| Rule Number: |
12P042 |
| Title: |
Children with Special Health Needs Financial Assistance for Respite Rule |
|
Type:
|
Standard |
|
Status:
|
Adopted |
| Agency: |
Department of Health
|
| Legal Authority: |
3 V.S.A. §§ 801(b)(11), 3003(a); and 18 V.S.A. §§ 102 and 104. |
| Summary:
| This amendment changes the financial assistance given to Children with Special Health Needs (CSHN) patients. All patients from birth to age 21 who were enrolled with CSHN as of December 31, 2012 and whose family income is at or less than 500 of the Federal Poverty Guidelines will be eligible for financial assistance through the end of 2013. Beginning January 1, 2013, patients over the age of 21 and families with incomes greater than 500 of the Federal Poverty Guidelines will not receive financial assistance. CSHN will use 2013 as a transition period where it will provide all patients with extensive Financial Technical Assistance to obtain public or private healthcare coverage most appropriate to their needs. As of January 1, 2014, the only financial assistance offered to CSHN patients, who family income is at or less than 500 of the Federal Poverty Guidelines, will be respite care, providing support to parents who are primary care-givers. |
| Persons Affected:
| Both current and future CSHN patients, vendors, such as pharmacies, medical equipment providers, medical food providers and healthcare providers, Hewlett Packard Enterprise Services as well as advocacy groups such as Vermont Family Network, The Vermont Cystic Fibrosis Advisory Council, The Cystic Fibrosis Lifestyle Foundation, Fletcher Allen Health Care ("FAHC") Specialty Provider teams, Children's Hospital at Dartmouth Specialty
Provider teams; Vermont Department of Health Business Office, Department of Vermont Health Access, and Department for Children and Families Children's Integrated Services – Early Intervention (CIS-EI). |
| Economic Impact:
| On 1/1/2013, CSHN anticipates that approximately 25 patients (2 of the current 3,500 CSHN patients) who have family incomes above 500 of Federal Poverty Guidelines, and approximately 70 patients over the age of 21 will lose access to CSHN financial assistance. Effective 01/01/2014 approximately 176 families eligible for CSHN financial assistance during the calendar year 2013 transition period will no longer receive assistance. Of this number we anticipate that as many as one-half will be eligible for Vermont Medicaid or other Green Mountain Care coverage. Vermont Medicaid, Green Mountain Care, and private insurers will see an increase in applications for coverage, spread out over approximately 17 months. Analysis by staff at Hewlett Packard |
| Posting date: |
Aug 29,2012 |
