Current through Bulletin 2024-18, September 15, 2024
(1) The division
annually reviews utilization of person-centered budgets to maintain alignment
of funding and the person's needs.
(a) The
division Administrative Services Director begins the review process in August
of each fiscal year.
(b) A Request
for Services Committee member reviews each budget with potential funding
misalignment.
(2) The
division shall reduce a person-centered budget after two consecutive and
completed plan cycles of underuse due to a misalignment of funding and actual
need.
(a) A budget with a $2,000 or more
surplus is subject to a budget reduction that realigns funding with actual
need.
(b) The division shall
presume that the person-centered budget aligns with the person's need if
underuse is caused by one or more of the following reasons:
(i) hospitalization, including placement in
the Utah State Hospital;
(ii)
incarceration;
(iii) temporary
placement in facility-based care, including placement in a nursing facility or
a private intermediate care facility;
(iv) temporary placement at the developmental
center;
(v) public health or other
declared emergency;
(vi) limited
access to a service provider; or
(vii) limited access to a direct care
employee for a person participating in the self-administered services
model.
(c) The division
Administrative Services Director may consider budget underuse for a reason not
listed in Subsection R539-12-7(2)(b) on a case-by-case basis.
(2) The division shall notify the
support coordinator of a budget reduction 30 days before sending a notice of
agency action.
(a) A support coordinator must
submit written justification within 30 days of notification to dispute the
reduction.
(b) The support
coordinator must include documentation that explains:
(i) why the unused service continues to
represent the person's need;
(ii)
why the service was not used; and (iii) how underuse is being
remedied.
(3)
The committee members will review the documentation and determine whether the
justification is adequate.
(4) If
the division reduces the unused portion of the person-centered budget, the
division shall send a notice of agency action as described in Section
R539-3-8.
(5) The division shall coordinate any appeal
of the person-centered budget review process as described in Section
R539-3-8.
(6) The support coordinator shall reduce the
person's plan cycle total within 30 days of the notice of agency action.
(a) The division monitors compliance with
each budget reduction.
(b) If the
support coordinator fails to reduce the person's plan cycle total within 30
days of the notice of agency action, the division sends the support coordinator
a second notice.
(i) The support coordinator
must make the requested change to the person's plan cycle total within 15 days
of the date of the second notice.
(ii) The division refers the support
coordinator to the Office of Quality and Design for any failure to make the
requested change.
