2005 North Carolina Code - General Statutes § 108A-70.23. Services for children with special needs established; definition; eligibility; services; limitation; recommendations; no entitlement.

§ 108A‑70.23.  Services for children with special needs established; definition; eligibility; services; limitation; recommendations; no entitlement.

(a)       [Special Needs Services Authorized. –] The Department shall, from federal funds received and State funds appropriated for the Program, pay for services for children with special needs as authorized under this section. As used in this section, the term "children with special needs" or "special needs child" means children who have been diagnosed as having one or more of the following conditions which in the opinion of the diagnosing physician (i) is likely to continue indefinitely, (ii) interferes with daily routine, and (iii) require extensive medical intervention and extensive family management:

(1)       Birth defect, including genetic, congenital, or acquired disorders;

(2)       Developmental disability as defined under G.S. 122C‑3;

(3)       Mental or behavioral disorder; or

(4)       Chronic and complex illnesses.

(b)       Eligibility for Services. – In order to be eligible for services under this section a special needs child must be enrolled in the Program.

(c)       Services Provided. – The services authorized to be provided to children eligible under this section are as follows:

(1)       The same level of services as provided for special needs children under the Medical Assistance Program as authorized in the Current Operations Appropriations Act except that:

a.         No services for long‑term care shall be provided under this section;

b.         Services for respite care shall be provided only under emergency circumstances; and

c.         The Department may limit services for special needs children after consultation with the Commission on Children with Special Health Care Needs.

(2)       Only those services eligible under this section that are not covered or otherwise provided under Part 5 of Article 3 of Chapter 135 of the General Statutes.

(d)       Limitation. – Funds may be expended for services under this section only if the special needs child is enrolled in the Program, the services provided under this section are not provided under Part 5 of Article 3 of Chapter 135 of the General Statutes, and the child meets the definition of a special needs child under this section.

(e)       Case Management Services. – The Department shall develop procedures for the provision of case management services by the Department to eligible special needs children. Case management services shall be developed to ensure to the maximum extent possible that services are provided in the most efficient and effective manner considering the special needs of the child. The cost of providing case management services for children with special needs shall be paid from funds available for services under this section.

(f)        Recommendations by Commission on Children With Special Health Care Needs. – In implementing this section the Department shall consider the recommendations of the Commission on Children With Special Health Care Needs established under Article 71 of Chapter 143 of the General Statutes. The Department, in consultation with the Commission on Children With Special Health Care Needs shall develop procedures for providing respite care services under emergency circumstances.

(g)       No Entitlement. – Nothing in this section shall be construed as entitling any person to services under this section. (1998‑1, s. 1; 2003‑284, s. 10.29(b).)