37.30.405    VOCATIONAL REHABILITATION PROGRAM: PAYMENT FOR SERVICES

(1) The consumer, except as otherwise specifically authorized in this subchapter, is responsible for paying the costs for the provision of any vocational rehabilitation services that are authorized to be provided to the consumer through the consumer's IPE.

(2) An applicant or a consumer is not responsible for paying the costs for the provision of the following vocational rehabilitation services:

(a) assessment for determining eligibility and priority for vocational rehabilitation services except for trial work experience type services provided to a person with a significant disability during an exploration of the person's abilities, capabilities and capacity to perform in work situations;

(b) vocational rehabilitation counseling and guidance;

(c) referral and related services;

(d) job development and placement related services;

(e) personal assistance services; and

(f) any auxiliary aid or service or other rehabilitation technology, including reader services, that the department determines a person with a disability may require in order to apply for or receive vocational rehabilitation services.

(3) A consumer who is eligible for Social Security Old Age, Survivors and Disability Insurance (OASDI) or Supplemental Security Income (SSI) benefits under Titles II and XVI of the Social Security Act is not responsible for paying the costs for the provision of any services that are authorized to be provided to the consumer through the consumer's IPE.

(4) The department may pay for the costs for the provision of any services that are authorized to be provided to the consumer through the consumer's IPE to the extent that the consumer's income and financial resources, determined as provided in this rule and ARM 37.30.407, do not exceed the maximum amounts allowable for income and for financial resources calculated by the department as provided for in (4)(a) and (b).

(a) The maximum allowable level for income is a prospective 12 month annual income calculated at 250% of the 2014 U.S. Department of Health and Human Services poverty guidelines for households of different sizes.

(b) The maximum allowable value for financial resources is calculated at 50% of the maximum allowable annual income level.

(5) The department does not pay for the costs for the provision of any services that are authorized to be provided to the consumer through the consumer's IPE to the extent that those costs are reimbursable through another governmental program or there is another source of funding that is available to be applied to the costs of all or a portion of the services.

(a) If benefits from any other program or other sources of funding are not immediately available for the payment of any or all of the costs of services for the consumer, the department may temporarily pay for the costs for the provision of services until those other benefits or other sources of funding become available.

(b) If the determination of the availability of benefits or other sources of funding would delay the provision of vocational rehabilitation services to a consumer who is at extreme medical risk or who is to receive an immediate job placement opportunity, the department may temporarily pay for the costs for the provision of services until those other benefits become available. The department makes the determination of extreme medical risk based upon medical evidence provided by an appropriate licensed professional.

(6) The responsibility of a consumer for the payment of the costs for the provision of services is initially determined by the department prior to the provision to the consumer of any services listed in the consumer's IPE.

(a) The financial responsibility of a consumer is redetermined at any time that there is a change in the income and resources available to the consumer.

History: 53-7-102, 53-7-206, 53-7-315, MCA; IMP, 53-7-102, 53-7-105, 53-7-108, 53-7-205, 53-7-310, MCA; NEW, 1982 MAR p. 1287, Eff. 7/1/82; AMD, 1996 MAR p. 1320, Eff. 5/10/96; TRANS, from SRS, 1998 MAR p. 2040; AMD, 2002 MAR p. 3628, Eff. 12/27/02; AMD, 2004 MAR p. 1789, Eff. 8/6/04; AMD, 2006 MAR p. 1892, Eff. 7/28/06; AMD, 2007 MAR p. 860, Eff. 6/22/07; AMD, 2008 MAR p. 953, Eff. 5/9/08; AMD, 2009 MAR p. 941, Eff. 6/12/09; AMD, 2013 MAR p. 789, Eff. 5/10/13; AMD, 2014 MAR p. 978, Eff. 5/9/14.