1. (a) The following independent living services, as defined in §853.11, relating to Scope of Services, are subject to customer participation in cost of service:

   1. (1) Transportation, excluding transportation for diagnostic services; and
   2. (2) Adaptive aids or appliances that cost more than $50.
2. (b) OIB staff shall administer the customer participation system in accordance with the rules in this chapter, the ILS-OIB policy manual, and 34 CFR §367.67(b)(1).
3. (c) OIB staff shall provide those independent living services defined as not requiring customer participation in cost of services in §853.11 of this chapter at no cost to the customer.
4. (d) OIB staff shall determine the customer's adjusted gross income and the percentage of the Federal Poverty Guidelines at https://aspe.hhs.gov/poverty-guidelines for that income, based on documentation provided by the customer.
5. (e) OIB staff is required to apply the Federal Poverty Guidelines at https://aspe.hhs.gov/poverty-guidelines to determine customer participation.

6. (f) The customer or customer's representative shall sign a customer participation agreement acknowledging the amount of the customer's fee for services and providing written agreement that:

   1. (1) the information provided by the customer or the customer's representative about the customer's household size, annual gross income, allowable deductions, and comparable services or benefits is true and accurate; or
   2. (2) the customer or the customer's representative chooses not to provide information about the customer's household size, annual gross income, allowable deductions, and comparable services or benefits.
7. (g) If the customer or the customer's representative, as appropriate, chooses not to provide information on the customer's household size, annual gross income, allowable deductions, and comparable services or benefits, the customer shall pay the entire cost of services.
8. (h) The customer shall report to OIB staff as soon as possible all changes to household size, annual gross income, allowable deductions, and comparable services or benefits and sign a new customer participation agreement.
9. (i) When the customer signs a new participation agreement, the new amount of the customer's fee for service takes effect the beginning of the following month. The new amount shall not be applied retroactively.

10. (j) OIB staff shall develop a process to reconsider and adjust the customer's fee for services based on circumstances that are both extraordinary and documented. This may include assessing the customer's ability to pay the customer's participation amount. Extraordinary circumstances include:

    1. (1) an increase or decrease in income;
    2. (2) unexpected medical expenses;
    3. (3) unanticipated disability-related expenses;
    4. (4) a change in family size;
    5. (5) catastrophic loss, such as fire, flood, or tornado;
    6. (6) short-term financial hardship, such as a major repair to the customer's home or personally owned vehicle; or
    7. (7) other extenuating circumstances for which the customer makes a request and provides supporting documentation.
11. (k) The customer's calculated fee for services remains in effect during the reconsideration and adjustment process.

12. (l) OIB staff shall:

    1. (1) use program income that is received from the customer participation system only to provide services outlined in §853.11; and
    2. (2) report fees collected as program income.
13. (m) The Agency may not use program income received from the customer participation system to supplant any other fund sources.
14. (n) The Agency may not pay any portion of the customer's participation fee.
15. (o) The customer's participation agreement and all financial information collected by OIB staff are subject to subpoena.

Source Note:The provisions of this §853.21 adopted to be effective August 21, 2018, 43 TexReg 5392.