(1) no cost-sharing will be charged clients whose income is at or below 150 percent of poverty levels specified by the office (unless they are eligible for Medicaid);

(2) the full cost of services will be charged clients whose income is at or above 250 percent of poverty levels specified by the office and clients who are eligible for Medicaid;

(3) partial cost-sharing will be charged clients whose income is between 150 percent and 250 percent of poverty levels specified by the office; and

(4) no cost-sharing will be charged clients for durable items provided on a loan basis as an ancillary service.

(1) includes, to the extent available, income of the client's spouse if the client is living with his or her spouse; and

(2) equals monthly income minus the threshold and the housing adjustment;

(1) The adjusted cost of an in-home, ancillary, or noninstitutional respite service equals the number of units received by the client under the care plan multiplied by the unit cost for the service under the county's approved county home care plan for functionally impaired elderly (or, if no such cost is stated in the plan, the actual cost incurred in providing or purchasing the service for the client) or, for clients required to pay less than the full cost of the service, by the lesser of the unit cost specified in such approved plan (or, if none, the actual cost incurred) or the statewide average unit cost of the service, if any, as specified by the office.

(2) The percentage of cost to be charged a client shall be determined according to the client's adjusted monthly income in accordance with the current cost-share schedule specified by the office. The cost-share schedule is adjusted regularly by the office to reflect changes in the consumer price index for all items, between the third quarters of the preceding two calendar years. At the time these regulations were originally promulgated, the cost-share schedule for clients living with spouses whose income was available to meet their needs (designated as couples) and for all other clients (designated as individuals) was as follows:

(1) declare sources and amounts of income of the client and, for clients living with their spouse, of the spouse of which the client is aware or which are available to meet the needs of the client;

(2) provide information necessary for assessing potential Medicaid eligibility;

(3) sign a statement prescribed by the office attesting to the truthfulness of declarations and agreeing to provide supporting documentation upon request;

(4) sign a cost sharing agreement promising to pay the required cost sharing and to notify the case manager or designated case management staff of any changes in income or expenses that would affect the amount of cost sharing required of the client; and

(5) to receive a housing adjustment, declare the kind, amount, and recipient of housing expenses.

(1) shall ensure that clients or their authorized representatives receive assistance as requested by clients or representatives in reviewing financial documents;

(2) shall sign the cost-sharing agreement attesting that the information contained therein is consistent with information provided by the client or his or her authorized representative and with any other available information;

(3) may require the client or his or her authorized representative to provide documentation to verify the accuracy of declarations;

(4) shall ensure the computation of cost sharing and the execution of a cost sharing agreement in accordance with this section and section 6654.16 of this Part;

(5) shall ensure that no cost sharing is required for services not received by a client or received prior to the cost sharing determination pursuant to this section; and

(6) shall ensure that the client's cost-sharing obligations are redetermined and a new cost-sharing agreement is developed if requested by the client or his or her authorized representative or if there is a change in in-home, ancillary, or noninstitutional respite services to be provided the client under the care plan; the client's adjusted monthly income; or the status of the client in a way that may affect the terms of the cost-sharing agreement, including new medical expenses that could make the client eligible for Medicaid. A redetermination shall not be required solely by reason of changes in the schedule of unit costs, cost share schedule, thresholds, of the client's monthly income resulting from cost of living adjustments in social security old-age, survivors, and disability insurance benefits or other income subject to periodic adjustments based on the cost of living, consumer price index, or similar measures.

(1) clearly present the responsibilities of the client for payment of cost sharing, including payment schedules, billing practices and payment procedures;

(2) describe the client's liability for the payment of cost sharing, including:

(3) be modified or replaced when a redetermination of cost sharing is conducted; and

(4) not be presented to the client or his or her authorized representative for signature until such person has been informed in writing of policies and procedures governing payment, redetermination and nonpayment of cost sharing, including the right to a redetermination or a hearing regarding the extent of cost sharing required of the client.

(1)

(2) designating authorized staff or agents to receive such cost sharing on behalf of the area agency;

(3) including the submission to the office for prior approval policies and procedures or actions for collecting cost sharing due but not paid by clients under cost-sharing agreements and for discharging clients due to nonpayment of cost sharing, providing that: