410 Ind. Admin. Code 3.2-4-1

Current through October 31, 2024

Section 410 IAC 3.2-4-1 - Availability of CSHCN funds

Authority: IC 16-35-2-7

Affected: IC 16-35-2

Sec. 1.

(a) The availability and range of all health care services, care coordination services, and travel reimbursement provided to children enrolled in the CSHCN program and their families is contingent upon the availability of funding.

(b) If the commissioner makes a written determination that sufficient funds, in addition to those required to fund services for children already enrolled in the program, are not appropriated or otherwise available to support the costs of health care services for children not already enrolled in the CSHCN program, the state department of health shall document the need for such funds or services by accepting application inquiries in accordance with the provisions specified in this rule.

(c) Applications filed and in the possession of the state department of health prior to the commissioner's written determination, but upon which no determination of eligibility has been made, shall be processed.

(d) If the commissioner subsequently makes a written determination that sufficient funds are appropriated or otherwise available to support the cost of health care services for additional children, the state department of health shall notify, in writing, those persons whose application inquiries are in the possession of the state department of health and who may now be eligible to have their application processed as determined by the availability of funding.

(e) The commissioner shall cause the posting of written notices in conspicuous places in the CSHCN program offices and clinics and in other locations where such notices are likely to be seen by prospective applicants when a determination has been made as described in subsection (b). The written notices shall state the following:

(1) That as of a date certain, the CSHCN program is no longer processing applications because of insufficient funds.

(2) Any other information the state department of health may deem necessary.

(f) The commissioner shall cause the posting of the notice set forth in subsection (e) at least fourteen (14) days prior to terminating the processing of applications for the CSHCN program.

(g) If the commissioner has made a written determination that processing of applications shall not continue, the county department shall, nevertheless, continue to obtain, from prospective applicants, an application inquiry form containing the following information:

(1) Name, address, and telephone number.

(2) Date that the prospective applicant came to the county department to make an application inquiry.

(3) Any other additional information required by the commissioner.

(h) The county department shall inform the prospective applicant that the signing of the application inquiry form and providing of information described in subsection (g) does not mean that the state department of health will process the application inquiry. The prospective applicant shall also be informed the completion and mailing of the application inquiry by the county department to the state department of health does not necessarily ensure eligibility for health care services under the CSHCN program. The county department shall also provide any additional information to the prospective applicant as may be required by the commissioner.

(i) The county department shall send the information provided in accordance with subsection (g) to the state department of health within fourteen (14) days of the filling out of the application inquiry as described in subsection (g).

(j) The commissioner shall cause the posting of written notices in conspicuous places in the CSHCN program offices and regional diagnostic and treatment centers and in other locations where such notices are likely to be seen by prospective applicants when the CSHCN program reinstates processing applications.

(k) The written notices shall state the following:

(1) The CSHCN program is reopening the processing of applications.

(2) Prospective applicants must contact the county department to complete the application.

(3) The effective date for payment of health care services.

(4) The prospective applicant's failure to contact the county department within thirty (30) days of notification shall result in the application not being processed.

(l) The state department of health shall also notify, in writing, the county department concerning the reopening of the CSHCN program. The written notice shall include the following information:

(1) The estimated number of prospective applicants that may be processed within the limitations of available funding.

(2) An individual listing of the prospective applicants residing within the county whose applications may be eligible for processing.

(m) The state department of health shall mail written notification to the county department and prospective applicants within fourteen (14) days of the date that the commissioner determines that the CSHCN program will resume processing applications.

(n) The county department shall keep copies of the written notification to the prospective applicants and shall make a written record of any other efforts made to notify the prospective applicants. These records shall be made a part of the county department's CSHCN program files and shall be open to the director for review.

(o) The state department of health will reopen the CSHCN program to prospective applicants in the order that the application inquiry information described in subsection (g) is received by the state department of health.

(p) For purposes of this rule, a transfer from one (1) county to another of a child already receiving health care services under the CSHCN program shall not be considered to be a new applicant unless the child or family has not notified their CSHCN care coordinator in accordance with 410 IAC 3.2-5-2.

410 IAC 3.2-4-1

Indiana State Department of Health; 410 IAC 3.2-4-1; filed Apr 12, 1993, 5:00 p.m.: 16 IR 2174; readopted filed Jul 11, 2001, 2:23 p.m.: 24 IR 4234; readopted filed May 22, 2007, 1:44 p.m.: 20070613-IR-410070141RFA; readopted filed Sep 11, 2013, 3:19 p.m.: 20131009-IR-410130346RFA

Readopted filed 11/13/2019, 3:14 p.m.: 20191211-IR-410190391RFA