Ability to Pay (ATP) is the assessed fee for services, provided to a person served by Easterseals MORC.
Who needs an Ability to Pay?
Anyone that receives services.
Why does this need to be done?
It is in accordance with The Michigan Mental Health Code and Department of Community Health (DCH) Administrative Rules.
When is it calculated?
Before, or as soon as possible after, the start of services.
What if you have Medicaid?
If a consumer has a taxable income and also has Medicaid, the ATP will be zero.
Who is financially responsible for ATP?
Individual consumers, spouses and parents of minor children. Parents are defined as the legal mother and father of an unmarried child who is less than 18 years of age. If a child is a minor and is a ward of the court or is in foster care, the ATP is based on the Medicaid status or income of the child. Step-parents are not responsible for ATP
How long are parents financially responsible for a minor’s ATP?
Once a child turns age 18 the parents are no longer financially responsible for their child’s services. A new ATP would be calculated and they would then become responsible for their own ATP.
What will happen if an individual fails to supply information regarding insurance benefits or proof of income?
If an individual or responsible party willfully fails to supply relevant financial information, the ATP is calculated to be the full cost of services received by an individual.
What if a family member already has an ATP at another CMH provider?
There can only be one ATP in effect at any time per family for all services provided by a CMH provider. You should notify your case manager if you have ATP in effect with another provider.
What information is required to calculate ATP?
A copy of most recently filed Michigan income tax return or the last three months of paycheck stubs.
What can be done if the responsible party still does not agree with the ATP amount after the completion of the Total Financial Determination?
The responsible party may request a local dispute resolution through Oakland County Community Mental Health Authority (OCCMHA), Office of Due Process. A meeting will be scheduled to review your ATP.
When is ATP re-calculated?
A re-calculation should be made yearly or if there is a major change in the financial situation such as gain or loss of employment or Medicaid.
Where can payments be made?
Payments can be dropped off at an Easterseals MORC office or they can be mailed in.
What can be done if an individual feels the ATP amount misrepresents their financial situation?
The responsible party has 30 days to appeal the ATP calculation and request a full financial review. At that time, Easterseals MORC will complete a Total Financial Determination (TFD) in which the responsible party’s total financial circumstances, including income, expenses, assets and liabilities are taken into consideration. The responsible party shall be required to pay the lesser of the two amounts, up to the cost of services.