DEPARTMENT OF HEALTH AND HUMAN SERVICES  
BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITY  
ADMINISTRATION  
FINANCIAL LIABILITY FOR MENTAL HEALTH SERVICES  
(By authority conferred on the department of health and human services by sections 114,  
818, and 842 of the mental health code, 1974 PA 258, MCL 330.1114, 330.1818, and  
330.1842)  
PART 8. FINANCIAL LIABILITY FOR MENTAL HEALTH SERVICES  
SUBPART 1. DEPARTMENT OF MENTAL HEALTH  
R 330.8005 Definitions.  
Rule 8005. As used in this part:  
(a) "Assets" means real and personal property that is owned, in whole or in part, by the  
responsible party and that has cash value or equity value.  
(b) "Department" means the department of health and human services.  
(c) "Dependent" means an individual who is allowed as an exemption under section 30  
of the income tax act of 1967, 1967 PA 281, MCL206.30.  
(d) “Excess medical expenses” means medical and dental expenses that exceed the  
threshold dictated by section 16 of the internal revenue code of 1986, 26 USC 213, that  
would be allowed to be deducted on itemized tax returns, less expenses for medical  
health services for the individual paid to the department or community mental health  
services programs.  
(e) “Family of 1” means the individual who has no dependent.  
(f) “Family of 2” means the individual and their spouse.  
(g) “Family size” means a family unit consisting of the individual, spouse, and  
dependents.  
(h) “Individual” means the individual, minor or adult, that receives services from the  
department or a community mental health services program or from a provider under  
contract with the department or a community mental health services program.  
(i) “Liquid asset” means an asset that can be easily converted to cash. Examples of  
liquid assets include, but are not limited to, the following:  
(i) Checking and savings accounts.  
(ii) Cash.  
(iii) Certificates of deposit.  
(iv) Treasury bills.  
(v) Money market investments.  
(vi) Bonds.  
(vii) Marketable securities, including stocks and bonds.  
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(viii) Pensions.  
(ix) Deferred compensation.  
(x) Annuities.  
(xi) Other funds that can be withdrawn or used as collateral for a loan.  
(j) “Poverty guidelines” means the version of the poverty threshold as issued annually  
by the United States Department of Human Services.  
(k) "Protected assets" means the portion of assets, as specified in these rules, that must  
not be considered when the total financial circumstance is used to determine financial  
liability.  
(l) "Protected income" means the portion of income, as specified in these rules, that  
must not be considered when the total financial circumstance is used to determine  
financial liability.  
(m) “Qualifying income” means income from whatever source derived, regardless of  
whether the source is reported on federal or state returns. Qualifying income includes,  
but is not limited to, the following:  
(i) Earned and unearned income.  
(ii) Government benefits.  
(iii) Other entitlements.  
(n) “Responsible party” means a person who is financially liable for services furnished  
to an individual, including the individual, and, as applicable, the individual’s spouse and  
parent or parents of a minor.  
(o) "Spouse" means the legal marriage partner of the individual.  
(p) "Undue financial burden" means a determination of ability-to-pay that would unduly  
impact the health and well-being of the individual or dependents to access the basic  
necessities of life, including, but not limited to, food, housing, clothing, and healthcare.  
History: 1979 AC; 1981 AACS; 1997 AACS; 2022 MR 18, Eff. Sept. 27, 2022.  
R 330.8008 Application of rules and policies.  
Rule 8008. Financial liability for services approved for state financial support by the  
department and provided by the department or community mental health services  
programs directly or under contract shall be determined pursuant to these rules and  
stated in the department’s and community mental health services programs’ written  
policies and procedures.  
History: 1979 AC; 1989 AACS; 1997 AACS.  
R 330.8012 Charges for invalid admission.  
Rule 8012. The department shall charge counties and responsible parties for state  
services rendered to an involuntary patient or judicially admitted individual, unless it has  
been medically determined under the act that the individual is not a person requiring  
treatment or that the individual does not meet the criteria for judicial admission or  
unless it is determined that probable cause for involuntary admission does not exist.  
History: 1979 AC; 1997 AACS.  
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R 330.8014 Review of financial liability determination.  
Rule 8014. Determination of financial liability shall be reviewed not less often than  
annually after an initial determination. Services shall not be withheld pending review  
of financial liability.  
History: 1979 AC.  
R 330.8016 Limitations of individual and spouse financial liability.  
Rule 8016. Calculation of the total days of care as a resident in a facility for which  
a spouse is financially liable shall include the days of care for which the spouse alone or  
the spouse and individual jointly have been liable in accordance with all  
previous determinations of liability by the state or a county.  
History: 1979 AC.  
R 330.8018 Limitation of parental liability.  
Rule 8018. Calculation of the total liability of parents for care of children as  
residents in facilities shall include the days of care for which the parents have been  
liable in accordance with previous determinations of liability by the state or a  
county.  
History: 1979 AC.  
R 330.8021 Appeal of determination of financial liability.  
Rule 8021. An individual receiving services, his spouse, or his parent may appeal the  
amount of financial liability by notifying the director  
of the facility or county  
community mental health services board in writing or on a form provided by the  
department, within 30 days of obtaining a new determination.  
History: 1979 AC.  
R 330.8024 Payment of transcription costs of contested hearings.  
Rule 8024. A party who requests a transcription of a contested hearing at which oral  
evidence has been recorded shall pay for the reasonable costs of the production of  
that transcript. Reasonable costs for a transcript shall be the number of pages  
multiplied by the current department of management and budget transcription cost  
per page plus postage and handling.  
History: 1981 AACS.  
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SUBPART 2. COMMUNITY MENTAL HEALTH  
R 330.8201 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8204 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8205 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8206 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8207 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8208 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8209 Limitation on concurrent determinations of ability to pay.  
Rule 8209. There shall be only 1 ability-to-pay determination  
responsible party at any given time and there shall be a cooperative, collaborative effort  
among the department, the community mental health services programs, and the  
department’s and programs’ contractors to assure that the information is available to all  
appropriate service providers.  
in effect for a  
History: 1989 AACS; 1997 AACS.  
R 330.8210 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8214 Delay of emergency services prohibited.  
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Rule 8214. The process of determining financial liability shall not delay the provision  
of required emergency mental health services.  
History: 1989 AACS; 1997 AACS.  
R 330.8215 Explanation of financial liability process.  
Rule 8215. The department and the community mental health services programs  
shall provide an explanation of the financial liability process before the start of  
service or as soon as practical thereafter. The explanation shall be given orally and  
in writing in a language and manner understandable by the responsible party, and a  
service charge schedule shall be made available to the party.  
History: 1989 AACS; 1997 AACS.  
R 330.8217 Minor seeking treatment under section 707 of the act.  
Rule 8217. A minor who is 14 years of age or older and who is seeking treatment  
under section 707 of the act shall be considered as the responsible party for the  
determination of ability to pay if the parents are not notified of the treatment.  
History: 1989 AACS; 1997 AACS.  
R 330.8220 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8224 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8227 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8229 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8230 Rescinded.  
History: 1989 AACS; 1997 AACS.  
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R 330.8234 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8237 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8238 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8239 Determination of ability-to-pay for non-residential services; parents of  
an individual; member or non-member of the household.  
Rule 8239. (1) A responsible party’s ability-to-pay for nonresidential services must be  
the amount established by this rule’s non-residential ability-to-pay table based upon the  
responsible party’s qualifying income and the most current poverty guidelines. The  
responsible party’s ability-to-pay must be established on a per-session, monthly, or  
annual basis, and the basis selected, and methodology used must be identified and  
described in the department’s and community mental health services program’s written  
policies.  
(2) The ability-to-pay for a parent of an individual must be determined, as follows:  
(a) If the parents of an individual, or the individual and spouse, are members of the  
same household, the department or community mental health services program shall use  
the combined qualifying income to determine the ability-to-pay.  
(b) If the parents of an individual, or the individual and spouse, are not members of  
the same household, the ability-to-pay of each parent or of the individual and their  
spouse is determined separately.  
(c) A parent shall not be determined to have an ability-to-pay for more than 1  
individual at any 1 time, and a parent's total liability for 2 or more individuals shall not  
exceed 18 years.  
(d) If either parent or either spouse has been made solely responsible for an  
individual's medical and hospital expenses by a court order, the other parent or spouse  
is determined to have no ability-to-pay.  
(e) The ability-to-pay of the parent or spouse made solely responsible by court  
order must be determined in accordance with this section. The ability-to-pay of a  
parent made solely responsible by court order must be reduced by the amount of child  
support the parent pays for the individual.  
(f) If an individual receives services for more than 1 year, the department or  
community mental health services program must annually redetermine the adult  
responsible parties' ability-to-pay.  
(3) An ability-to-pay may be determined on a per-session basis for nonresidential  
services other than respite care services. During a calendar month, the per-session ability-  
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to-pay must not be more than the monthly ability-to-pay amount determined from the  
non-residential ability-to-pay process and table specified as follows:  
(a) Determine the percent of poverty specified as the current federal minimum  
mandatory income level to qualify for medical assistance program or its successor, as  
specified in the patient protection and affordable care act of 2010, Public Law 111-148,  
or its successor.  
(b) Multiply 100% of poverty guideline income for family size by the percentage  
determined in subdivision (a) of this subrule. The result is the income level at which the  
responsible party will have zero ability-to-pay from this table.  
(c) Determine qualifying income.  
(d) Divide qualifying income by income calculated in subdivision (b) of this subrule  
and convert to a percentage.  
(e) Match the percentage determined in subdivision (d) of this subrule to the table in  
subrule (4) of this rule to determine the percent of income to charge as the ability-to-pay.  
(f) Deduct from qualifying income the poverty guideline income for family size  
determined in subrule (b) of this rule, at which the responsible party will have zero  
ability-to-pay. The result is income available for cost of care.  
(g) Multiply the percentage determined in subrule (e) of this rule by income available  
for cost of care determined in subrule (f) of this rule. The result is the annual ability-to-  
pay.  
(4) The following income and ability-to-pay crosswalk table must be used in the  
determination of the percent income for subrule (3)(e) of this rule.  
Qualifying income as percent of applicable  
poverty guidelines charged as ability-to-pay  
Percentage of Income  
100%  
0%  
101 - 125%  
126 - 150%  
151 - 175%  
176 - 200%  
201 - 225%  
226 - 250%  
251 - 275%  
276 - 300%  
301 - 325%  
326 - 350%  
351 - 375%  
376 - 400%  
401 +  
3%  
4%  
5%  
6%  
7%  
8%  
9%  
10%  
11%  
12%  
13%  
14%  
15%  
(5) The per-session ability-to-pay is applicable to each session of service provided to all  
individuals for whom the responsible party has an obligation to pay under section 804 of  
the mental health code, 1974 PA 258, MCL 330.1804, but may not be, in aggregate, more  
than the monthly ability-to-pay amount.  
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(6) A responsible party who has been determined under the medical assistance program  
or its successor to be Medicaid eligible is determined to have a $0.00 ability-to-pay for  
all mental health services other than inpatient. The ability-to-pay for inpatient services  
must be the amount determined as the patient pay amount by the medical assistance  
program or its successor.  
(7) If the ability-to-pay for parents is assessed separately and their combined ability-to-  
pay is more than the cost of services, then the charges must be prorated based on the ratio  
of each parent’s income.  
(8) A responsible party may request a new determination, based on the party’s total  
financial circumstances, within 30 days after notification of the initial determination  
made from the ability-to-pay process and table specified in subrule (4) of this rule.  
(9) Parents of children receiving public mental health services under the home and  
community-based waivers are determined to have a $0.00 ability-to-pay for the services  
provided as part of the community-based waivers for children. Parents shall  
independently arrange and pay for services that exceed or are not included in the services  
provided under the home and community-based waivers for children if the parent desires  
expanded services or those services are not included.  
History: 1989 AACS; 1997 AACS; 2022 MR 18, Eff. Sept. 27, 2022.  
R 330.8240 Determination of fee for respite services.  
Rule 8240. (1) The fee for respite services for a full day or any portion of the day must  
be determined by dividing the monthly ability-to-pay amount determined from the non-  
residential table specified in R 330.8239 by 30 and rounding up to the nearest dollar but  
must not be more than the cost of services. A responsible party may request a new  
determination under R 330.8239(8).  
(2) Respite fees charged during a calendar month may not be, in aggregate, more than  
the monthly ability-to-pay amount determined from the non-residential table.  
History: 1989 AACS; 1997 AACS; 2022 MR 18, Eff. Sept. 27, 2022.  
R 330.8241 Ability-to-pay method selected.  
Rule 8241. A per-session, monthly, or annual ability to pay shall apply to each program  
area, and the ability-to-pay method selected shall be identified in the department’s and  
community mental health services programs’ written policies and procedures.  
History: 1997 AACS.  
R 330.8242  
Ability-to-pay determinations  
based  
on  
total  
financial  
circumstances.  
Rule 8242. (1) If a responsible party’s ability-to-pay is determined pursuant to section  
819 of the mental health code, 1974 PA 258, MCL 330.1819, all the following provisions  
apply:  
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(a) The financial determination based on the responsible party’s total financial  
circumstances must consider all the following as specified in these process and table in  
subrule (2)(i) of this rule:  
(i) Qualifying income and protected income.  
(ii) Net liquid assets and protected assets.  
(iii) Applicable poverty guidelines for family size.  
(iv) Excess medical expenses.  
(v) Court-ordered payments, including those payments from a divorce decree.  
(vi) Student loan payments.  
(vii) Additional tax obligations assessed by municipal, county, state, or federal taxing  
authorities.  
(b) If the responsible party is the individual and is a family of 1 who has no expenses  
other than room and board expenses in an inpatient, specialized residential, or supported  
independent housing, an alternate full financial determination under subrule (2) of this  
rule must be completed that does not take into consideration all the provisions specified  
in R 330.8242. This alternate full financial determination must only include the  
following:  
(i) Qualifying income and protected income.  
(ii) Net liquid assets and protected assets.  
(iii) The personal needs allowance under the medical assistance program or its  
successor.  
(iv) Expense deduction equal to the provider payment rate for appropriate living  
arrangements allowed under the medical assistance program or its successor.  
(c) When determining ability-to-pay for an individual receiving inpatient services, one  
half of any compensation paid to the individual for performing labor under section 736 of  
the mental health code, 1974 PA 258, MCL 330.1736, must be protected.  
(d) Protected assets must be the same asset limit amounts allowed for the Medicaid  
group 2 category under the medical assistance program or its successor.  
(e) The department shall develop policies, procedures, and other tools for use in  
calculating a responsible party’s ability-to-pay under these rules.  
(2) The public mental health system full financial consideration ability-to-pay process  
and table is described as follows:  
(a) Determine the percent of poverty specified as the current federal minimum  
mandatory income level to qualify for medical assistance programs or its successor as  
specified in the patient protection and affordable care act of 2010, Public Law 111-148,  
or its successor.  
(b) Determine net assets by subtracting all costs incurred to liquidate liquid assets,  
including protected assets, from liquid assets.  
(c) Determine qualifying income.  
(d) Deduct from qualifying income to determine total income available for cost of care  
for all the following:  
(i) Protected income.  
(ii) Poverty guideline for family size at percent or poverty determined in subdivision  
(a) of this subrule.  
(iii) Excess medical expenses.  
(iv) Court ordered payments, including a divorce decree.  
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(v) Student loan payments.  
(vi) Additional tax obligations assessed by municipal, county, state, or federal taxing  
authority. The result is income available for cost of care.  
(e) Divide qualifying income from subdivision (c) of this subrule by the poverty  
guidelines for family size at 100% of poverty and convert to a percentage.  
(f) Match percentage determined in subdivision (e) of this subrule to the table in  
subrule (3) of this rule to determine the percent of income available for cost of care to  
charge as ability-to-pay.  
(g) Multiply the percentage determined in subdivision (f) of this subrule by the income  
available for cost of care determined in subdivision (a) of this subrule. The result is the  
annual ability-to-pay from income.  
(h) Add net assets from subdivision (b) of this subrule to the annual ability-to-pay from  
income determined from subdivision (g) of this subrule. The result is the annual ability-  
to-pay.  
(3) The following income and ability-to-pay crosswalk table must be used in the  
determination of the percent income for subrule (2)(f) of this rule.  
Qualifying Income as a Percent of applicable % Of Income charged  
poverty guidelines.  
as Ability- to-Pay  
100%  
0%  
101 - 200%  
201 - 250%  
251 - 300%  
301 - 400%  
401+  
10%  
15%  
20%  
25%  
30%  
(4) The alternate calculation process for full financial consideration for ability-to-pay is  
as follows:  
(a) Determine net assets by subtracting all costs incurred to liquidate liquid assets and  
protected assets from liquid assets.  
(b) Determine qualifying income.  
(c) Deduct from qualifying income, as applicable, all the following:  
(i) Protected income.  
(ii) Personal needs allocation.  
(iii) Expense deduction equal to the provider payment rate for appropriate living  
arrangements as allowed under the medical assistance program or its successor. The  
result is the income available for the cost of care.  
(d) Add net assets from subdivision (a) of this subrule to income available for cost of  
care from subdivision (c) of this subrule. The result is the annual ability-to-pay.  
History: 1997 AACS; 2022 MR 18, Eff. Sept. 27, 2022.  
R 330.8244 Rescinded.  
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History: 1989 AACS; 1997 AACS.  
R 330.8250 Division of assets jointly owned in determining ability to pay.  
Rule 8250. In determining ability to pay, the value of assets that are jointly owned  
shall be divided equally among all owners, unless otherwise specified by an ownership  
agreement.  
History: 1989 AACS; 1997 AACS.  
R 330.8251 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8254 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8256 Collection of ability-to-pay amounts.  
Rule 8256. The department and the community mental health services programs  
shall make a reasonable, bona fide collection effort and shall adopt policies that shall be  
consistently applied to all responsible parties for collection of determined ability-to-pay  
amounts. The amounts collected shall not be more than the determined ability to pay  
amount, plus any costs awarded by the court.  
History: 1989 AACS; 1997 AACS.  
R 330.8257 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8264 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8267 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8270 Installment payments; written policies and procedures.  
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Rule 8270. The department and the community mental health services programs  
shall have written policies and procedures if installment payment plans are allowed.  
History: 1989 AACS; 1997 AACS.  
R 330.8273 Nominal therapeutic fees for nonresidential services.  
Rule 8273. Community mental health services programs may charge an individual  
a nominal therapeutic fee for nonresidential services if all of the following conditions  
are met:  
(a) The community mental health services program has adopted a written therapeutic  
fee policy that is fair, equitable, and uniformly applied.  
(b) The fee charged is $3.00 or less for each counseling session.  
(c) The individual was determined to have a $0.00 ability to pay under R 330.8239.  
(d) The individual’s plan of service clinically substantiates the need for, and orders, a  
therapeutic fee to be assessed as specified in this rule.  
History: 1997 AACS.  
R 330.8275 Court orders.  
Rule 8275. A community mental health services program shall comply with the terms  
of a court order that is related to an individual’s obligation to pay for services rendered  
and that is issued before the individual presented for services. The amount shall not be  
less, but may be more, than the amount that would be determined by establishing the  
individual’s ability to pay in accordance with these rules.  
History: 1997 AACS.  
R 330.8277 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8279 Undue financial burden.  
Rule 8279. A responsible party’s ability-to-pay must not create an undue financial  
burden that does either of the following:  
(a) Unduly impacts the health and well-being of the individual or their dependents as  
determined by the ability to access the basic necessities of life, including, but not limited  
to, food, housing, clothing, and healthcare.  
(b) Deprives the party and his or her dependents of the financial means to maintain or  
reestablish the individual in a reasonable and appropriate community-based setting.  
History: 1997 AACS; 2022 MR 18, Eff. Sept. 27, 2022.  
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R 330.8280 Rescinded.  
History: 1989 AACS; 1997 AACS.  
R 330.8284 Rescinded.  
History: 1989 AACS; 1997 AACS.  
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;