Financial Eligibility and Costs for Certain Services

(1) Protective Services Casework shall be provided to Eligible Elders regardless of income. (2) Costs and Eligibility of Other Protective Services. (a) Home Care Services that may be provided under the Commonwealth's Home Care Program shall be subject to the financial eligibility and Cost Sharing Program requirements set forth in 651 CMR 3.00: Home Care Program. (b) Home Care Services that may be provided under the Commonwealth's Home Care Program shall be subject to the criteria established by the Home Care Program as set forth in 651 CMR 3.00: Home Care Program. (c) Home Care Program Respite Services shall be subject to the Respite Care Program requirements and copayment criteria set forth in 651 CMR 3.00: Home Care Program. (3) An Eligible Elder whose Protective Services plan requires Home Care Services and whose annual gross income is above the Cost Sharing Program income limits for the Home Care Program shall be assisted with private payment arrangements with private providers of the needed services. (4) In situations in which the Protective Services Caseworker and the Protective Services Supervisor have determined that private payment arrangements will have an adverse effect on the provision of Protective Services to the Elder, the executive director of the Home Care Program may approve Home Care Program Services subject to the following requirements: (a) The Eligible Elder shall be charged the full cost of those services. (b) Reasonable efforts shall be made to implement private payment arrangements. (5) No Eligible Elder shall be required to reimburse the Department for all or part of the cost of Protective Services unless she/he has been notified prior to the start of services that a reimbursement will be charged. (6) If in the judgment of the Department or a Protective Services Agency, discussion of financial eligibility and/or payment of fees would have an adverse effect upon the provision of Protective Services, no such discussion shall be required and no bill shall be sent to the Eligible Elder subject to the following requirements: (a) Supervisory approval of the determination of adverse effect shall be documented in the case record. (b) Reasonable efforts to discuss financial eligibility and to collect such copayments or charges shall be made on a monthly basis following the provision of services. (7) Services other than Protective Services Casework, Home Care Services and/or Respite Care shall be provided or arranged for by a Protective Services Agency subject to appropriation, and subject to the financial and other eligibility criteria of the government agency or private organization providing such service(s).