36-2912. Children's rehabilitative services program; definition

A. The administration shall:

1. Establish a children's rehabilitative services program for children who have a chronic illness or physical disability and shall develop, implement, monitor, supervise, control and establish policies for that program.

2. Develop and implement policies to determine medical eligibility for the children's rehabilitative services program.

3. Develop and implement all rules and policies for the operation of the children's rehabilitative services program.

4. Establish and administer a program of service for children and for individuals determined to be eligible before they reach twenty-one years of age who have a chronic illness or physical disability or who are suffering from a condition that leads to a chronic illness or a physical disability and are in active treatment. The program shall provide for:

(a) Medical, surgical, corrective and other services and care.

(b) The receipt and expenditure of monies made available to the administration for services to children who have a chronic illness or physical disability by the federal government, this state or its political subdivisions or from other sources, excluding monies received from parents or guardians for the care of children.

(c) Making necessary expenditures pursuant to the requirements of this section.

(d) Establishing and maintaining safeguards relating to the confidentiality of medical records.

(e) The acceptance and use of federal monies for children's rehabilitative services at the discretion of the administration and subject to any limitations imposed by annual state appropriations.

(f) Any other activities the administration determines are necessary for the effective operation of the program.

B. Pursuant to the requirements of section 36-2903, the director shall prepare and issue a public request for proposals, including a proposed contract format, at least once every five years to contract for the care and treatment of children who have a chronic illness or physical disability.

C. The total amount of state monies that the administration may spend in any fiscal year for children's rehabilitative services may not exceed the amount appropriated or authorized by section 35-173 for that purpose. This subsection does not impose a duty on an officer, agent or employee of this state to discharge a responsibility or to create any right in a person or group if the discharge or right would require an expenditure of state monies in excess of the expenditure authorized by legislative appropriation for that specific purpose.

D. Pursuant to the requirements of section 36-2923, the administration shall coordinate benefits provided pursuant to this section so that any costs payable by the administration are costs avoided or recovered from any available provider of first-party health insurance benefits. The administration shall act as payor of last resort unless specifically required by federal law.

E. For the purposes of this section, " children who have a chronic illness or physical disability" means children who are medically eligible for the children's rehabilitative services program and who require covered medical, surgical or therapeutic services for a covered condition that is medically disabling or potentially disabling, as prescribed by the administration.