The Arc of Minnesota - Position Statement on Parental Fees

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Position Statement on Parent Fees

Recommendation: The Arc of Minnesota Position Statements Task Force recommends that this revised position statement be renewed in 2002.

Issue: Families with private health care coverage pay a premium for insurance, and are assessed an additional state fee to use TEFRA (Tax Equity and Fiscal Responsibility Act/Children's Home Health Care Option), the Medical Assistance Waiver programs, or out-of-home residential care. Often times parents aren't notified of the state fee or don't know what it will be when they apply for support services. The administration of the parental fee process is often unresponsive when parents question the amount of the assessed or owed fee.

Position: The overriding consideration in setting fees for parents who have children with developmental disabilities is that each child should be able to receive all needed services in a timely manner, without forced disintegration or impoverishment of the family. Public policy must support this goal.

At the time of application for services and at the time of each annual fee recomputation, families must be given complete information in plain language regarding the amount of the fee assessed, details of how the fee was computed, complete information regarding all variances available, instructions about how to apply for any variance and the documentation required and, finally, a full explanation in plain language of their rights to appeal any state or county decision regarding their fee. The state or county should address any problems in variances raised due to the difference between the family's annual tax year and the state's fiscal year. All requests for variances should be acted upon within 30 days or within the time specified in the regulations if that time is shorter than 30 days.

Families must be treated in a respectful and dignified manner. Information accumulated concerning the finances of a family or individual should be treated by the county or state with appropriate confidentiality. No Minnesotan should be denied needed services by intimidation, lack of knowledge, or poor follow-through by the person receiving or processing the family's request for assistance.

Fees assessed to families must be at a level that is affordable so that the family does not fail to use needed services because they cannot afford the payment. Any parental fee schedule must allow deductions for payments families are making for services and supports for their children with disabilities. The schedule must also allow variances for extraordinary out-of-pocket expenses related to any family member.

A parental fee schedule should also include the following components:

There should not be income limits established for families in order for their children to be eligible for services. Children should qualify for services based on their disabilities.
Families who earn less than 300% of the federal poverty level should not be required to pay parental fees.*
When a child reaches the age of legal majority, all compulsory support from parents should end.
Families must not be subjected to multiple fee schedules within the social services system. A statewide fee schedule should be used. Families who have more than one child with a disability should only be assessed a fee equal to that for one child.
Fees imposed should be based on parental income rather than the disability level of the child.
Fees should not exceed the cost of the services received. When they do the State should reimburse the family for the difference within 30 days of the end of the fiscal year.
Fee schedules should be progressive.
The number of family members considered within the parent fee formula should correlate to the number identified on the family's federal income tax return form.
The parental fee system should not be replaced with a premium-based system as used by insurance companies.
The parental fee system must allow continued coverage if payments are missed or late and must provide a period of retroactive coverage to prevent impoverishment of families.
The in-home credit used in the current parental fee scale should be substantially increased and indexed to inflation on an annual basis.

* The 2002 Federal Poverty level is $18,100 for a family of four. Add or subtract $3,080 for each additional or fewer family members.

Approved by the delegate body at The Arc of Minnesota's Annual Meeting on September 21, 2002

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