SUBCHAPTER 43E ‑ CHILD HEALTH
SECTION .0100 ‑ SCHOOL HEALTH FUNDS
10A NCAC 43E .0101 GENERAL
(a) The purpose of the school health fund is to enhance the
provision of preventive, diagnostic, evaluative, and treatment services to
school age children and to develop cooperative arrangements among local health
departments, schools, the private health care providers and hospitals. Funds
are provided to local health departments to assist families of eligible school
children.
(b) The school health fund is administered by the Division
of Public Health, 1915 Mail Service Center, Raleigh, North Carolina 27699-1915.
History Note: Authority G.S. 130A‑124;
Eff. July 1, 1984;
Amended Eff. February 1, 1990.
10A NCAC 43E .0102 ALLOCATION OF
FUNDS
School health funds shall be allocated to local health
departments. One thousand dollars ($1,000) per year shall be allocated for each
county. Additional amounts are allocated per county based on each county's average
daily attendance for the previous school year as shown in the records provided
to the Division by the North Carolina Department of Public Instruction. The
allocation of funds to any county may be modified to reflect actual utilization
of funds.
History Note: Authority G.S. 130A‑124;
Eff. July 1, 1984;
Amended Eff. February 1, 1990.
10A NCAC 43E .0103 BUDGETING OF FUNDS
School health funds shall be budgeted as a separate line
item entitled "School Health" within each local health department's
Child Health budget.
History Note: Authority G.S. 130A‑124;
Eff. July 1, 1984;
Amended Eff. February 1, 1990.
10A NCAC 43E .0104 CLIENT ELIGIBILITY
(a) To be eligible for services paid for through the school
health fund, clients shall:
(1) meet the residency requirements of 15A NCAC
24A;
(2) meet the financial requirements of 15A NCAC
24A or the U.S. Department of Agriculture Financial Scale for the free lunch
program;
(3) be less than 20 years of age; and
(4) be enrolled in a public or private school,
grade kindergarten through grade 12.
(b) When financial eligibility for school health funds is
based upon the Free Lunch Program's income eligibility scale, written
verification shall be obtained from the local school system and retained for
audit purposes or a financial determination shall be performed by the local
health department.
History Note: Authority G.S. 130A‑124;
Eff. July 1, 1984;
Amended Eff. February 1, 1990.
10A NCAC 43E .0105 USE OF SCHOOL HEALTH FUNDS
(a) School health funds may be used:
(1) to provide reimbursement for the following
services:
(A) preventive, diagnostic, evaluative and treatment
services;
(B) psychosocial, emotional and nutritional counseling;
and
(C) medications.
(2) to purchase bulk medications under the
following conditions:
(A) Written approval for the purchase and use of such
medications is obtained from the medical consultant to the local health
department, and the proper use of such medications is described in the written
standing orders of a person entitled to prescribe medications in North
Carolina; or
(B) When treating infestations of school age children
and their immediate families.
(b) School health funds shall not be used for the
following:
(1) salaries of personnel;
(2) transportation;
(3) office supplies or equipment;
(4) community wide services such as: water
fluoridation;
(5) services covered by other third party
reimbursement sources when the health department has knowledge of coverage at
time of authorization;
(6) services mandated to be provided by another
public agency;
(7) orthodontic treatment;
(8) inpatient services; and
(9) health department services except as
allowed in Rule .0106(d) of this Section.
History Note: Authority G.S. 130A‑124;
Eff. July 1, 1984;
Amended Eff. February 1, 1990.
10A NCAC 43E .0106 AUTHORIZATION AND REIMBURSEMENT
(a) The local health department shall authorize each
service funded by school health funds, except as stated in Subparagraph (a)(2)
of Rule .0114.
(b) The authorization shall be sent to the anticipated providers
of care for each authorized service. The authorization shall include, at least
the following information:
(1) name of client;
(2) service authorized;
(3) expiration date of authorization;
(4) amount authorized; and
(5) signature of authorizing official.
(c) The local health department shall negotiate rates of
reimbursement for services to be provided under the school health fund. These
rates shall not exceed the Medicaid rate of reimbursement in effect at the time
the claim is received by the Division.
(d) Services provided by a dentist employed by the local
health department may be charged to school health funds. Claims shall be paid
at a rate not to exceed the current Medicaid rate in effect for dental services
provided in local health departments.
(e) If a local health department's dental program is
supported by other state and federal dollars, the local health department shall
demonstrate that total dental charges to the school health fund do not exceed
the difference between the total cost of the dental program and the total state
and federal dollars going into the dental program.
(f) Services provided by public health dentists employed by
the Department shall not be charged to school health funds.
(g) Other rules governing authorization and billing
procedures, payment limitations, and limitations on billing clients sponsored
by school health funds are found in 15A NCAC 24A.
History Note: Authority G.S. 130A‑124;
Eff. July 1, 1984;
Amended Eff. February 1, 1990.
10A NCAC 43E .0107 MONITORING AND EVALUATION
The local health department shall complete and submit the
annual school health fund report (DEHNR 3147) to the Division of Maternal and
Child Health.
History Note: Authority G.S. 130A‑124;
Eff. July 1, 1984;
Amended Eff. February 1, 1990.
SECTION .0200 ‑ KINDERGARTEN HEALTH ASSESSMENTS
10A NCAC 43E .0201 HEALTH ASSESSMENTS
(a) Every child in this state entering kindergarten in the
public schools shall receive a health assessment pursuant to G.S. 130A‑440.
(b) The health assessment shall be reported on a health
assessment transmittal form provided by the local education agency and shall
include at least the following:
(1) identifying information for the child,
including name, address, and parents' names;
(2) a listing of any significant medical
conditions, disabilities, or allergies determined by the medical history or the
physical examination;
(3) screenings for vision and hearing;
(4) testing for anemia and tuberculosis, if the
health care provider considers such tests to be appropriate;
(5) a listing of medications the child takes on
a regular basis; and
(6) a listing of special health considerations
or services needed for the child during school hours.
(c) The health care provider may include the results of a
developmental screening.
History Note: Authority G.S. 130A‑440; 130A‑443;
Eff. January 1, 1988.
10A NCAC 43E .0202 REPORTING
(a) Local education agencies shall provide health
assessment transmittal forms to:
(1) parents or guardians of children enrolling
in kindergarten; and
(2) local health care providers, upon request
by the provider.
(b) The health care provider shall submit health assessment
results to the school principal on the health assessment transmittal form.
(c) Access to health assessment transmittal forms shall be
limited to principals, teachers, school nurses, public health nurses, and
school psychologists. Other school personnel may have access to the
transmittal forms on a case by case basis if they have written authorization
from the school principal. These forms may also be released pursuant to court
order or the written consent of the parent or guardian.
History Note: Authority G.S. 130A‑441; 130A‑443;
Eff. January 1, 1988.
SECTION .0300 ‑ PEDIATRIC PRIMARY CARE PROGRAM
10A NCAC 43E .0301 GENERAL
10A NCAC 43E .0302 DEFINITIONS
10A NCAC 43E .0303 PROVIDER ELIGIBILITY
10A NCAC 43E .0304 CLIENT ELIGIBILITY
10A NCAC 43E .0305 APPLICATION FOR FUNDS: PROGRAM PLAN:
RENEWAL
10A NCAC 43E .0306 BUDGETING OF GRANT FUNDS
10A NCAC 43E .0307 MEDICAL RECORDS
10A NCAC 43E .0308 CLIENT AND THIRD PARTY FEES
10A NCAC 43E .0309 MONITORING AND EVALUATION
History Note: Authority G.S. 130A-124;
Eff. April 1, 1985;
Amended Eff. December 1, 1990; September 1, 1990; August 1, 1987; April 1, 1987; February 1, 1987;
Repealed Eff. July 1, 2014.
SECTION .0400 - Early Childhood Vision Care Program
10A NCAC 43E .0401 GENERAL
10A NCAC 43E .0402 COVERED SERVICES
10A NCAC 43E .0403 ELIGIBILITY
10A NCAC 43E .0404 APPLICATIONS FOR PROGRAM SERVICES
10A NCAC 43E .0405 REIMBURSEMENT TO PROVIDERS
History Note: Authority G.S. 130A-440.1; 143B-216.75;
Temporary Adoption Eff. November 1, 2007;
Temporary Adoption Expired August 11, 2008.
