R398-30-5. Awarding Financial Assistance to Recipients

  (1) Prior to awarding financial assistance the committee shall review the recipient's application for assistance to determine:

  (a) the needs of the recipient both physically and financially; and

  (b) the existence of other financial assistance including availability of insurance or other state aid.

  (2) Each listed or transplant recipient must apply for Medicaid, Children's Health Insurance Program assistance, or other public health coverage provided by the state, before the committee agrees to award any financial assistance.

  (3) As part of the review process, the responsible party of the recipient Shall sign a release to allow all medical records of the child to be released to the Utah Department of Health.

  (4) As a part of the review process, the Committee shall consider:

  (a) the success rate of the particular organ transplant procedure needed by the child; and

  (b) the extent of the threat to the child's life without the organ transplant.

  (5) In addition, the committee shall consider the availability of funds in the Children's Organ Transplant fund before awarding financial assistance. The committee may create a waiting list and prioritize the list by financial and medical need. A financial assistance award is not an entitlement. The Children's Organ Transplant fund should not incur a deficit.

  (6) The Utah Department of Health shall create a recipient file which shall include information such as: the application, related documentation, correspondence, repayment plans, repayment amounts and the approved contract. This file and documentation will be stored securely for 10 years after the recipient reaches the age of 18.

  (7) The committee may review and determine if the recipient is ineligible to receive funds when:

  (a) the recipient's account has been reviewed and found to be inactive for two years;

  (b) the Utah Department of Health has made three documented attempts to contact the responsible party or recipient to discuss inactivity without response;

  (c) there is a violation of the terms of the executed contract;

  (d) two years have passed since the transplant; or

  (e) the recipient is no longer a Utah resident.