Current through Register Vol. 49, No. 18, September 16, 2024
PURPOSE: This rule establishes the requirements for
assistance from the HIV/AIDS Medications Program.
(1) Individuals may be admitted to the
program at any time during any stage of Human Immunodeficiency Virus (HIV)
infection.
(2) Individuals may be
provided assistance by the medications program only pursuant to available
funding, as delineated in
19 CSR
20-43.020. An individual is eligible if s/he meets the
following criteria:
(A) Is a Missouri
resident;
(B) Is not incarcerated
in a state correctional facility nor an inpatient in a licensed heath care
facility as defined in Chapter 197, RSMo;
(C) Is HIV infected and has provided written
medical evidence of HIV status to a service coordinator;
(D) Is enrolled in the Human Immunodeficiency
Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) service coordination
program;
(E) Has an income at or
below three hundred percent (300%) of the federal poverty standard published
annually in the Federal Register by the U.S. Department of
Health and Human Services. A client shall provide updated documentation of
income and other medications assistance from other sources such as private
insurance, other third-party insurance or Medicaid annually, or at any time
when requested by the department or its contractors; and
(F) Is ineligible for medications assistance
from other sources such as private insurance, other third-party insurance or
Medicaid.
(3) If an
individual meets the requirements of subsections (2)(A) through (F), but
available funding is insufficient to provide assistance, they will be placed on
an access list.
(A) Individuals will be
removed from the access list and will begin to receive assistance as funding
becomes available.
(B) Individuals
residing in rural counties will be given priority for being removed from the
access list to receive medications assistance.
(C) Within the classification of rural or
urban counties, individuals who have been on the access list the longest time
will be given priority.
(D) Within
the urban classification of urban counties, the department will collaborate
with Title I grantees to assure client medications access at the local
levels.
(4) A client may
be terminated from the medications assistance program for any of the following
reasons:
(A) A client shall be terminated
from the medications program at any time that he/she no longer meets all
program eligibility requirements described in subsections (2)(A) through (E)
above.
1. It shall be the responsibility of
the client to inform the department or a service coordinator if he or she no
longer meets any one (1) or more of the program eligibility requirements and
initiates an application for assistance through the service coordination
system.
2. A client terminated from
the medications program due to no longer meeting program eligibility
requirements may be readmitted to the program at such time as the client again
meets all program eligibility requirements; and
(B) A client who knowingly provides false
information or fails to meet applicable statutes and regulations may be
terminated from the program at any time.
*Original authority: 192.006, RSMo 1993, amended 1995 and
192.020, RSMo 1939, amended 1945, 1951.
