reglab/statecodes huggingface dataset:
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PAYMENT ADJUSTMENTS AND PENALTIES › Section 16.06.12.702 - INTENTIONAL PROGRAM VIOLATIONS (IPV)

Current through August 31, 2023
An IPV is an intentionally false or misleading action or
				  statement as identified below in Subsections
				  702.01 through
				  702.08 of this rule. An IPV is
				  established when a family member or the child care provider admits the IPV in
				  writing and waives the right to an administrative hearing, or when determined
				  by an administrative hearing, a court decision, or through deferred
				  adjudication. Deferred adjudication exists when the court defers a
				  determination of guilt because the accused family member or child care provider
				  meets the terms of a court order or an agreement with the prosecutor.
				  (3-17-22)
01.
False
				Statement
. An individual makes a false statement to the Department,
				either orally or in writing, in order to participate in the Idaho Child Care
				Program. (3-17-22)
02.
Misleading Statement
. An individual makes a misleading statement
				to the Department, either orally or in writing, to participate in the Idaho
				Child Care Program. (3-17-22)
03.
Misrepresentation of Fact
. An individual misrepresents one (1) or
				more facts to the Department, either orally or in writing, to participate in
				the Idaho Child Care Program. (3-17-22)
04.
Concealing Fact
. An
				individual conceals or withholds one (1) or more facts to participate in the
				Idaho Child Care Program. (3-17-22)
05.
Non-Compliance With Rules and
				Regulations
. An individual fails repeatedly or substantially to comply
				with this chapter of rules. (3-17-22)
06.
Violation of Provider
				Agreement
. An individual knowingly violates any term of their provider
				agreement. (3-17-22)
07.
Failure to Meet Qualifications
. A provider fails to meet the
				qualifications specifically required by this chapter of rules or by any
				applicable licensing board. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PAYMENT ADJUSTMENTS AND PENALTIES › Section 16.06.12.703 - PENALTIES FOR AN IPV

Current through August 31, 2023
When the Department determines an IPV was committed, the
				  party who committed the IPV loses eligibility for ICCP. If an individual has
				  committed an IPV, the entire family is ineligible for child care benefits. If a
				  child care provider has committed an IPV, the provider is ineligible to receive
				  payments. The period of ineligibility for each offense, for both participants
				  and providers, is as follows: (3-17-22)
01.
First Offense
. Twelve (12)
				months, for the first IPV or fraud offense, or the length of time specified by
				the court. (3-17-22)
02.
Second Offense
. Twenty-four (24) months for the second IPV or
				fraud offense, or the length of time specified by the court.
				(3-17-22)
03.
Third
				Offense
. Permanent ineligibility for the third or subsequent IPV or
				fraud offense, or the length of time specified by the court.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PAYMENT ADJUSTMENTS AND PENALTIES › Section 16.06.12.704 - DENIAL OF PAYMENT

Current through August 31, 2023
The Department may deny payment for the reasons described in
				  Subsections 704.01 through
				  704.05 of this rule.
				  (3-17-22)
01.
Services Not
				Provided
. Any or all claims for child care services it determines were
				not provided. (3-17-22)
02.
Services Not Documented
. Child care services not documented by the
				provider as required in Subsection
				810.01 of these rules.
				(3-17-22)
03.
Contrary to
				Rules or Provider Agreement
. Child care services provided contrary to
				these rules or the provider agreement. (3-17-22)
04.
Failure to Provide Immediate Access
				to Records
. The Department may deny payment when the provider does not
				allow immediate access to records as provided in Subsection
				810.02 of these rules.
				(3-17-22)
05.
Paying for
				Attendance
. Payment will be denied if an eligible provider pays directly
				or indirectly, overtly or covertly, for a child to attend the provider's child
				care facility. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PAYMENT ADJUSTMENTS AND PENALTIES › Section 16.06.12.705 - FUNDING RESTRICTIONS

Current through August 31, 2023
If a funding shortfall is projected, the Department may
				  reduce child care benefits to ensure that ICCP operates within its financial
				  resources. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › ENFORCEMENT REMEDIES › Section 16.06.12.750 - TERMINATION OF PROVIDER STATUS

Current through August 31, 2023
Under Section
				  56-209h, Idaho Code, the
				  Department may terminate the provider agreement of, or otherwise deny provider
				  status for a period up to five (5) years from the date the Department's action
				  becomes final to any individual or entity providing ICCP. (3-17-22)
01.
Submits an Incorrect Claim
.
				Submits a claim with knowledge that the claim is incorrect. (3-17-22)
02.
Fraudulent Claim
. Submits a
				fraudulent claim. (3-17-22)
03.
Knowingly Makes a False Statement
. Knowingly makes a false
				statement or representation of material facts in any document required to be
				maintained or submitted to the Department. (3-17-22)
04.
Immediate Access to
				Documentation
. Fails to provide, upon written request by the Department,
				immediate access to documentation required to be maintained.
				(3-17-22)
05.
Non-Compliance
				With Rules and Regulations
. Fails repeatedly or substantially to comply
				with the rules and regulations governing Idaho child care payments.
				(3-17-22)
06.
Violation of
				Material Term or Condition
. Knowingly violates any material term or
				condition of the provider agreement. (3-17-22)
07.
Failure to Repay
. Has failed
				to repay, or was a managing employee or had an ownership or control interest in
				any entity that has failed to repay, any overpayments or claims previously
				found to have been obtained contrary to statute, rule, regulation, or provider
				agreement. (3-17-22)
08.
Fraudulent or Abusive Conduct
. Has been found, or was a managing
				employee in any entity which has been found, to have engaged in fraudulent
				conduct or abusive conduct. (3-17-22)
09.
Failure to Meet
				Qualifications
. Fails to meet the qualifications specifically required
				by rule or by any applicable licensing entity. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › ENFORCEMENT REMEDIES › Section 16.06.12.751 - REFUSAL TO ENTER INTO AN AGREEMENT

Current through August 31, 2023
The Department may refuse to enter into a provider agreement
				  for the reasons described in Subsections
				  751.01 through
				  751.06 of this rule.
				  (3-17-22)
01.
Convicted of a
				Felony
. The provider has been convicted of a felony or is under
				investigation for the commission of a felony. (3-17-22)
02.
Committed an Offense or Act Not in
				Best Interest of Child Care Participants
. The provider has committed an
				offense or act which the Department determines is inconsistent with the best
				interests of ICCP participants. (3-17-22)
03.
Failed to Repay
. The
				provider has failed to repay the Department monies which had been previously
				determined to have been owed to the Department. (3-17-22)
04.
Investigation Pending
. The
				provider has a pending investigation for program fraud or abuse.
				(3-17-22)
05.
Terminated
				Provider Agreement
. The provider was the managing employee, officer,
				owner, or spouse, partner, or relative of an owner of an entity, whose provider
				agreement was terminated under Section
				750 of these rules.
				(3-17-22)
06.
Excluded
				Individuals
. The provider has a current exclusion from participation in
				federal programs by the Office of Inspector General List of Excluded
				Individuals and Entities. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › ENFORCEMENT REMEDIES › Section 16.06.12.752 - PROVIDER NOTIFICATION

Current through August 31, 2023
When the Department determines actions defined in Sections
				  701 through
				  705,
				  750, and
				  751 of these rules are appropriate,
				  it will send written notice of the decision to the provider or person. The
				  notice will state the basis for the action, the length of the action, the
				  effect of the action on that person's ability to provide services under state
				  and federal programs, and the person's appeal rights. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › ENFORCEMENT REMEDIES › Section 16.06.12.753 - NOTICE TO STATE LICENSING AUTHORITIES

Current through August 31, 2023
The Department will promptly notify all appropriate licensing
				  authorities having responsibility for licensing of a Department action, and the
				  facts and circumstances of that action. The Department may request certain
				  actions be taken and that the Department be informed of actions taken.
				  (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.800 - CHILD CARE PROVIDER LICENSING

Current through August 31, 2023
All providers of child care who receive a Department subsidy
				  must be licensed or must comply with: applicable State Daycare licensing
				  requirements in Title 39, Chapter 11, Idaho Code; these rules; local licensing
				  ordinances; or tribal ordinances. If both state requirements and ordinances
				  apply to a provider, the provider must comply with the stricter requirement. A
				  provider operating outside Idaho must comply with the licensing laws of their
				  state or locality. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.801 - HEALTH AND SAFETY TRAINING

Current through August 31, 2023
All child care providers must complete a series of health and
				  safety trainings during an orientation period of not more than ninety (90)
				  days, in addition to ongoing annual training that address each of the following
				  topics: (3-17-22)
01.
Infectious
				Diseases
. The prevention and control of infectious diseases (including
				immunization). (3-17-22)
02.
Sudden Infant Death Syndrome
. The prevention of sudden infant
				death syndrome and use of safe sleeping practices. (3-17-22)
03.
Medication
. The
				administration of medication, consistent with standards for parental consent.
				(3-17-22)
04.
Allergic
				Reactions
. The prevention of and response to emergencies due to food and
				allergic reactions. (3-17-22)
05.
Environmental Safety
. Building and physical premises safety,
				including identification of and protection from hazards, bodies of water, and
				vehicular traffic. (3-17-22)
06.
Child Abuse Prevention
. Prevention of shaken baby
				syndrome
,
abusive head trauma, child maltreatment, and recognition
				and reporting of child abuse and neglect. (3-17-22)
07.
Emergency Preparedness
.
				Emergency preparedness and response planning for emergencies resulting from a
				natural disaster, or a man-caused event. (3-17-22)
08.
Hazardous Substances
. Proper
				handling, storage, and disposal of medicines, cleaning supplies, and other
				hazardous substances, including biocontaminants. (3-17-22)
09.
Transportation
. Appropriate
				precautions in transporting children, including the use of child safety
				restraints and seat belts. (3-17-22)
10.
Child Development
. Address
				major domains such as cognitive, social, emotional, physical development, and
				approaches to learning. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.803 - CHILD CARE PROVIDER TRAINING REQUIREMENTS

Current through August 31, 2023
Each child care provider must receive and ensure that each
				  staff member who provides child care receives and completes twelve (12) hours
				  of ongoing training every twelve (12) months after the staff member's date of
				  hire. (3-17-22)
01.
Training
				Contents
. Training must be related to continuing education in child
				development, teaching and curriculum, health and safety, and business
				practices. Pediatric rescue breathing (CPR) and pediatric first aid treatment
				training will not count towards the required twelve (12) hours of annual
				training. (3-17-22)
02.
Documented Training
. It is the responsibility of the child care
				provider to ensure that each staff member who provides child care has completed
				twelve (12) hours of training each year. The training must be documented in the
				staff member's record. (3-17-22)
03.
Staff Training Records
. Each
				child care provider is responsible for maintaining documentation of staff's
				training and must produce this documentation when the provider agreement is
				renewed annually. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.804 - CHILD CARE PROVIDER AGREEMENT

Current through August 31, 2023
01.
Compliance
. All providers must sign and comply with a provider
				agreement. (3-17-22)
02.
Provide Direct Care
. Except for Child Care Centers described in
				Subsection 101.01 of these rules, the
				individual who signs the provider agreement must provide the majority of direct
				care to the children in that child care facility. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.805 - CRIMINAL HISTORY AND BACKGROUND CHECK REQUIREMENT

Current through August 31, 2023
Applicants, providers, employees, volunteers, and all other
				  individuals age thirteen (13) or older who have direct contact with or provide
				  care to children eligible for ICCP benefits must comply with the requirements
				  and receive clearance as provided in IDAPA 16.05.06, "Criminal History and
				  Background Checks," every five (5) years. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.806 - PURVIEW OF CHILD PROTECTIVE ACT OR JUVENILE JUSTICE REFORM ACT

Current through August 31, 2023
Providers must certify that they are not, through stipulation
				  or adjudication, under the purview of the Child Protective Act, Section
				  16-1600, Idaho Code, or the
				  Juvenile Corrections Act, Section
				  20-501 through
				  20-547, Idaho Code. Any person who
				  has a substantiated child protection complaint cannot be a provider.
				  (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.807 - PARENT OR CARETAKER ACCESS TO CHILD CARE PREMISES

Current through August 31, 2023
Providers serving families who receive a child care subsidy
				  must allow parents or caretakers unlimited access to their children and to
				  persons giving care, except that access to children will not be required if
				  prohibited by court order. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.808 - REPORTING REQUIREMENTS FOR PROVIDERS

Current through August 31, 2023
A child care provider must report any of the following
				  changes within ten (10) days: (3-17-22)
01.
Change in Provider Charges
.
				The provider changes any rate for child care services. (3-17-22)
02.
Child Stops Attending Care
.
				A child covered under ICCP stops attending child care, or is taken to another
				child care provider. (3-17-22)
03.
Change of Provider Address
. The provider changes the location
				where child care is provided. (3-17-22)
04.
Change in Who Lives in Home
.
				An individual who provides child care in their home must report when any other
				person moves into the home. (3-17-22)
05.
Intent Not to Renew License
.
				The provider intends not to renew their license, or other required
				certifications. (3-17-22)
06.
Death or Serious Injury
. Providers must report when a child
				sustains a serious injury or dies while at the location of, or as a result of
				participating in child care. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.809 - CONSUMER EDUCATION INFORMATION

Current through August 31, 2023
The Department will make public by electronic means, in an
				  easily accessible format: (3-17-22)
01.
Monitoring and Inspection
				Reports
. The results of all child care monitoring and inspection
				reports. (3-17-22)
02.
Substantiated Complaints
. Substantiated complaints about failure
				to comply with child care laws, rules, and policies, that include information
				on the date of such an inspection, and where applicable, information on
				corrective action taken. (3-17-22)
03.
Death and Serious Injury
.
				The total number of deaths, serious injuries, and instances of substantiated
				child abuse that occurred in child care settings each year. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.12 - IDAHO CHILD CARE PROGRAM (ICCP) › PROVIDER ELIGIBILITY › Section 16.06.12.810 - DOCUMENTATION OF SERVICES AND ACCESS TO RECORDS

Current through August 31, 2023
01.
Documentation of Services
. Providers must generate documentation
				at the time of service sufficient to support the reimbursement for child care
				services. Documentation must be legible and retained for a period of three (3)
				years from the date the child care was provided. Documentation to support child
				care services includes: (3-17-22)
a. Records
				of attendance, including signatures of a parent or guardian;
				(3-17-22)
b. Immunization records,
				conditional admittance form, or exemption form according to IDAPA 16.02.11,
				"Immunization Requirements for Licensed Daycare Facility Attendees."
				(3-17-22)
c. Billing records and
				receipts; (3-17-22)
d. Policies
				regarding sign-in procedures, and others as applicable; and (3-17-22)
e. Sign-in records, electronic or manual, or
				the Child and Adult Food Care Program records. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.000 - LEGAL AUTHORITY

Current through August 31, 2023
Sections
				56-201, and
				56-202(b), Idaho
				Code, authorize the Department to adopt and enforce rules for administration of
				public assistance programs. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.001 - SCOPE

Current through August 31, 2023
These rules establish statewide provisions of emergency
				assistance to families with children eligible to receive assistance through
				Title IV-A funds to meet the family's emergency conditions. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.010 - DEFINITIONS

Current through August 31, 2023
01.
Adult Relatives
. Any
			 non-parent individual over the age of eighteen (18) years, who is related to
			 the eligible child in any of the following ways: (3-17-22)
a. Brother, sister, aunt, uncle, nephew,
			 niece, first cousin or first cousin once removed, or one (1) of these
			 relationships including parents prefixed by "grand" or "great," or:
			 (3-17-22)
b. One (1) of the
			 following relationships by half-blood: a step-parent, step-sibling, or the
			 spouse of a relative by marriage, even if the marriage has ended.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.100 - EMERGENCY CONDITION

Current through August 31, 2023
A family is assessed for an emergency condition when the
				Department receives a report, referral, or service request indicating an
				emergency condition exists, which includes a child who has unmet short-term
				basic needs affecting the child's health, safety, or well-being that place the
				child at risk of destitution. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.150 - APPLICATION FOR SERVICES

Current through August 31, 2023
An application must be completed and signed by one (1) of the
				following individuals on behalf of the eligible child for emergency assistance
				to be given: (3-17-22)
01.
A
			 Parent or Parents
. (3-17-22)
02.
An Adult Relative
. An adult
			 relative may sign on behalf of the child, when the child is residing with them
			 and they are responsible for the child's care. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.160 - ELIGIBILITY REQUIREMENTS

Current through August 31, 2023
The following requirements of this rule must be met before a
				family is eligible for emergency assistance. (3-17-22)
01.
Child
. There must be a child
			 in the household for the family to be eligible. (3-17-22)
02.
Citizenship
. To be eligible
			 for emergency assistance, an individual must meet the citizenship requirements
			 in IDAPA 16.03.08, "Temporary Assistance for Families in Idaho (TAFI),".
			 (3-17-22)
03.
Income
			 Guidelines
. The family is determined as needy when the household income
			 is below two hundred percent (200%) of the current Federal Poverty Guideline,
			 or is unable to meet the emergency condition because of circumstances beyond
			 their control, and insufficient resources are immediately available to meet the
			 child's basic needs and which threatens the child's safety, stability, or
			 well-being. (3-17-22)
04.
Residence
. The child must have lived with one (1) or both parents
			 or an adult relative, within six (6) months prior to the month of application
			 for emergency assistance. A child may move from one (1) household to another
			 and be eligible to receive emergency assistance in either household.
			 (3-17-22)
05.
Work Program
			 Compliance
. An individual who is required to participate in a work
			 program must not have refused, without good cause, to accept employment or
			 training for employment. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.200 - ASSESSMENT AND AUTHORIZATION FOR EMERGENCY ASSISTANCE

Current through August 31, 2023
01.
Authority to Assess Needs for
			 Emergency Assistance
. Contractors may conduct assessments and make
			 referrals for authorization. (3-17-22)
02.
Authorization Of Emergency
			 Assistance
. Emergency assistance payments and services may only be
			 authorized by the Department. (3-17-22)
03.
Authorization and Assessment
			 Period
. The thirty (30) day authorization and assessment period begins
			 the date the applicant signs the application. Services may be provided during
			 this authorization and assessment period. (3-17-22)
04.
Service Period
. A service
			 period may continue for a maximum of ninety (90) days following the assessment
			 period. (3-17-22)
05.
Total
			 Number of Days for Emergency Assistance
. The total number of days a
			 family may receive emergency assistance is one hundred twenty (120) consecutive
			 days in a twelve (12) month period from the date the application is signed.
			 (3-17-22)
06.
Assessment
			 Content
. The Department will describe in the assessment the following:
			 (3-17-22)
a. The emergency condition;
			 (3-17-22)
b. The family's issues
			 that caused the emergency condition; and (3-17-22)
c. A family service plan.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.210 - DURATION FOR EMERGENCY ASSISTANCE

Current through August 31, 2023
Emergency assistance may be provided to a family one (1) time
				during a twelve (12) month period counted from the date the application is
				signed, unless the original application was denied or withdrawn. The emergency
				assistance can not exceed a total of one hundred and twenty (120) consecutive
				days and if: (3-17-22)
01. More than
			 one (1) emergency condition occurs within the thirty (30) day authorization
			 assessment period, all emergency conditions are considered to be the same
			 emergency and additional funds may be authorized to cover additional services
			 needed. (3-17-22)
02. A second
			 emergency condition occurs after the thirty (30) day authorization assessment
			 period, it is considered a separate emergency condition and emergency
			 assistance cannot be used to provide services or payment of additional funds.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.06.13 - EMERGENCY ASSISTANCE FOR FAMILIES AND CHILDREN › Section 16.06.13.300 - EMERGENCY ASSISTANCE PAYMENTS

Current through August 31, 2023
Emergency assistance payments are short-term benefits for
				specific emergency conditions that are provided to assist a family with an
				eligible child. These payments are not intended to meet ongoing and recurrent
				needs that will extend beyond the one hundred twenty (120) day service period.
				(3-17-22)
01.
Emergency
			 Payments
. Emergency payments will be made to purchase goods and services
			 relating to the emergency condition. (3-17-22)
02.
Non-Allowable Payments
.
			 Emergency assistance funds may not be used to pay for the following: (3-17-22)
a. Medical services reimbursable by Medicaid
			 regardless of whether the individual is receiving or eligible for Medicaid.
			 (3-17-22)
b. Services provided to
			 meet a family's ongoing basic needs including housing, food, clothing,
			 transportation, and household goods that extend beyond the one hundred twenty
			 (120) days. (3-17-22)
c. Services
			 available through other community resources. (3-17-22)
d. Child care that is not considered respite
			 care. (3-17-22)
e. Medical or
			 automobile insurance. (3-17-22)
f.
			 Down payment or purchases of vehicles or real property.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES › Section 16.07.01.000 - LEGAL AUTHORITY

Current through August 31, 2023
Under Sections
				16-2433,
				19-2524,
				20-511A, and
				39-3137, Idaho Code, the Director
				is authorized to promulgate, adopt, and enforce rules for the charging of fees
				for services provided by mental health and substance use disorders providers.
				Under Section
				39-309, Idaho Code, the Board of
				Health and Welfare is authorized to promulgate, adopt, and enforce rules for
				the charging of fees for services provided by mental health and substance use
				disorders providers. (3-15-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES › Section 16.07.01.001 - TITLE AND SCOPE

Current through August 31, 2023
01.
Title
. These rules are titled IDAPA 16.07.01, "Behavioral Health
			 Sliding Fee Schedules." (3-15-22)
02.
Scope
. These rules provide
			 the sliding fee schedules, based on federal poverty guidelines, and fee
			 determination process for the adult mental health, children's mental health,
			 and substance use disorders programs within the Department. This chapter of
			 rules applies both to voluntary and court-ordered recipients.
			 (3-15-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES › Section 16.07.01.010 - DEFINITIONS

Current through August 31, 2023
For the purposes of this chapter, the following definitions
				apply. (3-15-22)
01.
Ability to
			 Pay
. The financial capacity that is available to pay for the program
			 services after allowable deductions in relation to gross income and family size
			 exclusive of any liability of third party payor sources. (3-15-22)
02.
Adjusted Gross Income
. Total
			 family annual income less allowable annual deductions. (3-15-22)
03.
Adult
. An individual
			 eighteen (18) years of age or older. (3-15-22)
04.
Adult Mental Health Program
.
			 A program administered by the Idaho Department of Health and Welfare to serve
			 seriously mentally ill and severely and persistently mentally ill adults.
			 (3-15-22)
05.
Allowable
			 Annual Deductions
. In determining the family's ability to pay for
			 behavioral health services, the following are allowable annual deductions:
			 (3-15-22)
a. Court-ordered obligations;
			 (3-15-22)
b. Dependent support;
			 (3-15-22)
c. Child care payments
			 necessary for parental employment; (3-15-22)
d. Medical expenses; (3-15-22)
e. Transportation; (3-15-22)
f. Extraordinary rehabilitative expenses; and
			 (3-15-22)
g. State and federal tax
			 payments, including FICA taxes. (3-15-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES › Section 16.07.01.100 - FINANCIAL RESPONSIBILITY OF PARENTS FOR CHILDREN'S MENTAL HEALTH SERVICES

Current through August 31, 2023
Parents of children eligible for services under IDAPA 16.07.37,
				"Children's Mental Health Services," Section
				407 who receive services either
				directly from the Department's Children's Mental Health program or through
				Department contracts with private providers are responsible for paying for
				services provided to their child and to their family. Financial responsibility
				of the child's parent(s) for each service not covered by third party liable
				resources or payments, including private insurance and Medicaid will be
				established in accordance with the child's parent(s) ability to pay as
				determined by the sliding fee scale in Section
				300 of these rules.
				(3-15-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES › Section 16.07.01.200 - FINANCIAL RESPONSIBILITY FOR ADULT MENTAL HEALTH SERVICES

Current through August 31, 2023
Adults receiving services either directly from the Department's
				Adult Mental Health program or through Department contracts with private
				providers are responsible for paying for services they receive. Financial
				responsibility for each service not covered by third party liable resources or
				payments, including private insurance and Medicaid will be established in
				accordance with the individual's ability to pay as determined by the sliding
				fee scale in Section 300 of these
				rules. (3-15-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES › Section 16.07.01.300 - SLIDING FEE SCHEDULE FOR CHILDREN'S MENTAL HEALTH, ADULT MENTAL HEALTH, AND SUBSTANCE USE DISORDERS SERVICES

Current through August 31, 2023
Following is the sliding fee schedule for children's mental
				health, adult mental health, and substance use disorders services:
TABLE 300 - SLIDING FEE SCHEDULE
							 FOR CHILDREN'S MENTAL HEALTH, ADULT MENTAL HEALTH, AND SUBSTANCE USE DISORDERS
							 SERVICES.
Percent Federal of Poverty
							 Guidelines
Percentage of Cost Sharing
							 Responsibility of a Parent, or Adult Services Recipient
0% - 99%
0%
100%-109%
5%
110%-119%
10%
120%-129%
15%
130%-139%
20%
140%-149%
25%
150%-159%
30%
160%-169%
35%
170%-179%
40%
180%-189%
45%
190%-199%
50%
200% - 209%
55%
210% - 219%
60%
220% - 229%
65%
230% - 239%
70%
240% - 249%
75%
250% - 259%
80%
260% - 269%
85%
270% - 279%
90%
280% - 289%
95%
290% - and above
100%
(3-15-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.01 - BEHAVIORAL HEALTH SLIDING FEE SCHEDULES › Section 16.07.01.400 - CALCULATING INCOME TO APPLY THE SLIDING FEE SCHEDULE FOR CHILDREN'S MENTAL HEALTH AND ADULT MENTAL HEALTH SERVICES

Current through August 31, 2023
The fee determination process includes consideration of the
				following subsections in this rule. (3-15-22)
01.
Application and Fee Determination
			 Form
. Prior to the delivery of behavioral health services, an
			 application for services and a "Fee Determination" form must be completed.
			 (3-15-22)
a. A child's parent(s) must complete
			 the application and fee determination form when requesting Children's Mental
			 Health services. (3-15-22)
b. An
			 adult requesting Adult Mental Health services must complete the application and
			 fee determination form. (3-15-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › Section 16.07.17.000 - LEGAL AUTHORITY

Current through August 31, 2023
Sections
				56-1003,
				56-1004,
				56-1004A,
				56-1007, and
				56-1009, Idaho Code, authorize the
				Director to promulgate, recommend, and enforce rules promoting substance use
				disorders services. Sections
				39-305,
				39-306, and
				39-311, Idaho Code, authorize the
				Idaho Board of Health and Welfare to adopt rules and to establish standards for
				treatment facilities. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › Section 16.07.17.003 - ADMINISTRATIVE APPEALS

Current through August 31, 2023
01.
Appeal of
			 Denial Based on Eligibility Requirements
. Administrative appeals from a
			 denial of substance use disorder services based on eligibility requirements are
			 governed by the provisions of IDAPA 16.05.03, "Contested Case Proceedings and
			 Declaratory Rulings." (3-17-22)
02.
Appeal of Decision Based on Clinical Judgment
. Decisions involving
			 ASAM clinical judgment, including the category of services, the particular
			 provider of services, or the duration of services, are reserved to the
			 Department, and are not subject to appeal, administratively or otherwise, under
			 Maresh v. State, 132 Idaho 221, 970 P.2d 14 (Idaho 1999). (3-17-22)
03.
Appeal by a Substance Use Disorder
			 Services Provider or Program
. Administrative appeals from a decision
			 that a substance use disorder services provider or program is out of compliance
			 with these rules are governed by the provisions of IDAPA 16.05.03, "Contested
			 Case Proceedings and Declaratory Rulings." An appeal does not stay Department
			 action. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › Section 16.07.17.004 - INCORPORATION BY REFERENCE

Current through August 31, 2023
The following are incorporated by reference in this chapter of
				rules: (3-17-22)
01.
ASAM
. American Society of Addiction Medicine (ASAM) Treatment
			 Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, Third
			 Edition, 2013. A copy of this manual is available by mail at the American
			 Society of Addiction Medicine, 4601 North Park Ave., Suite 101, Chevy Chase, MD
			 20815; by telephone and fax, (301) 656-3920 and (301) 656-3815 (fax); or on the
			 internet at
http://www.asam.org
.
			 (3-17-22)
02.
DSM-5
.
			 American Psychiatric Association: Diagnostic and Statistical Manual of Mental
			 Disorders, Fifth Edition, (DSM-5) Washington, DC, American Psychiatric
			 Association, 2000. Copies of the manual are available from the American
			 Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington VA
			 22209-3901. (3-17-22)
03.
Federal Guidelines for Opioid Treatment Programs (OTP)
. Substance Abuse
			 and Mental Health Services Administration. HHS Publication No. (SMA)
			 PEP15-FEDGUIDEOTP, March 2015. Center for Substance Abuse Treatment, Division
			 of Pharmacologic Therapies for the Substance Abuse and Mental Health Services
			 Administration, 1 Choke Cherry Road, Rockville, MD 20857. This manual is
			 available on the internet at
https://store.samhsa.gov/product/Federal-Guidelines-for-Opioid-Treatment-Programs/PEP15-FEDGUIDEOTP
.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › Section 16.07.17.009 - CRIMINAL HISTORY AND BACKGROUND CHECK REQUIREMENTS

Current through August 31, 2023
01.
Criminal History and Background
			 Check
. All employees, volunteers, interns, and contractors of substance
			 use disorder treatment and recovery support services must comply with the
			 provisions of IDAPA 16.05.06, "Criminal History and Background Checks.
			 (3-17-22)
02.
Availability to
			 Work or Provide Service
. An individual listed in Subsection
			 009.01 of this rule is available
			 to work on a provisional basis at the discretion of the employer or agency once
			 the individual has submitted their completed criminal history and background
			 check application, it has been reviewed by the employer or agency, and no
			 disqualifying crimes or relevant records are disclosed on the application. An
			 individual must be fingerprinted within twenty-one (21) days of submitting
			 their criminal history and background check. (3-17-22)
a. An individual is allowed to work or have
			 access to participants only under supervision until the criminal history and
			 background check is completed. (3-17-22)
b. An individual, who does not receive a
			 criminal history and background check clearance or have a Behavioral Health
			 waiver granted under the provisions in Subsection
			 009.03 of this rule, must not
			 provide direct care or services, or serve in a position that requires regular
			 contact with participants. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › Section 16.07.17.010 - DEFINITIONS - A THROUGH F

Current through August 31, 2023
For the purposes of these rules, the following terms apply:
				(3-17-22)
01.
Adolescent
.
			 A youth twelve (12) through seventeen (17) years of age. (3-17-22)
02.
Adult
. An individual
			 eighteen (18) years or older. (3-17-22)
03.
ASAM
. Refers to the manual
			 of the patient placement criteria for the treatment of substance-related
			 disorders, published by the American Society of Addiction Medicine,
			 incorporated by reference in Section
			 004 of these rules.
			 (3-17-22)
04.
ASAM Level of
			 Care Certification
.Verifies a treatment program's capacity to deliver
			 services consistent with the Level III standards of care described in the ASAM
			 criteria. (3-17-22)
05.
Clinical Assessment
. The gathering of historical and current
			 clinical information through a clinical interview and from other available
			 resources to identify an individual's strengths, weaknesses, problems, needs,
			 and determine priorities so that a service plan can be developed.
			 (3-17-22)
06.
Clinical
			 Judgment
. Refers to observations and perceptions based upon education,
			 experience, and clinical assessment. This may include psychometric, behavioral,
			 and clinical interview assessments that are structured, integrated, and then
			 used to reach decisions, individually or collectively, about an individual's
			 functional, mental, and behavioral attributes and substance use disorders
			 service needs. (3-17-22)
07.
Department
. The Idaho Department of Health and Welfare or its
			 designee. (3-17-22)
08.
Eligibility Screening
. The collection and review of information
			 directly related to the individual's substance use and level of functioning,
			 which the Department uses to determine whether an individual is eligible for
			 adult or adolescent substance use disorder services available through the
			 Department's Division of Behavioral Health. (3-17-22)
09.
Federal Poverty Guidelines
.
			 Guidelines issued annually by the Federal Department of Health and Human
			 Services establishing the poverty income limits. The federal poverty guidelines
			 for the current year may be found at:
http://aspe.hhs.gov/poverty/
.
			 (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › PARTICIPANT ELIGIBILITY › Section 16.07.17.100 - ACCESSING SUBSTANCE USE DISORDERS SERVICES

Current through August 31, 2023
Individuals may access substance use disorders services
				  administered by the Department's Division of Behavioral Health through an
				  eligibility screening. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › PARTICIPANT ELIGIBILITY › Section 16.07.17.101 - ELIGIBILITY SCREENING AND CLINICAL ASSESSMENT

Current through August 31, 2023
01.
Eligibility Screening
. The eligibility screening must be directly
				related to the individual's substance-related disorder and level of
				functioning, and will include: (3-17-22)
a.
				Questions about the individual's substance use and history; and
				(3-17-22)
b. Questions about the
				individual's income and living situation. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › PARTICIPANT ELIGIBILITY › Section 16.07.17.102 - ELIGIBILITY DETERMINATION

Current through August 31, 2023
01.
Determination of Eligibility for Substance Use Disorders Services
.
				The Department may limit or prioritize adult and adolescent substance use
				disorder services, impose income limits, define eligibility criteria, and
				establish the number of persons eligible based upon such factors as
				court-ordered services, availability of funding, the degree of financial need,
				the degree of clinical need, or other factors. (3-17-22)
02.
Eligibility Requirements
. To
				be eligible for substance use disorders services the individual must: (3-17-22)
a. Be an adult or adolescent with family
				income at or below federal poverty guidelines established by the Division;
				(3-17-22)
b. Be a resident of the
				state of Idaho; (3-17-22)
c. Be a
				member of a priority population; (3-17-22)
d. Meet diagnostic criteria for a
				substance-related disorder as described in the DSM-5; and (3-17-22)
e. Meet specifications in each of the ASAM
				dimensions required for the recommended level of care.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › PARTICIPANT ELIGIBILITY › Section 16.07.17.103 - NOTICE OF CHANGES IN ELIGIBILITY FOR SUBSTANCE USE DISORDERS SERVICES

Current through August 31, 2023
The Department may, upon ten (10) days' written notice,
				  reduce, limit, suspend, or terminate eligibility for substance use disorders
				  services. (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › PARTICIPANT ELIGIBILITY › Section 16.07.17.104 - NOTICE OF DECISION ON ELIGIBILITY AND RIGHT TO APPEAL

Current through August 31, 2023
01.
Notification of Eligibility
				Determination
. Within two (2) business days of receiving a completed
				screening, the Department will notify the individual or the individual's
				designated representative of its eligibility determination. When the individual
				is not eligible for services through the Department, the individual or the
				individual's designated representative will be notified in writing.
				(3-17-22)
02.
Notice of Right
				to Appeal
. When the individual is not eligible for services through the
				Department, the Department will notify the individual or the applicant's
				individual's designated representative. The written notice will include:
				(3-17-22)
a. A statement of the decision and
				the concise reasons for it; (3-17-22)
b. The process and timeline for pursuing an
				appeal of the decision under IDAPA 16.05.03, "Contested Case Proceedings and
				Declaratory Rulings"; and; (3-17-22)
c. The right to be represented on appeal.
				(3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › PARTICIPANT ELIGIBILITY › Section 16.07.17.120 - FINANCIAL RESPONSIBILITY FOR SUBSTANCE USE DISORDERS SERVICES

Current through August 31, 2023
An individual receiving substance use disorders services
				  through the Department is responsible for paying for the services received. The
				  financial responsibility for each service is based on the individual's ability
				  to pay as determined in IDAPA 16.07.01, "Behavioral Health Sliding Fee
				  Schedules." (3-17-22)
Idaho Administrative Code › Title IDAPA 16 - Health and Welfare, Department of › Rule 16.07.17 - SUBSTANCE USE DISORDERS SERVICES › PARTICIPANT ELIGIBILITY › Section 16.07.17.150 - SELECTION OF SERVICE PROVIDERS

Current through August 31, 2023
A participant who is eligible for substance use disorders
				  services administered by the Department's Division of Behavioral Health can
				  choose a service provider that is in the contracted substance use disorder
				  provider network. Treatment services must be within the recommended level of
				  care according to ASAM based on the individual's needs identified in the
				  assessment and resulting individualized service plan. (3-17-22)