§3030c–2 Consumer Contributions

Summary

States may make older people pay part of the cost for services paid under this law, but only with limits. They cannot charge for help with information, outreach, benefits counseling, or case management; for ombudsman, elder-abuse prevention, legal help, or other consumer-protection work; for congregate or home-delivered meals; or for any services run by tribal organizations. States must not charge anyone whose income is at or below the Federal poverty line, and they may choose to exempt other low-income people. States may not look at a person’s assets, savings, or property when deciding who is low income, setting a sliding scale, or asking for payments. Any sliding scale must be based only on each person’s income and the service cost. Area agencies on aging and providers must keep income and payment details private, safely handle money, use collected payments to expand the same service, not cut off services because someone can’t or won’t pay, accept a confidential self-declared income without requiring proof, and give clear written materials in appropriate languages and reading levels. Area agencies can ask for a waiver of state cost-sharing rules if many clients are below the state income threshold or if cost-sharing is an unreasonable burden. Voluntary contributions are allowed if asking is not coercive. Contributions are encouraged for people with self-declared income at or above 185 percent of the poverty line and should match actual service costs. Local agencies must work with providers and older people to decide how to take contributions. They must not means-test services that accept contributions or deny help to people who do not give money. Collected contributions must be private, properly accounted for, used to expand services, and only add to—not replace—federal funds. States and area agencies must hold public hearings and make plans to make sure low-income, minority, limited-English, and rural older people do not lose access when cost sharing starts. The Assistant Secretary must evaluate cost-sharing each year starting November 13, 2000, and require fixes if low-income, minority, or rural older people are hurt. States must share any written policies with area agencies if asked, but they are not required to write new policies.