SUBCHAPTER 43F ‑ CHILDREN'S SPECIAL HEALTH SERVICES:

CHILDREN AND YOUTH SECTION

SECTION .0100 ‑ GENERAL PROVISIONS

10A NCAC 43F .0101 PURPOSE

10A NCAC 43F .0102 DEFINITIONS

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. October 1, 1993; September 1, 1990; July 1, 1986; July 1, 1984; July 1, 1980;

Repealed Eff. July 1, 2014.

SECTION .0200 ‑ GENERAL POLICIES

10A NCAC 43F .0201 REFERRAL AND FOLLOW‑UP

10A NCAC 43F .0202 RELEASE OF MEDICAL INFORMATION

10A NCAC 43F .0203 OUT‑OF‑STATE CARE

10A NCAC 43F .0204 SPONSORED CLINICS

10A NCAC 43F .0205 PARTICIPATING PHYSICIANS, ORTHODONTISTS AND PROSTHODONTISTS

10A NCAC 43F .0206 NEW CLINIC DIRECTORS AND NEW CLINICS

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. September 1, 1990; November 1, 1989; August 1, 1988; July 1, 1986; July 1, 1984; April 1, 1981; July 1, 1980;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0207 SPEECH AND LANGUAGE PATHOLOGISTS AND AUDIOLOGISTS

History Note: Authority G.S. 130A-124;

Eff. July 1, 1980;

Amended Eff. September 1, 1990; July 1, 1986; July 1, 1984; December 1, 1980;

Repealed Eff. July 1, 2014.

SECTION .0300 ‑ ELIGIBILITY

10A NCAC 43F .0301 DETERMINATION

10A NCAC 43F .0302 AGE

10A NCAC 43F .0303 MEDICAL CONDITIONS SUPPORTED BY THE PROGRAM

10A NCAC 43F .0304 MEDICAL CONDITIONS OR PROCEDURES NOT SUPPORTED

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. September 1, 1990; July 1, 1986; January 1, 1982; July 1, 1981; July 1, 1980;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0305 APPEALS PROCEDURE CONCERNING ELIGIBILITY

History Note: Authority G.S. 130A-124;

Eff. July 1, 1980;

Amended Eff. September 1, 1990; February 1, 1987; July 1, 1986;

Repealed Eff. July 1, 2014.

SECTION .0400 ‑ SERVICES

10A NCAC 43F .0401 CLINIC SERVICES

10A NCAC 43F .0402 OTHER OUTPATIENT SERVICES

10A NCAC 43F .0403 HOSPITALS

10A NCAC 43F .0404 HOSPITALIZATION

10A NCAC 43F .0405 SPECIAL THERAPY

10A NCAC 43F .0406 ORTHODONTIC AND PROSTHODONTIC DENTAL CARE

10A NCAC 43F .0407 APPLIANCES AND EQUIPMENT

10A NCAC 43F .0408 DRUGS

10A NCAC 43F .0409 BLOOD

10A NCAC 43F .0410 STAFF CONSULTANT AND ADVISORY SERVICES

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. September 1, 1990; August 1, 1988; July 1, 1986; July 1, 1984; April 1, 1984; October 1, 1983; July 1, 1983; January 1, 1982; July 1, 1981; April 1, 1981; July 1, 1980;

Repealed Eff. July 1, 2014.

SECTION .0500 ‑ AUTHORIZATION AND BILLING PROCEDURES

10A NCAC 43F .0501 AUTHORIZATION POLICIES

10A NCAC 43F .0502 SERVICE AUTHORIZATION

10A NCAC 43F .0503 CANCELLATIONS

10A NCAC 43F .0504 SPECIAL THERAPY REQUESTS

10A NCAC 43F .0505 BILLING POLICIES

10A NCAC 43F .0506 PHYSICIANS' BILLING POLICIES

10A NCAC 43F .0507 OTHER PROFESSIONAL SERVICES

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. September 1, 1990; July 1, 1986; July 1, 1984; April 1, 1984; April 1, 1982; July 1, 1981; December 1, 1980; July 1, 1980;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0508 CLINIC CHARGES AND OUTPATIENT CHARGES

10A NCAC 43F .0509 CLERICAL CHARGES

10A NCAC 43F .0510 AUTHORIZED HOSPITALIZATION

10A NCAC 43F .0511 AUTHORIZED APPLIANCES

10A NCAC 43F .0512 AUTHORIZED DRUGS FOR OUTPATIENTS

History Note: Authority G.S. 130A-124;

Eff. July 1, 1980;

Amended Eff. September 1, 1990; July 1, 1986; April 1, 1982; July 1, 1981; December 1, 1980;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0513 REIMBURSEMENT RATES

History Note: Authority G.S. 130A-124;

Temporary Rule Eff. August 15, 1982, for a Period of 120 Days to Expire on December 12, 1982;

Eff. October 1, 1982;

Amended Eff. July 1, 1986;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0514 APPEALS PROCEDURE

History Note: Authority G.S. 130A-124;

Eff. February 1, 1987;

Repealed Eff. July 1, 2014.

SECTION .0600 ‑ FORMS

10A NCAC 43F .0601 REQUESTS FOR FORMS

10A NCAC 43F .0602 REQUEST FORM FOR COST SERVICES

10A NCAC 43F .0603 FINANCIAL ELIGIBILITY FORM

10A NCAC 43F .0604 FORMS FOR DENIAL OF REQUESTS FOR SERVICE

10A NCAC 43F .0605 CLINIC NOTES FORM

10A NCAC 43F .0606 CLINIC RECORD

10A NCAC 43F .0607 CLERICAL SERVICES

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. September 1, 1990; July 1, 1986; July 1, 1984; April 1, 1982; July 1, 1980;

Repealed Eff. July 1, 2014.

SECTION .0700 ‑ ROSTERS

10A NCAC 43F .0701 QUALIFICATIONS

10A NCAC 43F .0702 FURTHER INFORMATION

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. April 1, 1992; January 1, 1990; June 1, 1989; July 1, 1986; July 1, 1980;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0703 APPEALS PROCEDURE

History Note: Authority G.S. 130A-124;

Eff. February 1, 1987;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0704 ADMINISTRATIVE REQUIREMENTS

History Note: Authority G.S. 130A-124;

Eff. June 1, 1989;

Amended Eff. September 1, 1990;

Repealed Eff. July 1, 2014.

SECTION .0800 ‑ ADOPTION

10A NCAC 43F .0801 GENERAL PROVISION

10A NCAC 43F .0802 REQUIREMENTS FOR THE ADOPTIVE CHILD

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. January 4, 1993; June 1, 1990; July 1, 1986; July 1, 1981; July 1, 1980;

Repealed Eff. July 1, 2014.

10A NCAC 43F .0803 RESERVED FOR FUTURE CODIFICATION

10A NCAC 43F .0804 APPLICATION FOR COVERAGE AFTER ADOPTION

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. January 4, 1993; July 1, 1986; July 1, 1980;

Repealed Eff. July 1, 2014.

SECTION .0900 ‑ AGREEMENTS WITH OTHER AGENCIES

10A NCAC 43F .0901 AGREEMENT WITH VOCATIONAL REHABILITATION

History Note: Authority G.S. 130A-124;

Eff. February 1, 1976;

Readopted Eff. December 5, 1977;

Amended Eff. July 1, 1986; July 1, 1980;

Repealed Eff. July 1, 2014.

SECTION .1000 ‑ CHILDREN'S SPECIAL HEALTH CONTRACT FUNDS

10A NCAC 43F .1001 OUTPATIENT CLINIC SERVICES

10A NCAC 43F .1002 DEFINITIONS

10A NCAC 43F .1003 PROVIDER ELIGIBILITY

10A NCAC 43F .1004 CLIENT ELIGIBILITY

10A NCAC 43F .1005 SCOPE OF SERVICES

10A NCAC 43F .1006 ALLOCATION OF FUNDS: CONTRACT

10A NCAC 43F .1007 REPORTING REQUIREMENTS

10A NCAC 43F .1008 CLIENT AND THIRD PAR TY FEES

10A NCAC 43F .1009 APPLICATION FOR FUNDS

10A NCAC 43F .1010 BUDGETING OF GRANT FUNDS

10A NCAC 43F .1011 ANNUAL PLAN

10A NCAC 43F .1012 RENEWAL OF GRANT FUNDS

History Note: Authority G.S. 130A-124;

Eff. April 1, 1985;

Amended Eff. September 1, 1990; November 1, 1988; August 1, 1988; July 1, 1986;

Repealed Eff. July 1, 2014.

SECTION .1100 ‑ NORTH CAROLINA HEMOPHILIA ASSISTANCE PLAN

10A NCAC 43F .1101 GENERAL

10A NCAC 43F .1102 ALLOCATION OF FUNDS

10A NCAC 43F .1103 ELIGIBILITY

10A NCAC 43F .1104 PAYMENT LIMITATIONS

10A NCAC 43F .1105 SERVICES

History Note: Authority G.S. 130A‑124;

Eff. January 1, 1982;

Temporary Rule Eff. August 15, 1982, for a Period of 120 Days to Expire on December 12, 1982;

Amended Eff. January 1, 1996; June 1, 1990; July 1, 1986; July 1, 1983;

Expired Eff. November 1, 2017 pursuant to G.S. 150B-21.3A.

SECTION .1200 - NEWBORN SCREENING PROGRAM

10A NCAC 43F .1201 GENERAL

The hearing screening component of the Department of Health and Human Services' Newborn Screening Program is administered by the central office staff for Children's Special Health Services. The genetic screening component of the Department's Newborn Screening Program is found in 10A NCAC 43H .0314.

History Note: Authority G.S. 130A‑125;

Temporary Adoption Eff. October 1, 1999;

Eff. August 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. October 3, 2017.

10A NCAC 43F .1202 DEFINITIONS

As used in this Section:

(1) "CSHS" means the Children's Special Health Services Program central office staff;

(2) "Neonate" means any term infant less than one month of age or any preterm infant less than one month corrected age; and

(3) "Person" means any natural person, partnership, corporation, unit of government of this State, and any unincorporated organizations.

History Note: Authority G.S. 130A‑125;

Temporary Adoption Eff. October 1, 1999;

Eff. August 1, 2000;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. October 3, 2017.

10a ncac 43F .1203 SCREENING REQUIREMENTS

(a) Medical facilities that provide birthing or inpatient neonatal services shall:

(1) Physiologically screen each newborn in each ear for the presence of permanent hearing loss before the infant is discharged from the medical facility after birth unless medical complications prevent such; and

(2) Maintain the equipment necessary to physiologically screen each newborn for the presence of permanent hearing loss.

(b) Any physician that attends a newborn within 30 days of birth and determines that the newborn has not been physiologically screened in each ear for the presence of permanent hearing loss shall refer the patient for such screening within 30 days of birth or as soon as is practical.

(d) When an attending physician has issued an order that diagnostic auditory evoked response testing be performed for an infant who exhibits medically recognized risk factors of auditory deficits, a hearing screening is not required to be performed on the infant. The outcome of the diagnostic testing procedure shall be reported in accordance with 10A NCAC 43F .1204.

History Note: Authority G.S. 130A-125; S.L. 1998, c. 131, s. 13;

Temporary Adoption Eff. October 1, 1999;

Eff. August 1, 2000;

Amended Eff. August 1, 2004;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. October 3, 2017.

10a ncac 43f .1204 REPORTING REQUIREMENTS

(a) All persons performing physiologic hearing screenings for infants less than six months of age shall report within five days following the screening (or date of the appointment for the screening) to the North Carolina State Laboratory for Public Health, using forms developed by the Department of Health and Human Services:

(1) Identifying information (such as name, address, birthdate, mother's name, mother's Social Security number, mother's Medicaid number, birth hospital, physician, county of residence) for each infant, and either

(2) The outcome of each hearing screening; or

(3) The date of the missed scheduled appointment for such screening.

Birthing/neonatal facilities shall submit initial hearing screening outcomes simultaneously with each infant's blood specimen for genetic screening, using forms developed by the Department of Health and Human Services.

(b) All birthing/neonatal facilities performing neonatal physiologic hearing screenings shall report quarterly to the Division of Public Health, using forms developed by the Department of Health and Human Services, within 30 days after the end of each quarter in the calendar year, total unduplicated count of:

(1) Neonates who were screened;

(2) Neonates whose parents or guardians objected to the hearing screening;

(3) Live births, if the report is being submitted by a medical facility;

(4) Transfers into the facility, not previously screened; and

(5) Neonates not screened due to transfer out of the facility, NICU complications, missed screening, death or other reasons.

(a) All persons performing diagnostic auditory evaluations and assessments for selection of amplification for infants less than twelve months of age shall report within five days of the appointment to the North Carolina State Laboratory for Public Health, using forms developed by the Department of Health and Human Services:

(2) The outcome of the diagnostic evaluation and amplification selection; or

(3) The date of the missed appointment for such evaluations or assessments.

History Note: Authority G.S. 130A-125;

Temporary Adoption Eff. October 1, 1999;

Eff. August 1, 2000;

Temporary Amendment Eff. January 8, 2001;

Temporary Amendment Expired October 29, 2001;

Temporary Amendment Eff. May 17, 2002;

Amended Eff. April 1, 2003;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. October 3, 2017.