36-3436. Children's behavioral health services fund; exemption; use of monies
A. The children's behavioral health services fund is established consisting of monies appropriated to the fund, any gifts or donations to the fund and interest earned on those monies. The director shall administer the fund.
B. Monies in the fund:
1. Are exempt from the provisions of section 35-190 relating to lapsing of appropriations.
2. Are continuously appropriated.
C. The administration shall enter into an agreement with one or more contractors for children's behavioral health services using monies from the children's behavioral health services fund to pay for behavioral health services for children. To be eligible to receive behavioral health services paid by the fund, an individual must meet all of the following conditions:
1. Meet the legal age requirements for school admission under title 15 at the time the individual was admitted and be enrolled in school.
2. Be uninsured or underinsured.
3. Be referred for behavioral health services by an educational institution.
4. Have written parental consent to obtain the behavioral health services.
5. Receive the behavioral health services by a contracted licensed behavioral health provider.
6. Receive the behavioral health services on or off school grounds.
D. In addition to terms and conditions the director deems appropriate, the agreement between the administration and each contractor shall require that:
1. The monies allocated in the agreement not be used for persons who are eligible under title XIX or title XXI of the social security act. Preference shall be given to persons with lower household incomes.
2. The contractor coordinate benefits provided under this section with any third parties that are legally responsible for the cost of services.
3. The contractor make payments to providers based on contracts with providers or, in the absence of a contract, at the capped fee schedule established by the administration.
4. The contractor submit expenditure reports monthly in a format determined by the director for reimbursement of services provided under the agreement. The agreement may also provide for additional reimbursement for administering the agreement in an amount not to exceed eight percent of the expenditures for services.
5. The administration not be held financially responsible to the contractor for any costs incurred by the contractor in excess of the monies allocated in the agreement.
E. The administration may impose cost sharing requirements on a sliding fee scale for behavioral health services provided by contractors.
F. The administration shall act as payor of last resort for persons who are eligible pursuant to this section. On receipt of services under this section, a person is deemed to have assigned to the administration all rights to any type of medical benefit to which the person is entitled.
G. This section does not establish:
1. An entitlement for any person to receive any particular service.
2. A duty on the administration to provide services or spend monies in excess of the monies in the fund.