§ 108A-70.23. Services for children with special needs established; definition; eligibility; services; limitation; recommendations; no entitlement.
§ 108A‑70.23. Servicesfor children with special needs established; definition; eligibility; services;limitation; recommendations; no entitlement.
(a) [Special NeedsServices Authorized.] The Department shall, from federal funds received andState funds appropriated for the Program, pay for services for children withspecial needs as authorized under this section. As used in this section, theterm "children with special needs" or "special needs child"means children who have been diagnosed as having one or more of the followingconditions which in the opinion of the diagnosing physician (i) is likely tocontinue indefinitely, (ii) interferes with daily routine, and (iii) requireextensive medical intervention and extensive family management:
(1) Birth defect,including genetic, congenital, or acquired disorders;
(2) Developmentaldisability as defined under G.S. 122C‑3;
(3) Mental or behavioraldisorder; or
(4) Chronic and complexillnesses.
(b) Eligibility forServices. In order to be eligible for services under this section a specialneeds child must be enrolled in the Program.
(c) Services Provided. The services authorized to be provided to children eligible under thissection are as follows:
(1) The same level ofservices as provided for special needs children under the Medical AssistanceProgram as authorized in the Current Operations Appropriations Act except that:
a. No services for long‑termcare shall be provided under this section;
b. Services for respitecare shall be provided only under emergency circumstances; and
c. The Department maylimit services for special needs children after consultation with theCommission on Children with Special Health Care Needs.
(2) Only those serviceseligible under this section that are not covered or otherwise provided underthe Predecessor Plan.
(d) Limitation. Fundsmay be expended for services under this section only if the special needs childis enrolled in the Program, the services provided under this section are notprovided under the Predecessor Plan and the child meets the definition of aspecial needs child under this section.
(e) Case ManagementServices. The Department shall develop procedures for the provision of casemanagement services by the Department to eligible special needs children. Casemanagement services shall be developed to ensure to the maximum extent possiblethat services are provided in the most efficient and effective mannerconsidering the special needs of the child. The cost of providing casemanagement services for children with special needs shall be paid from fundsavailable for services under this section.
(f) Recommendations byCommission on Children With Special Health Care Needs. In implementing thissection the Department shall consider the recommendations of the Commission onChildren With Special Health Care Needs established under Article 72 of Chapter143 of the General Statutes. The Department, in consultation with theCommission on Children With Special Health Care Needs shall develop proceduresfor providing respite care services under emergency circumstances.
(g) No Entitlement. Nothingin this section shall be construed as entitling any person to services underthis section. (1998‑1,s. 1; 2003‑284, s. 10.29(b); 2008‑107, s. 10.13(h).)