reglab/statecodes huggingface dataset:
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 4 - Availability of Funds › Section 4-1 - Availability of CSHCN funds

Current through July 10, 2024
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.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 5 - Information › Section 5-1 - Health insurance information and utilization

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 1.
(a) The
				county department shall document information on any health insurance that the
				child's family may have.
(b)
				Families shall provide health insurance information to the county department.
				Families shall also release health insurance information to the providers when
				services are rendered.
(c) Families
				that are reimbursed directly by an insurance company shall reimburse the
				provider.
(d) The CSHCN program
				shall be a payor of last resort. Providers shall bill a family's health care
				insurance prior to submitting a claim to the CSHCN program for payment of a
				claim. Providers shall include an insurance rejection or payment statement on
				the claim when submitting the claim to the CSHCN program for payment.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 5 - Information › Section 5-2 - Family responsibility to disclose information

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 2.
A person who is applying for CSHCN services or a family of a
				  child enrolled in the CSHCN program shall immediately do the following:
(1) Inform the child's CSHCN care coordinator
				of changes in their financial circumstances that may affect the family's
				financial eligibility.
(2) Inform
				the child's CSHCN care coordinator of any plans that the family has to move to
				a new address within the current county of residence, to another county, or to
				another state.
(3) Inform the
				child's CSHCN care coordinator of changes in the child's medical condition that
				may affect the child's medical eligibility.
(4) Inform the child's CSHCN care coordinator
				of any changes in the child's health insurance benefits.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 6 - Eligibility › Section 6-1 - Financial eligibility

Current through July 10, 2024
Authority: IC 16-35-2-7
Affected: IC 16-35-2
Sec. 1.
(a) A child
				not enrolled as of December 31, 1992, is financially eligible for the CSHCN
				program services set forth in
				410
				IAC 3.2-7-2 and
				410
				IAC 3.2-7-3 if the child's family's gross income is
				equal to or less than one hundred eighty-five percent (185%) of the financial
				eligibility standard. A child must also be medically eligible according to
				section 2 of this rule.
(b) If
				funds are available in addition to those required to provide services to
				enrolled children eligible under subsection (a), and if the gross income of the
				family of a child not enrolled as of December 31, 1992, is greater than one
				hundred eighty-five percent (185%), but less than or equal to two hundred fifty
				percent (250%) of the financial eligibility standard, such child may be
				determined to be financially eligible to receive CSHCN program services or
				insurance. A child must also be medically eligible according to section 2 of
				this rule.
(c) To determine
				financial eligibility under the CSHCN program, the county department shall
				utilize the financial eligibility schedule equal to one hundred eighty-five
				percent (185%) of the poverty income guideline by family size. The state
				department of health shall provide the county department with the financial
				eligibility schedule.
(d) The state
				department of health shall publish annually in the Indiana Register the poverty
				income guidelines used to determine the financial eligibility for the CSHCN
				program.
(e) For purposes of
				determining financial eligibility, income includes the following:
(1) Public assistance or welfare
				payments.
(2) Monetary compensation
				for services, including wages, salary, commissions, or fees.
(3) Net income from farm and nonfarm
				self-employment.
(4) Social
				Security.
(5) Dividends or interest
				on savings, stocks or bonds, income from estates or trusts, or net rental
				income.
(6) Unemployment
				compensation.
(7) Government
				pensions, civilian or military, or veterans' payments.
(8) Private pensions or annuities.
(9) Alimony or child support.
(10) Regular contributions from persons not
				living in the household.
(11) Net
				royalties.
(12) Other cash income
				not previously designated. Other cash income includes, but is not limited to:
(A) cash amounts received or withdrawn from
				any source, including savings, investments, trust accounts, lottery, or other
				prize winnings;
(B) settlements or
				awards resulting from lawsuits;
(C)
				monetary gifts;
(D) contributions
				and funds raised by popular subscription; and
(E) other resources that are available to the
				child's family.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 6 - Eligibility › Section 6-2 - Medical eligibility

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 2.
(a) To be
				medically eligible for the CSHCN program, a child shall meet the following
				requirements:
(1) Be under twenty-one (21)
				years of age.
(2) Have a physical
				condition that has lasted or is expected to last at least two (2) years if not
				treated and the physical condition necessitates more health care services than
				are usually required for a child of that age.
(3) The physical condition also produces or
				will produce:
(A) disability;
(B) disfigurement;
(C) limitation of function;
(D) the need for a special diet; or
(E) dependence on an assistive device; or
				nonintervention will, within one (1) year, lead to a chronic disabling physical
				condition.
(4) Have at
				least one (1) of the eligible medical conditions defined in subsection
				(b).
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 7 - Delivery Systems › Section 7-1 - Health care service delivery system

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 1.
(a) The
				director shall select and approve physicians and other persons to provide
				health care services to children enrolled in the CSHCN program.
(b) To enable the child to receive health
				care services in a setting that is most appropriate for the type of medical
				condition affecting the child, the director may assign a child enrolled in the
				CSHCN program to receive the eligible health care services set forth in
				sections 2 and 3 of this rule from one (1) or more approved primary care
				physicians, medical specialists, or other health care providers.
(c) The CSHCN program shall only pay for the
				health care services set forth in section 2 of this rule if such health care
				services are provided in the state of Indiana.
(d) Health care services set forth in section
				3 of this rule may be provided outside the state of Indiana if the director
				determines that the specific health care service is not readily available to a
				child within the state of Indiana.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 7 - Delivery Systems › Section 7-2 - Basic services included in the health care service package

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 2.
(a) The
				availability and provision of health care services included in the basic
				service component is contingent upon the availability of program
				funding.
(b) The CSHCN program
				shall pay no greater than the Medicaid rate for any health care services
				included in the basic service package as defined as follows:
(1) Primary care visits conducted by approved
				providers in accordance with recommendations from the American Academy of
				Pediatrics.
(2) Secondary care
				visits at approved providers for medically necessary diagnostic and treatment
				services.
(3) Drugs and medications
				requiring a prescription under Indiana or federal law that are medically
				necessary for treatment or control of any medical conditions affecting the
				child. Insulin and insulin syringes shall be provided when prescribed by an
				approved provider.
(4)
				Immunizations required by Indiana law and administered in accordance with
				recommendations from the American Academy of Pediatrics and the Centers for
				Disease Control.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 7 - Delivery Systems › Section 7-3 - Limited health care services included in the health care service package

Current through July 10, 2024
Authority: IC 16-35-2-7
Affected: IC 16-35-2
Sec. 3.
(a) The
				availability and provision of health care services included in the limited
				service component is contingent upon the availability of program
				funding.
(b) Available funds may be
				utilized to purchase insurance or pay for one (1) or more of the following
				health care services authorized as appropriate to the eligible medical
				condition or conditions of an enrolled child:
(1) Inpatient services.
(2) Emergency services.
(3) Durable equipment and supplies.
(4) X-rays and laboratory services.
(5) Surgery.
(6) Dental services.
(7) Therapy. Payment of applied behavioral
				analysis as a therapy service for treatment of autism is limited to a maximum
				of ten thousand dollars ($10,000) per year, per participant.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 8 - Coordination Services › Section 8-1 - Care coordination services

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 1.
The availability and provision of care coordination services
				  is contingent upon the availability of CSHCN program funding.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 9 - Travel › Section 9-1 - Travel reimbursement

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 1.
(a) The
				availability and provision of travel reimbursement is contingent upon the
				availability of CSHCN program funding.
(b) The director may reimburse a child or
				family travel expenses incurred in transporting a child to approved health care
				providers.
(c) The director shall
				not reimburse a child or family for the first forty-nine (49) miles of travel.
				Once a child or family travels fifty (50) miles or more, the director shall
				reimburse the child or family at a rate of fifty percent (50%) of the state
				travel reimbursement rate established by the department of administration and
				approved by the state budget agency.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 10 - Confidentiality › Section 10-1 - Confidentiality

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 1.
The state department of health shall treat the medical
				  information of children applying for and enrolled in the CSHCN program as
				  confidential and follow all appropriate state and federal laws regarding the
				  confidentiality of medical information.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.2 - CHILDREN WITH SPECIAL HEALTH CARE NEEDS › Rule 11 - Advisory Council › Section 11-1 - Advisory council

Current through July 10, 2024
Authority: IC
				  16-35-2-7
Affected: IC 16-35-2
Sec. 1.
The director shall periodically report to the advisory
				  council on the administration of the CSHCN program, including, but not limited
				  to, providing information on the fiscal status of the CSHCN program.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-1 - Applicability

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 1.
The definitions in this rule apply throughout this article.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-2 - "Authorization" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 2.
"Authorization" means the process by which the
				  department:
(1) assesses;
(2) selects; and
(3) enters into;
agreements with stores that apply or subsequently reapply to
				  be authorized as WIC vendors.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-2.5 - "Cash value voucher" or "CVV" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 2.5.
"Cash value voucher" or "CVV" means a fixed-dollar amount
				  check, voucher, electronic benefit transfer (EBT) card, or other document that
				  is used by a participant to obtain authorized fruits and
				  vegetables.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-3 - "Commodity supplemental food program" or "CSFP" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 3.
"Commodity supplemental food program" or "CSFP" means a
				  program of the United States Department of Agriculture that works to improve
				  the health of low-income:
(1) pregnant
				and breastfeeding women;
(2) new
				mothers up to one (1) year postpartum;
(3) infants;
(4) children up to six (6) years of age;
				and
(5) elderly people at least
				sixty (60) years of age; by supplementing their diets with nutritious USDA
				commodity foods. The CSFP provides food and administrative funds to states to
				supplement the diets of these groups.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-4 - "Conflict of interest" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 4.
"Conflict of interest" means a situation in which a private
				  financial interest of:
(1) an
				officer;
(2) an employee;
				or
(3) the spouse or unemancipated
				child; of a vendor coincides with the private financial interest of a local
				agency or department employee.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-4.3 - "Contract brand infant baby food" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 4.3.
"Contract brand infant baby food" means all infant baby food
				  produced by the manufacturer awarded the infant baby food cost containment
				  contract. The infant baby food will include four (4) ounce glass jars of fruit
				  or vegetables. The four (4) ounce jars include single ingredient or combination
				  or combination of single ingredients excluding mixtures with cereal, desserts,
				  dinners, or food combinations (for example, meat and vegetables, rice, pasta,
				  yogurt, or noodles), organic, added sugar, starch, salt, or DHA. The infant
				  baby food also includes two and five-tenths (2.5) ounce glass jars, meat only,
				  may include broth or gravy. The two and five-tenths (2.5) ounce exclude
				  mixtures with cereal, organic, meat sticks, added sugar, salt, or
				  DHA.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-4.5 - "Contract brand infant cereal" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 4.5.
"Contract brand infant cereal" means all infant cereal in all
				  current can sizes produced by the manufacturer awarded the infant cereal cost
				  containment contract. The infant cereal will include eight (8) ounce boxes of
				  any grain or multigrain excluding organic, fruit, formula, or variety
				  packs.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-5 - "Contract brand infant formula" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 5.
"Contract brand infant formula" means all infant formulas
				  (except exempt infant formulas) produced by the manufacturer awarded the infant
				  formula cost containment contract. If under a single solicitation the
				  manufacturer subcontracts for soy-based infant formula, then all soy-based
				  infant formulas covered by the subcontract are also considered contract brand
				  infant formulas (see
				  7 CFR
				  246.16a(c)(1)(i) ). If a
				  state agency elects to solicit separate bids for milk-based and soy-based
				  infant formulas, all infant formulas issued under each contract are considered
				  the contract brand infant formula (see
				  7 CFR
				  246.16a(c)(1)(ii) ). For
				  example, the term includes the following:
(1) All of the milk-based infant formulas
				issued by a state agency that are produced by the manufacturer that was awarded
				the milk-based contract.
(2) All of
				the soy-based infant formulas issued by a state agency that are produced by the
				manufacturer that was awarded the soy-based contract.
The term also includes all infant formulas (except exempt
				  infant formulas) introduced after the contract is awarded.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-6 - "Controlled substances" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 6.
"Controlled substances" means material of a particular kind
				  that is regulated for limited distribution or use.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-7 - "Department" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 7.
"Department" means the Indiana department of health.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-8 - "Disqualification" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 8.
"Disqualification" means the act of ending the WIC program
				  participation of an authorized vendor.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-9 - "Food instrument" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 9.
"Food instrument" means:
(1) a voucher;
(2) a check; or
(3) an electronic transfer benefits (EBT)
				card;
issued by a local agency that specifies the quantity, size,
				  and type of authorized foods available to a WIC participant within a designated
				  time frame to be used at a WIC vendor.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-9.5 - "Harm" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 9.5.
"Harm" means any real or potential damage, either tangible or
				  intangible, to one (1) of the following areas:
(1) Physical.
(2) Emotional.
(3) Financial.
(4) Reputation.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-10 - "Local agency" defined

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 10.
"Local agency" means a:
(1) public or private;
(2) nonprofit; and
(3) health or human;
service agency that provides health services through a
				  contract with the department in accordance with
				  7 CFR
				  246.5.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-10.5 - "Open authorization period" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 10.5.
"Open authorization period" means the time during which
				  vendors apply to be reauthorized and vendors not currently authorized apply to
				  be authorized. The open authorization period shall be held for a thirty (30)
				  day period in the second quarter, every third year starting in
				  2009.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-11 - "Overcharge" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 11.
"Overcharge" means a charge of more than one dollar ($1) over
				  the shelf price at the time of the use of the food instrument in question.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-12 - "Participant" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 12.
"Participant" means:
(1) a woman who is:
(A) pregnant;
(B) breastfeeding; or
(C) postpartum;
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-13 - "Price comparison analysis" or "PCA" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 13.
"Price comparison analysis" or "PCA" means an analysis using
				  the prices of a selection of WIC foods submitted by the store or vendor to
				  determine the relative costs of the store or vendor for comparison purposes.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-14 - "Proxy" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-35-1.5-6
Sec. 14.
"Proxy" means any person designated by a:
(1) woman participant; or
(2) parent or caretaker of an infant or child
				participant;
to obtain and transact food instruments or to obtain
				  supplemental foods on behalf of a participant.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-15 - "Routine monitoring visit" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 15.
"Routine monitoring visit" means overt, onsite monitoring
				  during which WIC program representatives identify themselves to vendor
				  personnel.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-16 - "Reassessment" defined

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 16.
"Reassessment" means a nonroutine review of the WIC vendor's
				  compliance with the selection criteria in
				  410 IAC
				  3.6-3-4 and
				  410 IAC
				  3.6-3-5.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-17 - "Supplemental foods" defined

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 17.
"Supplemental foods" means those foods containing nutrients
				  determined to be beneficial for:
(1)
				women who are:
(A) pregnant;
(B) breastfeeding; or
(C) postpartum;
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-18 - "Vendor" defined

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 18.
"Vendor" means a sole proprietorship, partnership,
				  cooperative association, corporation, or other business entity operating one
				  (1) or more stores authorized by the state agency to provide authorized
				  supplemental foods to participants under a retail food delivery system. Each
				  store operated by a business entity:
(1) constitutes a separate vendor;
				and
(2) must:
(A) be authorized separately from other
				stores operated by the business entity; and
(B) have a single, fixed location, except
				when the authorization of mobile stores is necessary to meet the special needs
				described in the state agency's state plan in accordance with
				7 CFR
				246.4(a)(14)(xiv).
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-19 - "Vendor agreement" defined

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 19.
"Vendor agreement" means a legally binding contract,
				  complying with
				  7 CFR
				  246.12(h), between the
				  following:
(1) An authorized
				vendor.
(2) The WIC program.
The agreement describes the terms and conditions the two (2)
				  parties must follow for the vendor to redeem WIC food instruments.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-20 - "Vendor violation" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 20.
"Vendor violation" means any intentional or unintentional
				  action or omission of a vendor's current:
(1) owners;
(2) officers;
(3) managers;
(4) agents; or
(5) employees; with or without the knowledge
				of management, that violates the federal or state statutes, rules, or
				regulations governing the WIC program.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-21 - "WIC program" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 21.
"WIC program" means the Special Supplemental Nutrition
				  Program for Women, Infants and Children (WIC) authorized by Section 17 of the
				  Child Nutrition Act of 1966.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 1 - Definitions › Section 1-22 - "WIC service area" defined

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 22.
"WIC service area" means an area where local WIC participants
				  could conveniently shop alternative vendors. The term may include a county or
				  marketing area, whichever is determined more appropriate by the department
				  after considering factors including, but not limited to, the following:
(1) Geographic, population, and demographic
				information.
(2) Information
				submitted by the store or vendor.
In counties with a population less than seventy-seven
				  thousand (77,000), the service area would generally be the county. In counties
				  with a population greater than seventy-seven thousand (77,000), the service
				  area would generally be an area within five (5) miles of the applicant.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-1 - Application of rules

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 1.
This article shall apply to the following:
(1) All stores that apply for participation
				as vendors in the WIC program.
(2)
				All vendors contracting with the department or its designees.
(3) Any:
(A) individual;
(B) business entity; or
(C) commercial enterprise;
that accepts or receives food instruments or credit or
				  payment for food instruments, or both. Any authorization issued before the
				  effective date of this article shall remain valid and shall be subject to this
				  article.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-2 - Vendor selection

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 2.
The WIC program must authorize an appropriate number and
				  distribution of vendors in order to ensure the following:
(1) Adequate participant access to
				supplemental foods.
(2) Effective
				WIC program:
(A) management;
(B) oversight; and
(C) review;
of its authorized vendors.
In order to accomplish this, vendors and store applicants
				  shall be subject to the vendor selection criteria in
				  410 IAC
				  3.6-3-4 and
				  410 IAC
				  3.6-3-5.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-3 - Vendor reassessment

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 3.
Using the current vendor selection criteria, the department
				  may reassess the vendor at any time during the agreement period. The department
				  must terminate the vendor agreement if the vendor fails to meet the current
				  vendor selection criteria.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-4 - Vendor preauthorization visit

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 4.
Vendor applicants who have failed a preauthorization visit
				  shall not receive a subsequent preauthorization visit until after they have
				  advised in writing that they can comply with the vendor selection criteria.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-5 - Expiration of vendor agreement

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 5.
If the vendor wishes to continue to be authorized beyond the
				  period of its current vendor agreement, the vendor must apply for
				  reauthorization.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-6 - Vendor agreement

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 6.
(a) All
				stores authorized as a vendor by the department shall do the following:
(1) Sign a vendor agreement prescribed by the
				department in accordance with
				7 CFR
				246.12(h).
(2) Agree to comply with all applicable
				federal and state laws and rules, including, but not limited to,
				42
				U.S.C. 1786 and 7 CFR
				246.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-7 - Assignment or transfer

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 16-35-1.5
Sec. 7.
(a) A vendor
				shall not sell, assign, or transfer the following in any manner:
(1) Its authorization.
(2) The vendor:
(A) agreement;
(B) stamp; or
(C) number.
Any actual or attempted sale, assignment, or transfer of the
				  authorization, vendor agreement, vendor stamp, or vendor number shall result in
				  termination of the vendor agreement. Relocation of less than three (3) miles is
				  not a violation of this section.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 2 - General Provisions › Section 2-8 - Voluntary withdrawal from the WIC program

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC 4-21.5; IC 16-35-1.5
Sec. 8.
A vendor may voluntarily withdraw from participation in the
				  WIC program. The department, however, shall not accept voluntary withdrawal as
				  an alternative to an order of disqualification for which no appeal is pending
				  under IC 4-21.5. If, at the time of the withdrawal, the vendor owes:
(1) a fine assessment; or
(2) any other monies resulting from a
				sanction;
the fine assessment and any other monies due shall be paid in
				  full.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-1 - Authorization and reauthorization of vendors

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-19-3-5
Sec. 1.
(a) A store
				becomes a vendor when authorized in accordance with this rule.
(b) The department shall authorize vendors in
				accordance with this rule during the open authorization period. The contract
				for vendors authorized during this open authorization period begins on October
				1.
(c) A store wishing to become a
				vendor outside the open authorization period must meet the requirements of
				section 10 of this rule, unless the store can demonstrate it was not open for
				business and able to apply during the open authorization period.
Stores not open for business and able to apply during the
				  open authorization period shall be allowed to submit a WIC food vendor
				  application outside the open authorization period, and, notwithstanding the
				  date of submission, such applications shall be reviewed in accordance with
				  section 2 of this rule.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-2 - Authorization process for stores not currently authorized

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-19-3-5
Sec. 2.
(a) Stores
				not currently authorized but seeking authorization as a vendor in the open
				authorization period shall do the following:
(1) Request an application from the WIC
				program.
(2) Complete the
				application.
(3) Return the
				application to the WIC program before the end of the open authorization period.
Incomplete applications will be returned to the store's
				  representative and must be resubmitted within fifteen (15) days from when it
				  was returned to the store to be considered.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-3 - Reauthorization process for currently authorized vendors

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-19-3-5
Sec. 3.
(a) The
				store seeking reauthorization as a vendor during the open authorization period
				shall do the following:
(1) Complete the
				application for reauthorization.
(2) Return the application to the WIC program
				before the end of the open authorization period.
Incomplete applications will be returned to the store's
				  representative and must be resubmitted to the WIC program within fifteen (15)
				  days from when it was returned to the store to be considered timely.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-4 - Selection criteria for initial authorization

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-19-3-5
Sec. 4.
Only stores meeting all of the following criteria, and having
				  a total number of points assigned, under section 6 of this rule, greater than
				  or equal to the lowest point total of vendors applying in the same WIC service
				  area, will be selected for a preauthorization visit:
(1) The store shall be as follows:
(A) Located:
(i) within this state; or
(ii) in a county contiguous to the Indiana
				border.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-5 - Selection criteria for reauthorization

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-19-3-5
Sec. 5.
In addition to the criteria in section 4 of this rule, a
				  vendor seeking reauthorization must also meet the following criteria and have
				  been assigned at least two (2) points under section 6 of this rule:
(1) The vendor shall:
(A) redeem at least:
(i) forty (40) food instruments per month and
				a minimum of one percent (1%) of the food instruments in the county;
				or
(ii) one hundred fifty (150)
				food instruments per month for the immediately preceding six (6) months of food
				instrument redemption data;
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-6 - Application points

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-19-3-5
Sec. 6.
The department will assign points for the categories listed
				  in this section as part of the authorization process. Points will be assigned
				  to applications as follows:
(1) Low
				price comparison average (PCA). A store that has a PCA that is one percent (1%)
				to ten percent (10%) below the average price of vendors in the same WIC service
				area is awarded one (1) point. Any store that has a PCA more than ten percent
				(10%) below the average is awarded two (2) points.
(2) A store with a pharmacy will be awarded
				one (1) point if the WIC service area is without a WIC authorized
				pharmacy.
(3) A store that has at
				least fifty percent (50%) sales from food sales will be awarded one (1)
				point.
(4) Current authorized
				vendors who have:
(A) not received a second
				education/warning letter; or
(B)
				been required to attend a conference;
under
				  410 IAC 3.6-5-2(c)(3)
				   in the last two (2) years will be awarded
				  one (1) point.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-7 - Preauthorization visit

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-19-3-5
Sec. 7.
(a) If the
				store's application for authorization meets all criteria in section 4 of this
				rule, a representative of the WIC program shall conduct a preauthorization
				visit of the store to determine compliance with the following:
(1) All WIC food prices are marked on or near
				the foods.
(2) WIC food prices
				submitted on the application match the store's shelf prices.
(3) Minimum stocking requirements of section
				8 of this rule are met.
(4) WIC
				foods on the shelves available for sale are within their fresh date.
(5) WIC foods are stored and refrigerated in
				compliance with 410 IAC 7-24.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-8 - Minimum stock

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-19-3-5
Sec. 8.
(a) In order
				to ensure adequate participant access to supplemental foods, the following
				minimum stock shall be available on the shelf or in stock:
(1) Contract brand infant formula as follows:
(A) Twelve (12) cans of milk based with iron
				concentrate.
(B) Five (5) cans of
				milk based with iron powder.
(C)
				Five (5) cans of soy based iron fortified powder.
(D) Twenty (20) cans of milk based powder
				with reduced lactose, partially broken down protein, and DHA/ARA.
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-9 - Inadequate participant access

Current through July 10, 2024
Authority: IC 16-19-3-5; IC 16-35-1.5-6
Affected: IC 16-19-3-5
Sec. 9.
(a) The
				department may consider whether there is inadequate participant access when
				considering whether to grant or deny authorization or
				reauthorization.
(b) The department
				shall also consider whether there is inadequate participant access when
				deciding whether to impose a civil money penalty in lieu of disqualification
				under 410 IAC 3.6-4.
(c) There is
				inadequate participant access if:
(1) a
				vendor:
(A) has closed, withdrawn, or
				relocated farther than three (3) miles from its authorized location;
				and
(B) was redeeming more than
				forty (40) food instruments per month and one percent (1%) of the county's food
				instruments or one hundred fifty (150) food instruments per month with no
				minimum percentage;
Indiana Administrative Code › Title 410 - INDIANA DEPARTMENT OF HEALTH › Article 3.6 - WOMEN, INFANTS, AND CHILDREN PROGRAM RULES, PENALTIES, AND SANCTIONS FOR WIC VENDORS › Rule 3 - Selection of Vendors › Section 3-10 - Store application outside the open authorization period

Current through July 10, 2024
Authority: IC
				  16-19-3-5;
				  IC
				  16-35-1.5-6
Affected: IC
				  16-19-3-5
Sec. 10.
(a) A store
				must submit a WIC food vendor application to be considered for
				authorization.
(b) Applications
				received outside the open authorization period, except those received from a
				store meeting the exception in section 1(c) of this rule, shall be reviewed to
				determine if there is inadequate participant access.
(c) If the department determines that there
				is not inadequate participant access:
(1) the
				store will be notified in writing of that determination; and
(2) the application will be denied.