No. 29753 (Amendment): R270-1. Award and Reparation Standards

DAR File No.: 29753
Filed: 03/30/2007, 11:02
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

All proposed changes are the result of an internal review by the Crime Victim Reparations (CVR) Board.

Summary of the rule or change:

The change in Section R270-1-4 allows providers of mental health services to request an extension of the mental health benefits before the maximum is actually reached. This reduces the likelihood of a break in mental health services to the victim while the request is being made and reviewed. In Section R270-1-10, changes the maximum transportation award from $500 to $1,000 to more accurately reflect the typical costs of transportation; clarifies that all crime-related transportation expenses will be considered; and makes technical wording changes. In Section R270-1-20, makes grammatical changes and corrects an erroneous cross-reference. In Section R270-1-22, groups the treatment of sexually-transmitted disease as an emergency department service rather than the collection of evidence, but makes no substantive changes. In Section R270-1-24, reinserts language that was inadvertently deleted during the last amendment.

State statutory or constitutional authorization for this rule:

Subsection 63-25a-406(c)

Anticipated cost or savings to:

the state budget:

For Section R270-1-4, considering the request for an extension of mental health benefits before the maximum is reached is more efficient in personnel time than doing so after the maximum has been reached. However, the efficiencies are likely too small to quantify. For Section R270-1-10, it is possible that this amendment will increase the total amount of transportation benefits paid to victims of crime, which would increase the total amount paid out of the CVR Fund. However, the CVR Board has been approving expenditures above the $500 maximum on a case-by-case basis, so any increase is expected to be negligible. Sections R270-1-20, R270-1-22, and R270-1-24 involve only technical changes and will not result in any cost or savings.

local governments:

None of these changes are expected to result in any direct cost or savings to local government because the changes do not impact local government. Rather, the changes impact individual victims of crime and the providers of mental health services. The technical changes have no impact on any other entity other than CVR.

other persons:

In Section R270-1-4, victims are less likely to need to pay out-of-pocket expenses for mental health services while the request for an extension is being reviewed. This will increase efficiency for mental health providers as they are less likely to need to change billing practices while waiting for CVR to review their request. They will be able to continue providing services to victims as usual. In Section R270-1-10, victims are less likely to pay out of pocket transportation costs. However, as previously stated, the CVR Board has been approving many requests to exceed the current maximum so many victims are already realizing the benefit of this change. Sections R270-1-20, R270-1-22, and R270-1-24 involve only technical changes and will not result in any cost or savings to other persons.

Compliance costs for affected persons:

In Section R270-1-4, victims are less likely to need to pay out-of-pocket expenses for mental health services while the request for an extension is being reviewed. This will increase efficiency for mental health providers as they are less likely to need to change billing practices while waiting for CVR to review their request. They will be able to continue providing services to victims as usual. In Section R270-1-10, victims are less likely to pay out of pocket transportation costs. However, as previously stated, the CVR Board has been approving many requests to exceed the current maximum so many victims are already realizing the benefit of this change. Sections R270-1-20, R270-1-22, and R270-1-24 involve only technical changes and will not result in any cost or savings to other persons.

Comments by the department head on the fiscal impact the rule may have on businesses:

Section R270-1-4 changes will involve additional efficiencies for mental health providers as previously explained. Changes for Section R270-1-10 might have a positive impact on business if more victims engage in travel because the maximum is raised. However, many victims have been receiving increased benefits on a case-by-case basis. Sections R270-1-20, R270-1-22, and R270-1-24 make technical changes and will therefore not have any impact on businesses. Ronald B. Gordon, Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Crime Victim Reparations
Administration
350 E 500 S
SALT LAKE CITY UT 84111-3347

Direct questions regarding this rule to:

Connie Wettlaufer at the above address, by phone at 801-238-2371, by FAX at 801-533-4127, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

05/15/2007

This rule may become effective on:

05/22/2007

Authorized by:

Ronald B Gordon, Director

RULE TEXT

R270. Crime Victim Reparations, Administration.

R270-1. Award and Reparation Standards.

R270-1-4. Counseling Awards.

A. Pursuant to Subsections 63-25a-402(20) and 63-25a-411(4)(c), out-patient mental health counseling awards are subject to limitations as follows:

1. The reparation officer shall approve a standardized treatment plan.

2. The cost of initial evaluation and testing may not exceed $300 and shall be part of the maximum allowed for counseling. For purposes herein, an evaluation shall be defined as diagnostic interview examination including history, mental status, or disposition, in order to determine a plan of mental health treatment.

3. Primary victims of a crime shall be eligible for a $3500 maximum mental health counseling award.

(a) Parents, children and siblings of homicide victims shall be considered at the same rate as primary victims for inpatient and outpatient counseling.

4. Secondary victims of a crime shall be eligible for a $2000 maximum mental health counseling award.

5. Extenuating circumstances warranting consideration of counseling beyond the maximum may be submitted by the mental health provider [after]when it appears likely that the maximum award [has been]will be reached.

6. Counseling costs will not be paid in advance but will be paid on an ongoing basis as victim is being billed.

7. Inpatient hospitalization, residential and day treatment shall be reviewed by the CVR Board or contracting agency who will make recommendations to the Reparation Officers regarding treatment. The CVR Board or contracting agency will review all levels of care and assign a reimbursement percentage based on the crime. All cases having less than a $1000 balance may be determined by the Reparation Officer. Outpatient cases shall be reviewed at the same rate as inpatient reviews.

8. In-patient hospitalization shall only be considered when the treatment has been recommended by a licensed therapist in life-threatening situations. A direct relationship to the crime needs to be established. Acute in-patient hospitalization shall not exceed $600 per day, which includes all ancillary expenses, and will be considered payment in full to the provider. Inpatient psychiatric visits will be limited to one visit per day with payment for the visit made to the institution at the highest rate of the individuals providing therapy as set by rule. Reimbursement for testing costs may also be allowed. Parents, children and siblings of homicide victims shall be considered at the same rate as primary victims for inpatient hospitalization. All other secondary victims of other crime types are excluded.

9. Residential and day treatment shall only be considered when the treatment has been recommended by a licensed therapist to stabilize the victim's behavior and symptoms. Only facilities with 24 hour nursing care or 24 hour on call nursing care will be compensated for residential and day treatment. Residential and day treatment shall not be used for extended care of dysfunctional families and containment placements. A direct relationship to the crime needs to be established. Residential treatment shall not exceed $300 per day and will be considered payment in full to the provider. Residential treatment shall be limited to 30 days, unless there are extenuating circumstances requiring extended care. All residential clients shall receive routine assessments from a psychiatrist and/or APRN at least once a week for medication management. Day treatment shall not exceed $200 per day and will be capped at $10,000. These charges will be considered payment in full to the provider. Parents, children and siblings of homicide victims shall be considered at the same rate as primary victims for residential and day treatment. All other secondary victims of other crime types are excluded.

10. Wilderness programs shall not be covered as an appropriate treatment modality when considering inpatient hospitalization, residential or day treatment.

11. Child sexual abuse victims under the age of 13 who become perpetrators shall only be considered for mental health treatment awards directly related to the victimization. Perpetrators age 13 and over who have been child sexual abuse victims shall not be eligible for compensation. The CVR Board or contracting agency for managed mental health care shall help establish a reasonable percentage regarding victimization treatment for inpatient, residential and day treatment. Out-patient claims shall be determined by the Reparation Officer on a case by case basis upon review of the mental health treatment plan.

12. Payment for mental health counseling shall only be made to licensed therapists; or to individuals working towards a license that provide certified verification of satisfactory completion of an education and earned degree as required by the State of Utah Department of Commerce, Division of Professional and Occupational Licensing, working under the supervision of a supervisor approved by the Division. Student interns otherwise eligible under 58-1-307(1)(b) Exceptions from licensure, and/or the institution/facility/agency responsible for the supervision of the student, shall not be eligible for payment under this rule for counseling services provided by the student.

13. Payment of hypnotherapy shall only be considered when treatment is performed by a licensed mental health therapist based upon an approved Treatment Plan.

14. The following maximum amounts shall be payable for mental health counseling:

(a) up to $130 per hour for individual and family therapy performed by licensed psychiatrists, and up to $65 per hour for group therapy;

(b) up to $90 per hour for individual and family therapy performed by licensed psychologists and up to $45 per hour for group therapy;

(c) up to $70 per hour for individual and family therapy performed by a licensed master's level therapist or an Advanced Practice Registered Nurse, and up to $35 per hour for group therapy. These rates shall also apply to therapists working towards a license and supervised by a licensed therapist;

(d) The above-mentioned rates shall apply to individuals performing treatment, and not those supervising treatment.

15. Chemical dependency specific treatment will not be compensated unless the Reparation Officer determines that it is directly related to the crime. The CVR Board may review extenuating circumstance cases.

 

R270-1-10. Moving, Transportation Expenses.

A. Pursuant to Subsection 63-25a-411(4)(a), victims of violent crime who suffer a traumatic experience or threat of bodily harm are allowed moving expenses up to $2000. Board approval is needed where extenuating circumstances exist.

B. Transportation expenses up to [$500]$1000 are allowed for crime-related travel including, but not limited to, participation in court hearings and parole hearings as well as[,] medical or mental health visits for primary and secondary victims. The Board may[approval is needed] approve travel expenses in excess of $1000 where extenuating circumstances exist.

 

R270-1-20. Misconduct.

Pursuant to Subsections [63-25a-402(21)]63-25a-402(22) and 63-25a-412(1)(b) misconduct shall be considered conduct which contributed to the victim's injury or death or [engaged in ]conduct [in ]which the victim could have reasonably foreseen could lead to injury or death. In determining whether the victim engaged in misconduct, the CVR staff shall consider any behavior of the victim that may have directly or indirectly contributed to the victim's injury or death including consent, provocation, verbal utterance, gesture, incitement, prior conduct of the victim or the ability of the victim to have reasonably avoided the incident upon which the claim is based.

 

R270-1-22. Sexual Assault Forensic Examinations.

A. Pursuant to Subsections 63-25a-402(19) and 63-25a-411(4)(i), the cost of sexual assault forensic examinations for gathering evidence and providing treatment may be paid by the CVR office in the amount of $300.00 without photo documentation and up to $600.00 with a photo examination. The CVR office may also pay for the cost of medication and up to 85% of the hospital expenses. The following agency guidelines need to be adhered to when making payments for sexual assault forensic examinations:

1. A sexual assault forensic examination shall be reported to law enforcement.

2. Victims shall not be charged for sexual assault forensic examinations.

3. The agency may reimburse any licensed health care facility that provides services for sexual assault forensic examinations.

4. The agency may reimburse licensed medical personnel trained to gather evidence of sexual assaults who perform sexual assault forensic examinations.

5. CVR may pay for the collection of evidence and not attempt to prove or disprove the allegation of sexual assault.

6. A request for reimbursement shall include the law enforcement case number or be signed by a law enforcement officer, victim/witness coordinator or medical provider.

7. The application or billing for the sexual assault forensic examination must be submitted to CVR within one year of the examination.

8. The billing for the sexual assault forensic examination shall:

a. identify the victim by name, address, date of birth, Social Security number, telephone number, patient number;

b. indicate the claim is for a sexual assault forensic examination; and

c. itemize services and fees for services.

9. All collateral sources that are available for payment of the sexual assault forensic examination shall be considered before CVR Trust Fund monies are used. Pursuant to Subsection 63-25a-411(i), the Director may determine that reimbursement for a sexual assault forensic examination will not be reduced even though a claim could be recouped from a collateral source.

10. Evidence will be collected only with the permission of the victim or the legal guardian of the victim. Permission shall not be required in instances where the victim is unconscious, mentally incapable of consent or intoxicated.

11. Restitution for the cost of the sexual assault forensic examination may be pursued by the CVR office.

12. Payment for sexual assault forensic examinations shall be considered for the following:

a. Fees for the collection of evidence, for forensic documentation only, to include:

i. history;

ii. physical; and

iii. collection of specimens and wet mount for sperm[; and

iv. treatment for the prevention of sexually transmitted disease up to four weeks].

b. Emergency department services to include:

i. emergency room, clinic room or office room fee;

ii. cultures for gonorrhea, chlamydia, trichomonas, and tests for other sexually transmitted disease;

iii. serum blood test for pregnancy;[ and]

iv. morning after pill or high dose oral contraceptives for the prevention of pregnancy; and

v. treatment for the prevention of sexually transmitted disease up to four weeks.

13. The victim of a sexual assault that is requesting payment by CVR for services needed or rendered beyond the sexual assault forensic examination needs to submit an application for compensation to the CVR office.

 

R270-1-24. Rent Awards.

A. Pursuant to Subsection 63-25a-411(4)(a), victims of domestic violence or child abuse may be awarded for actual rent expenses for up to three months, not to exceed a maximum rent award of $1800, if the following conditions apply:

1. The perpetrator was living with the victim at the time of the crime or the rent assistance appears directly related to the victim's ability to distance herself/himself from the perpetrator.

2. It appears reasonable that the perpetrator was assisting or was solely responsible for rent.

3. The victim agrees that the perpetrator is not allowed on the premises.

4. The victim submits a safety plan to CVR and the plan is approved by CVR.

5. The victim submits a self-sufficiency plan to CVR and the plan is approved by CVR.

6. The need for rent assistance is directly related to and caused by the crime upon which the claim is based.

B. No victim shall receive more than one rent award in their lifetime.

 

KEY: victim compensation, victims of crimes

Date of Enactment or Last Substantive Amendment: [January 10, ]2007

Notice of Continuation: July 3, 2006

Authorizing, and Implemented or Interpreted Law: 63-25a-401 et seq.