Section 441.151.22. Expenses.

The following lists of expenses that are either eligible or ineligible for reimbursement from the court-ordered services fund are intended to be exhaustive. Billings for services not listed in subrule 151.22(1) shall not be paid except as provided in subrule 151.22(3).

         151.22(1) Expenses to be reimbursed. The expenses for which reimbursement shall be made include:

            a.               Expenses, other than salary, incurred by a person ordered by the court, other than a juvenile court officer, in transporting a child to or from a place designated by the court, including mileage, lodging and meals.

            b.               The expense of care or treatment ordered by the court whenever the minor is placed by the court with someone other than the parents; or a minor is given a physical or mental examination or treatment under order of the court; or, upon certification by the department, a minor is given physical or mental examinations or treatment with the consent of the parent, guardian or legal custodian relating to a child abuse investigation and no provision is otherwise made by the law for payment for the care, examination, or treatment of the minor. Care and treatment expenses for which no other provision for payment is made by law that shall be reimbursable include court-ordered:

             (1)             Individual services for the child separate from a family’s treatment plan.

             (2)             Diagnosis and evaluation on an outpatient basis unless the diagnosis and evaluation is provided by a person or agency with a contract with the department for that service for which the child is eligible.

             (3)             An evaluation of a child in a residential facility.

             (4)             Inpatient (hospital) evaluation of a child previous to disposition.

             (5)             Medical treatment for a child. This includes medical treatment while in detention in a facility used for detention when the medical treatment is court-ordered.

             (6)             Drug treatment, testing and care for a child.

             (7)             Intensive in-home supervision and monitoring and alternatives to shelter care unless a person or agency that has a contract with the department provides the service for which the child is eligible.

             (8)             Evaluation of parents pursuant to a delinquent adjudication unless the diagnosis and evaluation is provided by a person or agency with a contract with the department for that service for which the child is eligible.

             (9)             One-to-one supervision of a child not in a detention facility unless the service is provided by a person or agency with a contract with the department for that service for which the child is eligible.

             (10)            Physical or mental examinations ordered pursuant to Iowa Code section 232.49 or 232.98 except those set forth in paragraph 151.22(2)“c” or those eligible for payment pursuant to Iowa Code chapter 249A.

             (11)            Services ordered under family in need of assistance proceedings unless a person or agency with a contract with the department provides the service for which the child is eligible.

             (12)            Expenses for all educational testing or programming for children, not weighted as special education students, who attend an on-campus school in an out-of-state facility.

             (13)            Expenses for educational testing or programs related to a general equivalency diploma (GED) or for credit hours, when the expenses are not required to be paid by the state.

            c.               Medical cost sharing for payment of one deductible amount or a coinsurance amount when Medicaid or private insurance is then available to pay the remainder of the cost.

         151.22(2) Expenses not reimbursed. Expenses that are excluded from reimbursement from court-ordered services funds because another source is available to pay for the service include:

            a.               Foster care (including shelter care). Payment provision is Iowa Code section 234.35.

            b.               All charges for which the county is obligated by statute to pay including:

             (1)             Care and treatment of patients by any state mental health institute. Payment provision is Iowa Code section 230.20(5).

             (2)             Care and treatment of patients by either of the state resource centers or by any other facility established under Iowa Code chapter 222. Payment provision is Iowa Code section 222.60.

             (3)             Care and treatment of patients by the psychiatric hospital at Iowa City. Payment provision is Iowa Code chapter 225.

             (4)             Care and treatment of persons at the alcoholic treatment center at Oakdale or any other facility as provided in Iowa Code chapter 125. Payment provision is Iowa Code section 125.44.

             (5)             Care of children admitted or committed to the Iowa juvenile home at Toledo. Payment provision is Iowa Code section 233B.14.

             (6)             Clothing, transportation, and medical or other service provided to persons attending the Iowa Braille and Sight-Saving School, the Iowa School for the Deaf, or the state hospital-school for severely handicapped children at Iowa City for which the county becomes obligated to pay pursuant to Iowa Code sections 263.12, 269.2, and 270.4 to 270.7.

             (7)             Expenses for detention in a facility used for detention. The payment provision is Iowa Code section 232.142.

             (8)             Care and treatment of persons placed in the county hospital, county care facility, a health care facility as defined in Iowa Code section 135C.1, subsection 6, or any other public or private facility in lieu of admission or commitment to a state mental health institute, resource center, or other facility established pursuant to Iowa Code chapter 222. Payment provisions are Iowa Code sections 222.50, 230.1 and 233B.14.

            c.               Child-abuse photos and X-rays. Payment provision is Iowa Code section 232.77.

            d.               Any expenses set forth in subrule 151.22(1) above, which qualify for payment pursuant to Iowa Code chapter 249A.

            e.               Expense of a child sexual abuse examination. Payment provision is Iowa Code section 915.41.

            f.                Expense of child day care. Payment provision is Iowa Code section 234.6.

            g.               Expense of in-home treatment services. Payment provision is 441—Chapters 78, 79, and 83.

            h.               Expense of homemaker-home health aide services. Payment provision is department of public health rules 641—Chapter 80.

            i.                Expenses for all educational testing or programming required to be paid by the state, except for juveniles who attend an on-campus school in an out-of-state facility and who are not weighted as special education students. The payment provision is Iowa Code chapter 256.

            j.                Expenses, except for the allowable medical cost sharing, for all court-ordered counseling and treatment for adults, including individual, marital, mental health, substance abuse and group therapy. The payment provision is private insurance, Medicare, Medicaid, or other resources consistent with Medicaid and social services eligibility and Iowa Code chapter 249A.

            k.               Expenses, except for the allowable medical cost sharing, for psychiatric medical institutions for children (PMIC). The payment provision is private insurance, Medicare, Medicaid, or other resources consistent with Medicaid and social services eligibility and Iowa Code chapter 249A.

         151.22(3) Services not listed. If a court orders a service not currently listed in subrule 151.22(1), the chief juvenile court officer or approved administrator shall review the order and shall consult with the department. If reimbursement for the service expense is not in conflict with current law or administrative rules and meets the criteria for certification of the court, the chief juvenile court officer or approved administrator shall authorize reimbursement to the provider.

[ARC 2435C, IAB 3/16/16, effective 5/1/16]