Minnesota Administrative Rules
Agency 196 - Human Services Department
Chapter 9515 - STATE HOSPITAL ADMINISTRATION
REIMBURSEMENT FOR COST OF CARE OF PATIENTS AND RESIDENTS IN STATE FACILITIES
Part 9515.2600 - RESPONSIBLE RELATIVE'S ABILITY TO PAY
Current through Register Vol. 49, No. 13, September 23, 2024
Subpart 1. In general.
When the client is determined not to be able to pay the full cost of care, the department shall determine the ability of each responsible relative of the client to pay the amount permitted by statute.
Subp. 2. Interview.
The responsible relative shall be contacted to obtain and verify financial information.
Subp. 3. Insurance benefits.
The responsible relative shall inform the department about dependent benefits from hospital and medical insurance carried by the relative.
Dependent benefits to a client shall be considered the same as the client's insurance.
Any difference between benefits to a client and others covered by the responsible relative's policy shall be verified.
The responsible relative shall complete and sign the forms necessary to verify eligibility for benefits and assign benefits to pay the cost of care of the client.
The amount of the premium paid by the responsible relative may be deducted from the responsible relative's total obligation to pay.
Subp. 4. Liability of responsible relatives.
When the sum of the benefits described in subpart 3 and the client's other resources pay less than the full cost of care, the ability of each responsible relative to pay shall be determined in the statutory order of liability for cost of care. When two responsible relatives have the same order of liability for cost of care, a determination shall be made for each one except that a joint determination shall be made for parents who reside in the same household.
Subp. 5. Limitations on relative's ability to pay.
The ability of a responsible relative to pay shall be determined from the annual gross earnings of the responsible relative subject to the following limitations:
Subp. 6. Determination of relative's ability to pay.
A responsible relative who provides the department the information, documents, and proofs necessary to determine ability to pay as provided in part 9515.1500, items F and G shall have his or her ability to pay determined from the table in subpart 8. For purposes of this table, household size consists of the responsible relative and the responsible relative's dependents living in the responsible relative's household, other than the client.
A responsible relative who chooses not to provide the department the information, documents, and proofs necessary to determine ability to pay as provided in part 9515.1500, items F and G may be determined liable for the full cost of care.
Subp. 7. Purpose of table.
The table in subpart 8 shall be used to determine a relative's ability to pay, as described in subpart 6. When there is a change in the cost of care, the department shall revise subpart 8. Adjustments shall be made according to the following formula: at each level of annual gross earnings, daily payments equal to ten percent of the cost of care for the previous year shall be adjusted to equal either the daily payment at the next lower level of earnings plus 25 percent, or ten percent of the cost of care for the current year, whichever is less; successive levels of earnings shall be added to subpart 8 if needed to incorporate daily payments up to ten percent of the cost of care for the current year; the daily payment of a responsible relative whose earnings are above these levels shall be at ten percent of the current cost of care.
Subp. 8. Daily payment based on ability to pay according to household size and annual gross earnings of responsible relatives.
Annual Gross Earnings of Responsible Relative | ||||||||||
Household Size | ||||||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | |
11,000- 11,999 | .33 | 0 | ||||||||
12,000- 12,999 | .45 | .33 | 0 | |||||||
13,000- 13,999 | .57 | .45 | .33 | 0 | ||||||
14,000- 14,999 | .72 | .57 | .45 | .33 | 0 | |||||
15,000- 15,999 | .87 | .72 | .57 | .45 | .33 | 0 | ||||
16,000- 16,999 | 1.05 | .87 | .72 | .57 | .45 | .33 | 0 | |||
17,000- 17,999 | 1.23 | 1.05 | .87 | .72 | .57 | .45 | .33 | 0 | ||
18,000- 18,999 | 1.45 | 1.23 | 1.05 | .87 | .72 | .57 | .45 | .33 | 0 | |
19,000- 19,999 | 1.81 | 1.45 | 1.23 | 1.05 | .87 | .72 | .57 | .45 | .33 | 0 |
20,000- 20,999 | 2.26 | 1.67 | 1.45 | 1.23 | 1.05 | .87 | .72 | .57 | .45 | .33 |
21,000- 21,999 | 2.82 | 1.92 | 1.67 | 1.45 | 1.23 | 1.05 | .87 | .72 | .57 | .45 |
22,000- 22,999 | 3.52 | 2.17 | 1.92 | 1.67 | 1.45 | 1.23 | 1.05 | .87 | .72 | .57 |
23,000- 23,999 | 4.41 | 2.45 | 2.17 | 1.92 | 1.67 | 1.45 | 1.23 | 1.05 | .87 | .72 |
24,000- 24,999 | 5.51 | 3.06 | 2.45 | 2.17 | 1.92 | 1.67 | 1.45 | 1.23 | 1.05 | .87 |
25,000- 25,999 | 6.89 | 3.82 | 2.75 | 2.45 | 2.17 | 1.92 | 1.67 | 1.45 | 1.23 | 1.05 |
26,000- 26,999 | 8.61 | 4.77 | 3.05 | 2.75 | 2.45 | 2.17 | 1.92 | 1.67 | 1.45 | 1.23 |
27,000- 27,999 | 10.76 | 5.96 | 3.37 | 3.05 | 2.75 | 2.45 | 2.17 | 1.92 | 1.67 | 1.45 |
28,000- 28,999 | 13.45 | 7.46 | 4.21 | 3.37 | 3.05 | 2.75 | 2.45 | 2.17 | 1.92 | 1.67 |
29,000- 29,999 | 16.81 | 9.32 | 5.26 | 3.72 | 3.37 | 3.05 | 2.75 | 2.45 | 2.17 | 1.92 |
30,000- 30,999 | 21.01 | 11.65 | 6.57 | 4.07 | 3.72 | 3.37 | 3.05 | 2.75 | 2.45 | 2.17 |
31,000- 31,999 | 23.30 | 14.56 | 8.21 | 4.45 | 4.07 | 3.72 | 3.37 | 3.05 | 2.75 | 2.45 |
32,000- 32,999 | 26.29 | 18.20 | 10.26 | 4.83 | 4.45 | 4.07 | 3.72 | 3.37 | 3.05 | 2.75 |
33,000- 33,999 | 27.15 | 22.75 | 12.83 | 6.03 | 4.83 | 4.45 | 4.07 | 3.72 | 3.37 | 3.05 |
34,000- 34,999 | 27.15 | 27.15 | 16.04 | 7.53 | 5.25 | 4.83 | 4.45 | 4.07 | 3.72 | 3.37 |
35,000- 35,999 | 27.15 | 27.15 | 20.05 | 9.41 | 5.67 | 5.25 | 4.83 | 4.45 | 4.07 | 3.72 |
36,000- 36,999 | 27.15 | 27.15 | 25.06 | 11.76 | 6.12 | 5.67 | 5.25 | 4.83 | 4.45 | 4.07 |
37,000- 37,999 | 27.15 | 27.15 | 27.15 | 14.70 | 7.56 | 6.12 | 5.67 | 5.25 | 4.83 | 4.45 |
38,000- 38,999 | 27.15 | 27.15 | 27.15 | 18.38 | 9.45 | 7.56 | 6.12 | 5.67 | 5.25 | 4.83 |
39,000- 39,999 | 27.15 | 27.15 | 27.15 | 22.96 | 11.81 | 9.45 | 7.56 | 6.12 | 5.67 | 5.25 |
40,000- 40,999 | 27.15 | 27.15 | 27.15 | 27.15 | 14.76 | 11.81 | 9.45 | 7.56 | 6.12 | 5.67 |
41,000- 41,999 | 27.15 | 27.15 | 27.15 | 27.15 | 18.45 | 14.76 | 11.81 | 9.45 | 7.56 | 6.12 |
42,000- 42,999 | 27.15 | 27.15 | 27.15 | 27.15 | 23.06 | 18.45 | 14.76 | 11.81 | 9.45 | 7.56 |
43,000- 43,999 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 23.06 | 18.45 | 14.76 | 11.81 | 9.45 |
44,000- 44,999 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 23.06 | 18.45 | 14.76 | 11.81 |
45,000- 45,999 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 23.06 | 18.45 | 14.76 |
46,000- 46,999 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 23.06 | 18.45 |
47,000- 47,999 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 23.06 |
48,000- 48,999 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 | 27.15 |
Subp. 9. Maximum rate.
When the annual gross earnings exceed the amount shown in the table in subpart 8, the daily payment shall be at the statutory limitation of ten percent of the cost of care.
Subp. 10. Verification of financial information.
The annual gross earnings of a relative and the number of dependents of a relative shall be verified from the relative's Minnesota state income tax return or, in the case of a relative who is not a resident of Minnesota and does not file a Minnesota state income tax return, from the United States income tax return.
The amount of the premium paid by the relative to provide dependent hospital and medical insurance coverage for the client shall be verified.
Subp. 11. Clothing and personal needs allowance of a minor.
The parents of a client who is an unmarried, dependent child are responsible for meeting the child's clothing and personal needs allowance in addition to the amount they are determined able to pay to meet the cost of care.
Statutory Authority: MS s 246.01; 246.23; 246.50 to 246.55