DAR File No. 40402
This rule was published in the June 1, 2016, issue (Vol. 2016, No. 11) of the Utah State Bulletin.
Health, Family Health and Preparedness, Children with Special Health Care Needs
Autism Treatment Account
Notice of Proposed Rule
DAR File No.: 40402
Filed: 05/03/2016 04:49:15 PM
Purpose of the rule or reason for the change:
The statute (Title 26, Chapter 52) that authorizes the rule was repealed in S.B. 50 during the 2016 General Session.
Summary of the rule or change:
This rule is repealed in its entirety.
State statutory or constitutional authorization for this rule:
- Title 26, Chapter 52
Anticipated cost or savings to:
the state budget:
The Division may incur minimal cost of approximately $50 to delete and repeal the rule out of publications. The proposed repeal does not have costs affiliated with it. The deletion of the rule cuts costs for the Division. The left over funds from the Autism Treatment Account (ATA) transferred to the Medicaid plan increases funds available for the autism spectrum disorder patients.
No funding was provided to local government and therefore none will be affected by this repeal.
Contracts to four small businesses from the Autism Treatment Account expired June 2014. No further impact on small businesses will be experienced.
persons other than small businesses, businesses, or local governmental entities:
Contracts to provide services to children with autism expired in June 2014. No further services have been provided since that date. No further impact will be experienced.
Compliance costs for affected persons:
No funding has been appropriated since fiscal year 2014. There are no ongoing programs or compliance cost associated with the Autism Treatment Account.
Comments by the department head on the fiscal impact the rule may have on businesses:
There may be fiscal impact on business in that any funds remaining in the ATA are to be deposited into the state Medicaid plan and used for the autism spectrum disorder program including payment for services from Medicaid providers.
Joseph Miner, MD, Executive Director
The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:Health
Family Health and Preparedness, Children with Special Health Care Needs
44 N MARIO CAPECCHI DR
SALT LAKE CITY, UT 84113
Direct questions regarding this rule to:
- Joyce McStotts at the above address, by phone at 801-584-8239, by FAX at 801-584-8488, or by Internet E-mail at email@example.com
Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:
This rule may become effective on:
Joseph Miner, Executive Director
R398. Health, Family Health and Preparedness, Children with Special Health Care Needs.
R398-15. Autism Treatment Account.
R398-15-1. Purpose and Authority.
The purpose of this rule is to identify criteria and
procedures for selecting children who may qualify for assistance
from the account and identify qualifications, criteria, and
procedures for selecting service and treatment providers that
receive disbursements from the Autism Treatment Restricted
Account. This rule is authorized by Section 26-52-202(4) which
provide that the Autism Treatment Account Advisory Committee,
hereafter known as the "Committee", may make rules
governing the Committee's activities.
R398-15-2. Qualification Criteria and Procedures for
Selecting Children Who May Qualify for Assistance from the
(1) Qualification Criteria a. Child who is at least two but younger than seven years
of age upon enrollment, b. Resident of Utah, c. Diagnosed by a qualified professional as having an
autism spectrum disorder, and d. Have a need that can be met within the requirements of
UCA 26-52, i. Must need and be able to receive a minimum of six
months of applied behavior analysis (ABA) therapy, and ii. Cannot be receiving formal ABA therapy services from
other state funded sources under this law (Medicaid Waiver or
PEHP) or ABA therapy for a minimum of 20 hours per week covered
at 80 percent or more of cost of treatment by other insurance
while receiving services funded through this account. (2) Procedures for selecting children a. Providers selected through the request for application
(RFA) process are responsible for enrollment and determining if a
child meets qualification criteria utilizing UDOH enrollment
forms for children. b. If applications for enrollment of children exceeds
capacity of this funding, providers shall select children using a
R398-15-3. Qualifications, Criteria and Procedures for
Evaluating Service and Treatment Providers to Include in the
(1) Providers are qualified to receive funds if: a. They utilize ABA for treatment alone or in conjunction
with other proven effective treatments as outlined in an RFA
process; b. Treatment is provided by or supervised by a board
certified behavior analyst or licensed psychologist with
equivalent university training and supervised experience who is
working toward board certification in ABA; c. They are willing to collaborate with existing
telehealth networks to reach children in rural and underserved
areas of the state; d. They utilize methods to engage family members in the
treatment process; and e. They agree to serve and treat only eligible children
with this funding. (2) Procedures for evaluating providers a. Funding requests to the Committee from providers will
be made on a standard RFA which will be developed and authorized
by the Committee and made available by the Department. b. Providers that meet the minimum requirements in
Subsection 3.1., will be evaluated for funding by a review
committee. c. Criteria used to select providers for funding will
include: i. Per eligible child cost for treatment proposed by
provider; ii. Provider or organization's background and
qualifications; iii. Description of treatment and services to be
provided; iv. Additional consideration will be given to those with
existing connections to telehealth or evidence of written
policies and procedures for providing ABA services via
telehealth; and v. Additional consideration will be given to those who
show evidence of providing services in rural and underserved
communities. (3) Funded providers will submit required reports as
outlined in the RFA to UDOH/Committee on use of funds, two of
which shall include: a. Detailed description of how provider will report
evaluation of benefits and outcomes for children receiving
services; and b. Monthly invoice and justification of expenditures
consistent with uses as specified in UCA 26-52. (4) RFAs will be authorized contingent on funds
R398-15-4. Conflict of Interest within the Advisory
(1) Committee members will sign a conflict of interest
form identifying affiliations with providers that apply for
funding from the Autism Treatment Account, and/or known family
members that may receive treatment or evaluation services
directly funded through the Autism Treatment Account from a
provider that has submitted an application for funding. The
conflict of interest form will be signed prior to review of
funding requests. (2) If an issue is to be decided by the Advisory
Committee that involves potential conflict of interest with a
member of the committee, it is the responsibility of the member
to: a. Identify the potential conflict of interest. b. Not participate in discussion of the program or motion
being considered. c. Not vote on the issue. (3) It is the responsibility of the Committee
to: a. Award funds based on quality of application regardless
of committee affiliation. b. Record in the minutes of the Advisory Committee
Meeting the potential conflict of interest, and the use of the
procedures and criteria of this policy.
KEY: autism treatment, applied behavior analysis (ABA),
autism spectrum disorders
Date of Enactment or Last Substantive Amendment: August 27,
Authorizing, and Implemented or Interpreted Law: 26-52-201;
More information about a Notice of Proposed Rule is available online.
The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull-pdf/2016/b20160601.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.
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For questions regarding the content or application of this rule, please contact Joyce McStotts at the above address, by phone at 801-584-8239, by FAX at 801-584-8488, or by Internet E-mail at firstname.lastname@example.org. For questions about the rulemaking process, please contact the Division of Administrative Rules.