pay a fee of $371.25. The fee is composed of $90.00 based on the family gross income and $281.25, an amount equal to 75% of the child's SSI benefit. Upon request, the father may receive a partial waiver in the amount of $56.25, which is the difference between:
The Department's response to a request for a full or partial waiver shall be in writing. If the Department denies the request for a waiver in full or in part, the response shall include notice to the family of their right to request a fair hearing and the procedures for requesting such a hearing.
If the family requests a fair hearing, services shall not be terminated until a fair hearing is held as long as the family continues to pay all assessed fees. If the issue for the fair hearing is the denial of a request for a waiver or the amount of a partial waiver of a fee for substitute care services under 110 CMR 4.08A(7)(a) then only the undisputed portion of the fee must be paid pending the fair hearing. If the issue for the fair hearing is whether the family's income falls at or below 150% of the federal poverty level under 110 CMR 4.08(7)(b) no fee is required pending the outcome of the fair hearing. However, if the denial of the full or partial waiver or the determination that the family's income is above 150% of the federal poverty level is upheld at the fair hearing, the total fee will be applied retroactively to the date the sliding fee agreement was signed, and the family will be responsible for paying past due amounts.
Commentary. This commentary is to provide an example of a situation where a family would pay the undisputed portion of a fee pending a fair hearing on a denial of a partial waiver to the fee.
Example Family A is assessed a fee of $ 250.00 for their child's placement. The family requests and is denied a partial waiver of the fee in the amount of $ 50.00. During the pendency of the fair hearing the family would be required to pay a $ 200.00 fee, which is the undisputed portion of the total assessed fee. If the denial of the partial waiver of the fee is upheld by the fair hearing, and it had been three months since the original fee was assessed, Family A would owe the Department $150.00 for the past due amount of the fee.
110 CMR 4.08A