La. Admin. Code tit. 48 § V-3703

Current through Register Vol. 50, No. 9, September 20, 2024

Section V-3703 - Fee Adjustment Schedule

A.

1. The fee adjustment schedule is designed to provide for proportional payment of each service based on the family's ability to pay. Three variable figures are utilized in calculating the schedule:

a. United State Community Services Administration Poverty Guidelines as found in 45 CFR 1060.2 ;

b. family size; and

c. cost of service provided.

2. The client shall provide a statement of gross family size.

B. Persons whose income adjusted for family size is at or below 100 percent poverty as is defined by the United State Community Services Administration poverty guidelines shall not be responsible for payment of services. Persons whose gross family income is set at or above 250 percent poverty as is defined by the United States Community Services Administration poverty guidelines shall be charged the full cost of services provided. Between these two levels, fees shall be adjusted in accordance with the formula used in the schedule of charges included in the following revised Fee Adjustment Schedule.

Fee Adjustment Schedule
% Poverty Income Family Size	I 100% or Less No Charge	II 101%-115% 10% of Cost	III 116%-103% 20% of Cost	IV 131%-145% 30% of Cost	V 146%-160% 40% of Cost
1	6620	6686	7679	8672	9665
2	8880	8969	10301	11633	12965
3	11140	11251	12922	14593	16264
4	13400	13534	15544	17554	19564
5	15660	15817	18166	20515	22864
6	17920	18099	20787	23475	26163
7	20180	20382	23409	26436	29463
8	22440	22664	26030	29396	32762
9	24700	24947	28652	35357	36032
10	26960	27230	31274	35318	39362
11	29220	29512	33895	38278	42661
12	31480	31795	36517	41239	45961
13	33740	34077	39138	44199	19260
14	36000	36360	41760	47160	52560
15	38260	38643	44382	50121	55860
16	40520	40925	47003	53081	59159
17	42780	43208	49625	56042	62459
VI 161%-175% 50% of Cost	VII 176%-190% 60% of Cost	VIII 191%-205% 70% of Cost	IX 205%-220% 80% of Cost	X 221%-235% 90% of Cost	XI 236%-250% 100% of Cost
10658	11651	12644	13637	14630	15623
14297	15629	16961	18293	19625	20957
21574	23584	25594	27604	29614	31624
25213	27562	29911	32260	34609	36958
28851	31539	34227	36915	39603	42291
32490	35517	38544	41571	44598	47625
36128	39494	42860	46226	49592	52958
39767	43472	47177	50882	54587	58292
43406	47450	51494	55538	59582	63626
47044	51427	55810	60193	64576	68959
50683	55405	60127	64849	69571	74293
54321	59382	64443	69504	74565	79626
57960	63360	68760	74160	79560	84960
61599	67338	73077	78816	84555	90294
65237	71315	77393	83471	89549	95627
68876	75293	8170	88127	94544	100961

La. Admin. Code tit. 48, § V-3703

Promulgated by the Department of Health and Human Resources, Office of Preventive and Public Health Services, LR 13:246 (April 1987), amended LR 14:534 (August 1988), LR 15:471 (June 1989), LR 16:546 (April 1990, LR 17:888 (September 1991).

AUTHORITY NOTE: Promulgated in accordance with 42 USC 300; 42 CFR Subpart A, Part 59.