reglab/statecodes huggingface dataset:
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.4 - Access to Confidential Records

Current through Register Vol. 47, No. 3, July 24, 2024
Under Iowa Code section
				  22.7 or other applicable
				  provisions of law, the lawful custodian may disclose certain confidential
				  records to one or more members of the public. Other provisions of law authorize
				  or require the custodian to release specified confidential records under
				  certain circumstances or to particular persons. In requesting the custodian to
				  permit the examination and copying of such a confidential record, the following
				  procedures apply and are in addition to those specified for requests for access
				  to records in rule 441-9.3 (17A,22).
(1)
Proof of identity.
A
				person requesting access to a confidential record may be required to provide
				proof of identity or authority to secure access to the record.
(2)
Requests.
The custodian
				may require a request to examine and copy a confidential record to be in
				writing. A person requesting access to such a record may be required to sign a
				certified statement or affidavit enumerating the specific reasons justifying
				access to the confidential record and to provide any proof necessary to
				establish relevant facts.
(3)
Notice to subject of record and opportunity to obtain
				injunction.
Except as provided in 441-subrule 175.41(2), after the
				custodian receives a request for access to a confidential record, and before
				the custodian releases such a record, the custodian may make reasonable efforts
				to notify promptly any person who is a subject of that record, is identified in
				that record, and whose address or telephone number is contained in that record.
				To the extent such a delay is practicable and in the public interest, the
				custodian may give the subject of such a confidential record to whom
				notification is transmitted a reasonable opportunity to seek an injunction
				under Iowa Code section
				22.8, and indicate to the
				subject of the record the specific period of time during which disclosure will
				be delayed for that purpose.
(4)
Request denied.
When the custodian denies a request for access
				to a confidential record, the custodian shall promptly notify the requester. If
				the requester indicates to the custodian that a written notification of the
				denial is desired, the custodian shall promptly provide such a notification
				that is signed by the custodian and that includes:
a. The name and title or position of the
				custodian responsible for the denial; and
b. A citation to the provision of law vesting
				authority in the custodian to deny disclosure of the record and a brief
				statement of the reasons for the denial to this requester.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.5 - Requests for Treatment of a Record as a Confidential Record and Its Withholding From Examinations

Current through Register Vol. 47, No. 3, July 24, 2024
The custodian may treat a record as a confidential record and
				  withhold it from examination only to the extent that the custodian is
				  authorized by Iowa Code section
				  22.7, another applicable
				  provision of law, or a court order, to refuse to disclose that record to
				  members of the public.
(1)
Persons who may request.
Any person who would be aggrieved or
				adversely affected by disclosure of a record and who asserts that Iowa Code
				section 22.7, another applicable
				provision of law, or a court order, authorizes the custodian to treat the
				record as a confidential record, may request the custodian to treat that record
				as a confidential record and to withhold it from public inspection.
(2)
Request.
A request that
				a record be treated as a confidential record and be withheld from public
				inspection shall be in writing and shall be filed with the custodian.
a. The request must set forth the legal and
				factual basis justifying such confidential record treatment for that record,
				and the name, address, and telephone number of the person authorized to respond
				to any inquiry or action of the custodian concerning the request.
b. A person requesting treatment of a record
				as a confidential record may also be required to sign a certified statement or
				affidavit stating the specific reasons justifying the treatment of that record
				as a confidential record and to provide any proof necessary to establish
				relevant facts.
c. Requests to
				temporarily treat a record as a confidential record shall specify the precise
				period of time for which that treatment is requested.
d. A person filing such a request shall, if
				possible, provide a copy of the record in question from which those portions
				for which such confidential record treatment has been requested have been
				deleted. If the original record is being submitted to the department by the
				person requesting confidential treatment at the time the request is filed, the
				person shall indicate conspicuously on the original record that all or portions
				of it are confidential.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.6 - Procedure by Which Additions, Dissents, or Objections May Be Entered Into Certain Records

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
All
				programs.
Except as otherwise provided by law, a subject may file a
				request with the custodian to review, and to have a written statement of
				additions, dissents, or objections entered into, a record containing personally
				identifiable information pertaining to that subject. However, the subject is
				not authorized to alter the original copy of the record or to expand the
				official record of any department proceeding.
a. The subject shall send the request to
				review such a record or the written statement of additions, dissents, or
				objections to the department.
b.
				The request to review such a record or the written statement of additions,
				dissents, or objections must be dated and signed by the subject, and shall
				include the current address and telephone number of the subject or the
				subject's representative.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.8 - Notice to Suppliers of Information

Current through Register Vol. 47, No. 3, July 24, 2024
When the department requests a person to supply information
				  about that person, the department shall notify the person of how the
				  information will be used, which persons outside the department might routinely
				  be provided this information, which parts of the requested information are
				  required and which are optional, and the consequences of a failure to provide
				  the information requested. This notice may be given in these rules, on the
				  written form used to collect the information, on a separate fact sheet or
				  letter, in brochures, in formal agreements, in contracts, in handbooks, in
				  manuals, verbally, or by other appropriate means. The notice shall generally be
				  given at the first contact with the department and need not be repeated. Where
				  appropriate, the notice may be given to a person's legal or personal
				  representative. Notice may be withheld in an emergency or where it would
				  compromise the purpose of a department investigation.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.9 - Release to Subject

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Access
				by subjects to protected health information.
The department will
				follow the access of individuals to protected health information standards as
				outlined in 45 CFR §
										164.524 as amended to February 6, 2014.
				Subjects shall submit all requests for access to the department using the
				Request for Access to Health Information form. If the department does not
				maintain the protected health information that is the topic of the subject's
				request for access, and the department knows where the requested information is
				maintained, the department shall inform the subject where to direct the request
				for access.
(2) Reserved.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.10 - Use and Disclosure Without Consent of the Subject

Current through Register Vol. 47, No. 3, July 24, 2024
Open records are routinely disclosed without the consent of
				  the subject. To the extent allowed by law, the department may also use and
				  disclose confidential information without the consent of the subject or the
				  subject's representative.
(1)
Internal use.
Confidential information may be disclosed to
				employees and agents of the department as needed for the performance of their
				duties. The custodian of the record shall determine what constitutes legitimate
				need to use confidential records.
(2)
Audits and health oversight
				activities.
a.
Audits.
Information concerning program expenditures and client
				eligibility is released to staff of the state executive and legislative
				branches who are responsible for ensuring that public funds have been managed
				correctly. Information is also released to auditors from federal agencies when
				those agencies provide program funds.
b.
Health oversight
				activities.
The department will follow the uses and disclosures
				standards for health oversight activities as outlined in
				45 CFR §
											164.512 as amended to January 6,
				2016.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.11 - Availability of Records

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Open
				records.
Department records are open for public inspection and copying
				unless otherwise provided by rule or law.
(2)
Confidential records.
Iowa Code chapters governing the operations of the department establish the
				confidential nature of many department records. The department also administers
				several federally funded programs and is authorized by Iowa Code section 22.9
				to enforce confidentiality standards from federal law and regulation as
				required for receipt of the funds where the department has determined that the
				right to examine and copy public records under Iowa Code section
				22.2 would cause the denial of
				funds, services, or essential information from the United States government
				that would otherwise be available to the department.
(3)
Authority to release confidential
				records.
The department may have discretion to disclose some
				confidential records that are exempt from disclosure under Iowa Code section
				22.7 or other provision of
				law.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.12 - Personally Identifiable Information

Current through Register Vol. 47, No. 3, July 24, 2024
The nature and extent of personally identifiable information
				  collected by the department varies by the type of record. This rule describes
				  personally identifiable information collected, maintained, and retrieved by the
				  department by personal identifiers in record systems and the legal authority
				  for the collection of that information. This rule also identifies the legal
				  authority for keeping some or all of the collected personally identifiable
				  information confidential.
(1)
				Department administrative records.
a.
Personnel records.
These records contain information about
				employees, families and dependents, and applicants for positions with the
				department. Some of this information is confidential under Iowa Code section
				22.7(11) and 22.7(18).
b.
Fiscal records.
These
				records contain itemized vouchers collected from individuals pursuant to Iowa
				Code section 8A.514. Some of this information
				is confidential under Iowa Code section
				22.7(11)  and
				22.7(18).
c.
Litigation
				files.
These files or records contain information regarding litigation
				or anticipated litigation, which includes judicial and administrative
				proceedings. The records include briefs, depositions, docket sheets, documents,
				correspondence, attorney's notes, memoranda, research materials, witness
				information, investigation materials, information compiled under the direction
				of the attorney, and case management records. The files contain materials that
				are confidential as attorney work product and attorney-client communications.
				Some materials are confidential under other applicable provisions of law or
				because of a court order. Persons wishing copies of pleadings and other
				documents filed in litigation should obtain them from the clerk of the
				appropriate court that maintains the official copy. These records are
				confidential as outlined in Iowa Code sections
				217.30,
				22.7(4)  and
				622.10.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.13 - Special Policies and Procedures for Protected Health Information

Current through Register Vol. 47, No. 3, July 24, 2024
The department will follow all special policies and
				  procedures for using and disclosing protected health information as outlined in
				  45 CFR Part 164 as amended through December 31, 2023, including the minimum
				  necessary standard, uses and disclosures for premium rating and related
				  purposes, verification and documentation requirements, notice of privacy
				  practices, the right to receive an accounting of disclosures, complaint
				  procedures, appeal rights and record retention.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.14 - Person Who May Exercise Rights of the Subject

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Adults.
When the subject is an adult, including an emancipated
				minor, the subject's rights under this rule may also be exercised by the
				subject's legal or personal representative, except as provided in subrule
				9.14(3).
(2)
Minors.
Within the limits of subrule 9.14(3), when the subject
				is an unemancipated minor, the subject's rights under this rule shall be
				exercised only by the subject's legal representative, except as follows:
a. When the department otherwise deals with
				the minor as an adult, as in the case of minor parents under the family
				investment program.
b. When
				otherwise specifically provided by law. However, minor subjects shall be
				granted access to their own records upon request, subject to the limits in rule
				441-9.9(17A,22).
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 9 - Public Records and Fair Information Practices › Rule 441-9.15 - Person Who May Exercise Rights of the Subject

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Adults.
When the subject is an adult, including an emancipated
				minor, the subject's rights under this rule may also be exercised by the
				subject's legal or personal representative, except as provided in subrule
				9.15(3).
(2)
Minors.
Within the limits of subrule 9.15(3) , when the
				subject is an unemancipated minor, the subject's rights under this rule shall
				be exercised only by the subject's legal representative, except as follows:
a. When the department otherwise deals with
				the minor as an adult, as in the case of minor parents under the family
				investment program.
b. When
				otherwise specifically provided by law. However, minor subjects shall be
				granted access to their own records upon request, subject to the limits in rule
				441-9.9
				(17A,22).
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 10 - Collection of Delinquent Debts › Rule 441-10.2 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
For purposes of this rule, the following definitions
				  apply:
"Debtor"
means any person who owes a debt to
				  the department.
"Department"
means the Iowa department of
				  public health.
"Income offset program"
means the program
				  established in Iowa Code section
				  8A.504 through which the
				  department of administrative services coordinates with state agencies to
				  satisfy liabilities owed to those state agencies.
"Liability"
or
"debt"
means
				  a "qualifying debt" as defined in Iowa Code section
				  8A.504(1)  or
				  any liquidated sum due, owing, and payable by a debtor to the department. Such
				  liquidated sum may be accrued through contract, subrogation, tort, operation of
				  law, or any legal theory regardless of whether there is an outstanding judgment
				  for that sum.
"Liquidated"
means that the amount of the
				  claim or debt is definite, determined, and fixed by agreement of the parties,
				  by operation of law, or through court or administrative proceedings.
"Notification of offset"
means receipt of
				  actual notice by the department from the department of administrative services
				  that the debtor is entitled to a payment that qualifies for offset.
"Offset"
means to set off liabilities owed
				  by a person to the department against claims owed to persons by public
				  agencies.
"Person"
means an individual, corporation,
				  business trust, estate, trust, partnership or association, or any other legal
				  entity, but does not include a state agency.
"Preoffset notice"
means the notice required
				  by rule 641-179.4
				  (8A).
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 10 - Collection of Delinquent Debts › Rule 441-10.3 - Liability File

Current through Register Vol. 47, No. 3, July 24, 2024
The department may provide the department of administrative
				  services a liability file.
(1)
Contents.
With respect to each individual debtor, the
				liability file shall contain the following:
a.
				Information relevant to the identification of the debtor, as required by the
				department of administrative services and including the debtor's name and
				social security number or federal identification number,
b. The amount of liability, and
c. A written statement declaring the debt to
				have occurred.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 10 - Collection of Delinquent Debts › Rule 441-10.4 - Notification of Offset

Current through Register Vol. 47, No. 3, July 24, 2024
Within 10 calendar days of receiving notification from the
				  department of administrative services that the debtor is entitled to a payment,
				  the department shall:
(1) Send a
				preoffset notice to the debtor. The preoffset notice shall inform the debtor of
				the amount the department intends to claim and shall include all of the
				following information:
a. The department's
				right to the payment in question.
b. The department's right to recover the
				payment through the offset procedure.
c. The basis of the department's case in
				regard to the debt.
d. The right of
				the debtor to request, in accordance with rule
				641-179.5 (8A) and within 15
				days of the mailing of the preoffset notice, a split of the payment between
				parties when the payment in question is jointly owned or otherwise owned by two
				or more persons.
e. The debtor's
				right to appeal the offset, in accordance with rule
				641-179.6 (8A) and within 15
				days of the mailing of the preoffset notice, and the procedure to follow in
				that appeal.
f. The department's
				contact information, including a telephone number, for the debtor to contact in
				case of questions.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 10 - Collection of Delinquent Debts › Rule 441-10.5 - Request to Divide a Jointly or Commonly Owned Right to Payment

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A debtor who
				receives a preoffset notice may request release of a joint or common owner's
				share if the request is received by the department within 15 days of the date
				the preoffset notice is mailed.
(2)
				In conjunction with such a request, the debtor shall provide to the department
				the full name and social security number of any joint or common
				owner.
(3) Upon receipt of such a
				request, the department shall notify the department of administrative services
				of the request.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 10 - Collection of Delinquent Debts › Rule 441-10.6 - Appeal Process

Current through Register Vol. 47, No. 3, July 24, 2024
(1) A
				debtor who receives a preoffset notice may request an appeal of the existence
				or amount of the underlying debt if such request is made within 15 days of the
				date the preoffset notice is mailed.
(2) Request for appeal must be submitted in
				writing to the Iowa Department of Public Health, Bureau of Finance, Attn:
				Offset Appeals, 321 E. 12th Street, Des Moines, Iowa 50319-0075.
(3) If a request for appeal is timely made,
				the department shall issue a notice of hearing to the debtor and provide a copy
				of the notice of hearing to the assistant attorney general for the
				department.
(4) The appeal shall be
				conducted as a contested case proceeding pursuant to 641-Chapter 173.
(5) If a request for appeal is timely made,
				the department shall notify the department of administrative services within 45
				days of the notification of offset. The department shall hold a payment in
				abeyance until the final disposition of the contested liability or
				offset.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 10 - Collection of Delinquent Debts › Rule 441-10.7 - Notice of Offset

Current through Register Vol. 47, No. 3, July 24, 2024
Once any offset has been completed, the department shall
				  notify the debtor of the action taken, and of what balance, if any, still
				  remains owing to the department.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 11 - Collection of Public Assistance Debts › Rule 441-11.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Current"
shall mean that amount which is
				  due and owing within the previous 12 months from the date of submission to the
				  department of administrative services or that amount which is due and owing
				  from the date the repayment agreement or court order is implemented, if less
				  than 12 months, before the date of submission to the department of
				  administrative services.
"Current repayment"
shall mean that payment
				  of the cumulative sum due and owing in accordance with a repayment agreement or
				  court order for the preceding 12 months or the date of the order or agreement
				  if the order or agreement is more recent.
"Debtor"
shall mean a current or former
				  recipient of public assistance that has been determined by the department to be
				  responsible for the repayment of a particular debt. For supplemental nutrition
				  assistance program (SNAP), "debtor" shall include all adult members of the SNAP
				  household participating at the time the SNAP overpayment or program violation
				  occurred and shall include nonrecipients found guilty of violating SNAP rules
				  by committing an act such as, but not limited to, trafficking. For child care
				  assistance, "debtor" may include the current or former provider or current or
				  former recipient of child care assistance. For Medicaid, "debtor" shall include
				  any current or former Medicaid member, or the parents of a current or former
				  Medicaid member who was under the age of 21 when the parents completed the
				  application and had responsibility for reporting changes, who received services
				  or benefits as a result of client or agency error or administrative overpayment
				  or who owes a debt of unpaid premium payments for medical assistance.
"Department"
shall mean the department of
				  human services.
"Public assistance"
shall mean family
				  investment program, SNAP, Medicaid, state supplementary assistance, PROMISE
				  JOBS, child care assistance, refugee cash assistance, and hawki program.
"Repayment agreement"
shall mean an
				  agreement entered into voluntarily between the department and the debtor for
				  the repayment of debts. Agreements shall be made on Form 470-0495 or
				  470-0495(S), Agreement to Pay a Debt, or on a notice of debt listed in subrule
				  11.2(2).
"Written notification"
shall mean the
				  notification sent to a debtor by the department on Form 470-1668, Notice of
				  Setoff of an Iowa Income Tax Refund for Debts Owed the Department of Human
				  Services, Form 470-4139, Notice of Income Offset Against State Warrants, and
				  Form 470-4140, Notice of Income (Payroll) Offset.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 11 - Collection of Public Assistance Debts › Rule 441-11.2 - Establishment of Claim

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Accounts.
The department shall maintain an account for each
				debt that has occurred. The account shall contain the following:
a. A debtor name and account
				number.
b. Program in which the
				debt occurred.
c. Date the debt was
				discovered.
d. Inclusive dates of
				the debt.
e. Total dollar amount of
				each debt.
f. Primary cause of the
				debt.
g. Any transaction applied to
				this debt.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 11 - Collection of Public Assistance Debts › Rule 441-11.3 - Application of Payment

Current through Register Vol. 47, No. 3, July 24, 2024
Payment shall be applied only to debts subject to collection
				  pursuant to subrule 11.2(4).
(1)
Application of payment to single program area.
a. If there is more than one debt in a
				program, payment shall be applied:
(1) First
				to all debts which have an agreement in chronological order of discovery,
				and
(2) Then to debts which do not
				have an agreement in chronological order of discovery until all debts have been
				paid in full or the full payment amount has been exhausted.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 11 - Collection of Public Assistance Debts › Rule 441-11.4 - Setoff Against State Income Tax Refund, Rebate, or Other State Payments, Including, for Example, State Employee Wages

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Criteria for setoff.
a. A claim against a debtor may be made by
				the department for public assistance debts when:
(1) A debtor has failed to negotiate a
				repayment agreement for that program area of public assistance, or
(2) A repayment agreement is not current,
				and
(3) The cumulative balance of
				the applicable debts in 11. 4(1)
"a"
(1) and (2) exceeds
				$50.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 11 - Collection of Public Assistance Debts › Rule 441-11.5 - Setoff Against Federal Income Tax Refund or Other Federal Payments, Including, for Example, Federal Employee Wages

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Criteria for setoff.
a.
				Debtors not participating in SNAP shall be subject to collection action through
				the treasury offset program (TOP) which includes, but is not limited to,
				federal salary offset and federal tax refund offset.
(1) Debtors shall be referred to TOP if they
				are delinquent in repaying their SNAP debt and there is a claim or combination
				of claims with an unpaid balance which exceeds $25.
(2) No claim which is less than three months
				old or more than ten years old as of January 31 of the offset year shall be
				referred. Exception: Claims which have had a final judgment entered are not
				subject to the ten-year time limit.
(3) Debtors are delinquent in repaying their
				SNAP debt if:
1. A repayment agreement has not
				been signed and 120 days have elapsed since the due date of the demand letter
				as defined in 441-subrule 65.21(4) minus any days the claim was not subject to
				collection action because of an appeal.
2. A repayment agreement has been signed but
				the debtor has failed to make the agreed-upon payments and has failed to make
				up the missed payments. The debtor shall be referred to TOP when 120 days have
				elapsed since the first of the month following the month that the debtor failed
				to make the agreed-upon payment and has not subsequently made up the missed
				payment.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Active case"
means a case that was
				  receiving assistance for the month of review.
"Case record"
means the record used to
				  establish a client's eligibility.
"Client"
means a current or former applicant
				  or recipient of the family investment program (FIP), Supplemental Nutrition
				  Assistance Program (SNAP), child care assistance program, or medical assistance
				  program.
"Field investigation"
means a contact
				  involving the public or other agencies to obtain information about the client's
				  circumstances for the appropriate month of review.
"Medical assistance programs"
means those
				  programs funded by Medicaid or the Children's Health Insurance Program
				  (CHIP).
"Month of review"
means the specific
				  calendar or fiscal month for which the assistance under review is
				  received.
"Negative case"
means a case that was
				  terminated or denied assistance in the month of review.
"Public assistance programs"
means those
				  programs involving federal funds, i.e., FIP, SNAP, child care assistance
				  program, and medical assistance program.
"Random sample"
means a systematic (or every
				  nth unit) sample drawn monthly for which each item in the universe has an equal
				  probability of being selected. Sample size is determined by federal guidelines
				  or state corrective action needs.
"State policies"
means the rules and
				  regulations used by the department to administer FIP, SNAP, child care
				  assistance program, and medical assistance program.
This rule is intended to implement Iowa Code sections
				  234.12,
				  239B.4,
				  249A.4 and
				  514I.4.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.2 - Review of Public Assistance Records by the Department

Current through Register Vol. 47, No. 3, July 24, 2024
(1) Authorized
				representatives of the department shall have the right to review case records
				to determine the following:
a. Whether the
				client has provided complete, correct and accurate information to the
				department to be used in the determination of the assistance
				benefits.
b. Whether the department
				has correctly administered the state policies in determination of assistance
				for the public assistance programs.
c. Whether overpayments or underpayments have
				been made correctly to the public assistance client during the month of
				review.
d. Whether there is
				indication of fraudulent practice or abuse of the public assistance programs by
				either the client or department.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.3 - Cases to Be Reviewed

Current through Register Vol. 47, No. 3, July 24, 2024
Any active or negative public assistance case may be reviewed
				  at any time at the discretion of the department to:
(1) Ensure federal and state requirements for
				quality control are met.
(2) Detect
				error prone case issues to assist in corrective action.
(3) Maintain public assistance program
				integrity.
This rule is intended to implement Iowa Code sections
				  234.6,
				  234.12,
				  239B.4,
				  249A.4, and
				  514I.4.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.4 - Notification of Review

Current through Register Vol. 47, No. 3, July 24, 2024
On positive case actions, clients will be notified, either
				  orally or in writing, that their case has been selected for review when contact
				  is required by federal guidelines, or when contact is allowed and additional
				  information is required to complete the review. The client will be contacted in
				  a negative case only if a discrepancy exists that cannot be resolved from the
				  case record and contact is allowed by federal guidelines.
This rule is intended to implement Iowa Code sections
				  234.6,
				  234.12,
				  239B.4,
				  249A.4, and
				  514I.4.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.5 - Review Procedure

Current through Register Vol. 47, No. 3, July 24, 2024
The department will select the appropriate method of
				  conducting the review.
(1) A random
				sampling of active and negative case actions will be used to determine the case
				records to be studied.
(2) The case
				record will be analyzed for discrepancies and correct application of policies
				and procedures and will be used as the basis for a field
				investigation.
(3) Client
				interviews are required as follows:
a.
				Personal interviews are required on all active SNAP reviews.
b. An appointment letter may be sent to the
				client by the department to schedule or confirm the appointment date, time and
				location.
c. Client contacts are
				only required in negative case reviews when there is a discrepancy that cannot
				be resolved from the case record.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.6 - Failure to Cooperate

Current through Register Vol. 47, No. 3, July 24, 2024
Client cooperation with quality control is a program
				  eligibility requirement as set forth in rule
				  441-65.3 (234). When quality
				  control determines that a client has refused to cooperate with the review
				  process, the client is no longer eligible for the program benefits and will not
				  be eligible for the program benefits until the client has cooperated.
This rule is intended to implement Iowa Code section
				  234.12.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.7 - Report of Findings

Current through Register Vol. 47, No. 3, July 24, 2024
The quality control review findings are used by the
				  department in the following ways:
(1)
				To take the appropriate case action where an overpayment or underpayment has
				been found in a client's case record.
(2) To identify error-prone program issues to
				be used in planning a department corrective action plan.
(3) To determine the error rate used to
				establish state agency liability.
This rule is intended to implement Iowa Code sections
				  234.12,
				  239B.4,
				  249A.4, and
				  514I.4.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 13 - Program Evaluation › Rule 441-13.8 - Federal Review

Current through Register Vol. 47, No. 3, July 24, 2024
A sample of cases may also be reviewed by the applicable
				  federal agency to determine the correctness of the department's action or of
				  the department's review of the case.
This rule is intended to implement Iowa Code sections
				  234.12,
				  237A.12,
				  239B.4,
				  249A.4, and
				  514I.4.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 16 - Notices › Rule 441-16.1 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
"Adequate notice"
means any notice of
				  decision or notice of action that includes all of the following
				  information:
1. A description of the
				action taken;
2. The effective date
				of the action;
3. The specific
				reasons supporting the action, stated language likely to be understood by the
				average program applicant or enrollee;
4. References to applicable provisions of law
				supporting the action;
5. An
				explanation of the right to appeal; and
6. The circumstances under which assistance
				is continued when an appeal is filed.
"Adverse benefit determination"
means any
				  adverse action taken by the department regarding assistance program benefits
				  administered by the department or on the department's behalf, excluding
				  department decisions about requests for exceptions to policy.
"Assistance program"
means a program
				  administered by the department or on the department's behalf through which
				  qualifying individuals receive benefits or services.
"Enrollee"
means any applicant for, or
				  recipient of, benefits or services pursuant to an assistance program.
"Timely"
means that the notice is sent at
				  least ten calendar days before the date the adverse benefit determination would
				  become effective. The timely notice period shall begin on the day after the
				  notice is sent.
Iowa Administrative Code › Agency 441 - Human Services Department › Title I - General Departmental Procedures › Chapter 16 - Notices › Rule 441-16.3 - Notices

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Timely notice.
For individuals applying for, or receiving,
				benefits pursuant to an assistance program, the department will provide timely,
				written notice of the right to appeal any adverse benefit determinations
				affecting the individual's benefits or eligibility, when required to do so
				under state or federal law.
The department will also provide timely, written notice of
				  pending actions for a state or federal tax or debtor offset.
Timely notice must also be adequate as provided in subrule
				  16.3(2).
(2)
Adequate notice.
The department shall give adequate notice of
				the approval or denial of assistance or services; the approval or denial of a
				license, certification, approval, registration, or accreditation; pending
				action for a state or federal tax or debtor offset; or to the extent standards
				provided elsewhere in state or federal law are inapplicable. Adequate notice
				shall include:
a. A description of the action
				taken;
b. The effective date of the
				action;
c. The specific reasons
				supporting the action, stated in clear language likely to be understood by the
				average program applicant or enrollee;
d. References to applicable provisions of law
				supporting the action;
e. An
				explanation of the right to appeal; and
f. The circumstances under which assistance
				is continued when an appeal is filed.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 22 - Autism Support Program › Rule 441-22.3 - Cost-sharing Requirements and Graduated Schedule of Cost Sharing

Current through Register Vol. 47, No. 3, July 24, 2024
(1) An individual
				with a household income equal to or greater than 200 percent of the federal
				poverty level, up to a maximum of 500 percent of the federal poverty level,
				shall be subject to cost-sharing requirements. Cost sharing shall be
				implemented incrementally up to a maximum of 15 percent of the costs of the
				services provided through the program for an individual with a household income
				equal to 500 percent of the federal poverty level. The following is a chart of
				the cost-sharing requirements:
Family income as a
%
of FPL
%
of cost sharing of service costs
Family income as a
%
of FPL
%
of cost sharing of service costs
200-209%
0.5%
350-359%
8.0
210-219%
1.0%
360-369%
8.5
220-229%
1.5%
370-379%
9.0
230-239%
2.0%
380-389%
9.5
240-249%
2.5%
390-399%
10.0%
250-259%
3.0%
400-409%
10.5%
260-269%
3.5%
410-419%
11.0%
270-279%
4.0%
420-429%
11.5%
280-289%
4.5%
430-439%
12.0%
290-299%
5.0%
440-449%
12.5%
300-309%
5.5%
450-459%
13.0%
310-319%
6.0%
460-469%
13.5%
320-329%
6.5%
470-479%
14.0%
330-339%
7.0%
480-489%
14.5%
340-349%
7.5%
490-500%
15.0%
(2)
				An individual may request an exemption from cost sharing due to financial
				hardship. To qualify for an exemption, an individual shall submit written
				documentation to the department that the individual or the individual's family
				does not have the financial means to fulfill cost-sharing
				requirements.
(3) Criteria to
				determine financial hardship include, but are not limited to, a change in
				income, change in employment of the parent or guardian, additional medical
				expenditures, other family members' health conditions, or other conditions
				which may affect the ability to fulfill cost-sharing requirements. The
				department shall provide a written determination regarding eligibility for
				exemption from cost-sharing requirements. Eligibility for exemption from cost
				sharing expires at the end of the financial eligibility period.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 22 - Autism Support Program › Rule 441-22.4 - Review of Financial Eligibility, Cost-sharing Requirements, Exemption From Cost Sharing, and Disenrollment in the Program

Current through Register Vol. 47, No. 3, July 24, 2024
(1) An eligible individual's continued
				financial eligibility for the program, cost-sharing requirements, and exemption
				from cost sharing shall be determined on an annual basis.
(2) The administrator shall request needed
				information from the eligible individual's parent or guardian for
				redetermination of financial eligibility, cost-sharing requirements, and
				exemption from cost sharing at least 30 days prior to the expiration of the
				eligible individual's eligibility period. The notice requesting information
				needed for renewal of eligibility shall include the ending date of eligibility
				for services.
(3) The department
				shall provide a written notice of decision determining ongoing eligibility or
				denial within 15 calendar days of receipt of the continued financial
				eligibility documentation.
(4) If
				the signed application and verification of continuing eligibility are not
				received by the department by the last working day of the renewal month, the
				individual's eligibility for the program shall be terminated.
(5)Reasons for disenrollment in the autism
				support program include:
a. Death of the
				eligible individual.
b. The family
				no longer meets one or more of the eligibility criteria outlined in rule
				441-22.2(225D).
c. The parent or
				legal guardian has failed to provide information required for redetermination
				of eligibility.
d. The eligible
				individual has failed to access authorized services for a period of three
				consecutive months and has not made arrangements with the autism service
				provider or administrator to access authorized services.
e. No funds are appropriated for the autism
				support program.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 22 - Autism Support Program › Rule 441-22.5 - Initial Service Authorization and Renewal of Service Authorization

Current through Register Vol. 47, No. 3, July 24, 2024
(1) All services
				reimbursed through the program shall be prior-authorized by the
				administrator.
(2) An autism
				service provider shall submit an initial treatment plan to the administrator
				specifying a plan of treatment for a period of no more than six months. The
				initial treatment plan shall specify the amount of units of applied behavioral
				analysis services requested for the eligible individual and include a baseline
				standardized assessment score.
(3)
				Family engagement and participation are required for participation in the
				autism support program. Treatment plans shall identify specific activities and
				responsibilities of parents or guardians in the treatment plan.
(4) The treatment plan shall reflect the
				autism service provider's engagement with the school in which the eligible
				individual is enrolled. Treatment plans shall identify specific actions taken
				by the autism service provider to engage the eligible individual's school and
				the results of such actions.
(5)
				The treatment plan may include services provided by staff with a minimum of a
				bachelor's degree in a human services or education field, working under the
				supervision of an autism service provider who is board-certified as a behavior
				analyst. The treatment plan shall identify which services shall be provided
				directly by the board-certified behavior analyst and which services shall be
				provided by staff under the supervision of a board-certified behavior
				analyst.
(6) For renewal or
				modification of service authorizations, the autism service provider shall
				submit an updated plan of treatment with a request for the number of units of
				applied behavioral analysis the provider believes is medically necessary to
				address the eligible individual's ongoing treatment needs. The autism service
				provider shall also provide evidence of the eligible individual's progress on
				identified treatment goals. The administrator shall consider the eligible
				individual's updated standardized assessment score along with other clinical
				information when reviewing requests for renewal or modification of service
				authorizations. Ongoing service authorization requests shall not exceed six
				months in duration.
(7) The
				administrator shall provide approval, request for modification, or denial
				within five business days of receipt of all service authorization
				requests.
Iowa Administrative Code › Agency 441 - Human Services Department › Title III - Mental Health › Chapter 22 - Autism Support Program › Rule 441-22.6 - Provider Network

Current through Register Vol. 47, No. 3, July 24, 2024
The administrator shall establish and maintain a network of
				  department-approved autism service providers so that applied behavioral
				  analysis services are available to eligible individuals statewide to the
				  maximum extent possible.
(1) A
				provider shall be approved to participate in the autism support program
				provider network if the provider meets one of the following standards in
				paragraph 22.6(1)
"a, " "b "
or
"c":
a. The autism service provider is certified
				as a behavior analyst by the Behavior Analyst Certification Board; or
b. The autism service provider is a
				psychologist licensed under Iowa Code chapter 154B; or
c. The autism service provider is a
				psychiatrist licensed under Iowa Code chapter 148; and
d. A provider shall be deemed eligible to
				participate in the autism support program provider network if the autism
				service provider meets the standards in paragraph 22.6(1) "a,
				"
"b"
or
"c"
and the provider is approved to
				provide applied behavioral analysis services through Medicaid.