Fees
for Services
by
Herbert D. Hinkle, Esq. and Ira M. Fingles, Esq.
Herbert D. Hinkle
Law Office
2651 Main Street
Lawrenceville, New Jersey 08648
(609) 896-4200 or (215) 860-2100
As many readers
are aware, several years ago, New Jersey began systematically assessing
clients in residential services a fee based on the ability to pay.
The assessment
process begins with a financial questionnaire sent to families by
a private organization called Maximus. The form is usually sent out
several months in advance of the IHP meeting. At the IHP meeting,
the family and a case manager of the Division of Developmental Disabilities
fill out a form listing income from all sources and then budgeting
anticipated expenditures. After this, Maximus mails the family a coupon
book for monthly payments.
Since the procedure
began two years ago, the authors have handled over 20 appeals. Most
have been settled. The cases can be broken down by issues involving:
retroactive assessments; erroneous calculations based on incomplete
or mistaken facts; and special circumstances.
To illustrate:
Mary Smith's son John resides in an out-of-state facility. He receives
$640 per month in Social Security benefits. According to the DDD formula,
John should keep $40 for his personal needs and ¸ of the remaining
amount, or $300, for a total of $340. The monthly payment to Maximus
should be $300. Instead, Mary received an assessment of $450 and a
bill for a retroactive assessment of $4,950. On top of this, Johnâs
actual expenses exceed $340 per month. Of special note, Mary, who
is 82 years old, must pay an attendant to accompany John home for
visits because she cannot lift him when he needs assistance in daily
living. The settlement eliminated the retroactive charge, led to a
recalculation of benefits and permitted Mary an additional sum over
the $340 to pay for home assistance.
Copyright 2000
H.D. Hinkle. All rights reserved.
Mr. Hinkle maintains
a multi-state law practice with offices in Lawrenceville, Florham
Park, and Marlton, NJ, and Yardley, Pa. Mr. Hinkle and his colleagues
Ira Fingles, and Paul Prior lecture and write frequently on topics
of law, aging, and disability, and are available
to speak to groups in New Jersey and Pennsylvania
at no charge. Call (609) 896-4200.
