Minnesota Legislature
Office of the Revisor of Statutes
Minnesota Administrative Rules
9530.7020 LOCAL AGENCY TO DETERMINE CLIENT ELIGIBILITY.
Subpart 1.
Local agency duty to determine client eligibility.
The local agency shall determine a client's eligibility for the behavioral health fund at the time the client is assessed under parts 9530.6600 to 9530.6655. Client eligibility must be determined using forms prescribed by the department. To determine a client's eligibility, the local agency must determine the client's income, the size of the client's household, the availability of a third-party payment source, and a responsible relative's ability to pay for the client's chemical dependency treatment, as specified in items A to C.
A.
The local agency must determine the client's income. A client who is a minor child shall not be deemed to have income available to pay for chemical dependency treatment, unless the minor child is responsible for payment under Minnesota Statutes, section 144.347, for chemical dependency treatment services sought under Minnesota Statutes, section 144.343, subdivision 1.
B.
The local agency must determine the client's household size according to subitems (1), (2), and (3).
(1)
If the client is a minor child, the household size includes the following persons living in the same dwelling unit:
(2)
If the client is an adult, the household size includes the following persons living in the same dwelling unit:
(3)
For purposes of this item, household size includes a person listed in subitems (1) and (2) who is in out-of-home placement if a person listed in subitem (1) or (2) is contributing to the cost of care of the person in out-of-home placement.
C.
The local agency must determine the client's current prepaid health plan enrollment, the availability of a third-party payment source, including the availability of total payment, partial payment, and amount of copayment.
D.
The local agency must provide the required eligibility information to the department in the manner specified by the department.
E.
The local agency shall require the client and policyholder to conditionally assign to the department the client and policyholder's rights and the rights of minor children to benefits or services provided to the client if the department is required to collect from a third-party pay source.
Subp. 1a.
Redetermination of client eligibility.
The local agency shall redetermine a client's eligibility for CCDTF every six months after the initial eligibility determination, if the client has continued to receive uninterrupted chemical dependency treatment services for that six months. For purposes of this subpart, placement of a client into more than one chemical dependency treatment program in less than ten working days, or placement of a client into a residential chemical dependency treatment program followed by nonresidential chemical dependency treatment services shall be treated as a single placement.
Subp. 2.
Client, responsible relative, and policyholder obligation to cooperate.
A client, responsible relative, and policyholder shall provide income or wage verification, household size verification, and shall make an assignment of third-party payment rights under subpart 1, item C. If a client, responsible relative, or policyholder does not comply with the provisions of this subpart, the client shall be deemed to be ineligible to have the behavioral health fund pay for his or her chemical dependency treatment, and the client and responsible relative shall be obligated to pay for the full cost of chemical dependency treatment services provided to the client.
History:
12 SR 53; 12 SR 2748; 15 SR 1540; 32 SR 2268
Published Electronically:
October 13, 2021
Official Publication of the State of Minnesota
Revisor of Statutes