|
Appendix B
Recommended Consumer Contribution Schedule
NC Division of Aging
and Adult Services
Recommended Contribution Schedule
Based on the 2008 US
Poverty Guidelines
Service Recipients Name:
Service #1 Rate$ Service
#2 Rate $
Service #3 Rate
$
|
%
of Poverty
|
Monthly
Income of:
|
Suggested
Percentage of the Cost of Service
|
Recommended
Contribution Amount per Unit of Service
|
|
Individual
|
Couple
|
Service #1
|
Service #2
|
Service #3
|
|
100%
|
$867 - $1,083
|
$1,167 - $1,458
|
10%
|
|
|
|
|
125%
|
$1,084 $1,300
|
$1,459 $1,750
|
20%
|
|
|
|
|
150%
|
$1,301 $1,516
|
$1,751 $2,041
|
30%
|
|
|
|
|
175%
|
$1,517 - $1,733
|
$2,042 - $2,333
|
40%
|
|
|
|
|
200%
|
$1,734 - $1,950
|
$2,334 - $2,625
|
50%
|
|
|
|
|
225%
|
$1,951 - $2,167
|
$2,626 - $2,917
|
60%
|
|
|
|
|
250%
|
$2,168 $2,383
|
$2,918 $3,208
|
70%
|
|
|
|
|
275%
|
$2,384 $2,600
|
$3,209 $3,500
|
80%
|
|
|
|
|
300%
|
$2,601 $3,034
|
$3,501 $4,084
|
90%
|
|
|
|
|
350%
|
$3,035 -- above
|
$4,085 -- above
|
100%
|
|
|
|
* The Recommended Consumer
Contribution Schedule may only be shared with service recipients
who are above poverty and receive a Type I service(s). *
Voluntary contributions made toward the cost of services
received are not tax deductible
|
