13-002 Code Vt. R. 13-100-002-X

Current through August, 2024

Section 13 100 002 - FINANCIAL ASSISTANCE FOR SUBSTANCE ABUSE TREATMENT SERVICES

Financial assistance for substance abuse treatment services is available for Vermont residents from substance abuse treatment programs that are supported by funds from the Vermont Office of Alcohol and Drug Abuse Programs. State rules pertaining to this program are established pursuant to 18 VSA Section 9143.

Section I Eligibility

Any person with a substance abuse problem requiring professional treatment services can request this assistance from a State approved and funded substance abuse treatment program. To be eligible for assistance, the applicant must meet the following requirements:

1. The applicant must be a Vermont resident;

2. Applicants who have an individual or group health insurance plan, Medicaid or any other form of health insurance which provides for reimbursement for alcohol treatment services for persons seeking services for an alcohol abuse problem or for reimbursement for drug treatment services for a person seeking assistance for a drug abuse problem shall not be eligible;

3. Applicants who are covered under another agreement/contract entered into by any State, other public or private organization with a substance abuse treatment provider affected by this rule shall be covered under the terms and conditions of such agreements/contracts and may not be eligible for assistance under the provisions of this rule; additionally, persons who are otherwise eligible for assistance under this rule and who require certification of successful completion of a substance abuse treatment program because of a DWI offense, must pay a minimum fee that is at least equal to the current fee for the Drinking Driver Rehabilitation School (CRASH School.) This CRASH School equivalency fee must be met only once during the course of the DWI offender's treatment, for each offense, regardless of the number of treatment providers involved. The person will then be placed on the fee schedule contained in these rules; and,

4. The applicant's gross family income must be in the range of incomes contained in the attached uniform schedule.

The uniform fee schedule determines the percentage of the fee that the person will be required to pay. This is arrived at from the person's gross family income and number of dependents. The minimum payment for any person seeking treatment is 15% of the provider fee for the service provided. The Office of Alcohol and Drug Abuse shall annually republish the fee schedule after review and adjustment to assure it remains consistent with Federal poverty income guidelines.

Section II Applying for Assistance

Vermont residents can apply for assistance for substance abuse treatment services at any State designated substance abuse treatment provider. There are treatment providers located in most major Vermont communities. A complete list of these providers can be obtained by writing to:

Office of Alcohol and Drug Abuse Programs 103 South Main Street 3 North Waterbury, Vermont 05671-1701 or, by calling: 241-2170.

Section III Substance Abuse Treatment Services

Therapeutic and diagnostic treatment services are available in both outpatient and residential treatment facilities designated by the State Office of Alcohol and Drug Abuse Programs. The person seeking assistance must be able to demonstrate a clinical need for the substance abuse treatment that is being requested. All services are subject to State criteria and limits.

Section IV Benefits

Eligibility is good for as long as there is a need for substance abuse treatment services and provided there is no change in financial resources or in the availability of other forms of insurance. In no event will the client be required to pay a fee that is greater than the provider's charge for the service received times the percentage from the uniform fee schedule.

The client is responsible for reporting any changes in insurance or income to the provider.

Section V Requirements for Substance Abuse Treatment Providers

The State Office of Alcohol and Drug Abuse Programs awards funds to substance abuse treatment providers for the delivery of services to eligible clients. To be selected, a provider must be in compliance with Office of Alcohol and Drug Abuse Program Approval Standards for substance abuse treatment services and, in addition, the provider is required:

1. To receive and evaluate all requests for assistance;

2. To notify the client and the State of the client's eligibility;

3. To have established procedures and methods to assure that all information on client eligibility is correct and complete and that such methods are in compliance with State standards;

4. To report any changes in client income and resources and to review client resources at least annually;

5. To provide the State with full access to all records on clients deemed eligible under this rule; and,

6. Client payments shall be determined by the uniform fee schedule. The provider may waive all or part of any fee.

Agency of Human Services Office of Alcohol and Drug Abuse Programs Subsidy Schedule for Alcohol & Drug Treatment Services

GROSS FAMILY INCOME

Client	Household Size:
Payment	1	2	3	4	5	6	7
15%	7,491 or less	10,109 or less	12,727 or less	15,345 or less	17,963 or less	20,581 or less	23,199 or less
20%	7,492- 8,526	10,110- 11,517	12,728 14,429	15,346- 17,193	17,964- 19,736	20,582- 22,080	23,200- 24,523
25%	8,527- 9,561	11,518- 12,925	14,430- 16,131	17,194- 19,041	19,737- 21,309	22,081- 23,579	24,524- 25,847
30%	9,562 10,596	12,926 14,333	16,132 17,833	19,042 20,889	21,310 22,982	23,580 25,078	26,848 27,171
35%	10,597- 11,631	14,334- 15,741	17,834- 19,535	20,890- 22,737	22,983- 24,655	25,079- 26,577	27,172- 28,495
40%	11,632- 12,666	15,742- 17,149	19,536- 21,237	22,738- 24,585	24,656- 26,328	26,578- 28,076	28,496- 29,819
45%	12,667- 13,701	17,150- 18,557	21,238- 22,939	24,586- 26,433	26,329- 28,001	28,077- 29,574	29,820- 31,143
50%	13,702- 14,736	18,558- 19,965	22,940- 24,641	26,434- 28,281	28,002- 29,674	29,575- 31,073	31,144- 32,467
60%	14,737- 16,805	19,966- 22,781	24,642- 28,044	28,282- 31,976	29,675- 33,019	31,074- 34,069	32,468- 35,114
70%	16,806- 18,874	22,782- 25,597	28,045- 31,447	31,977- 35,671	33,020- 36,364	34,070- 37,065	35,115- 37,761
80%	18,875- 20,943	26,598- 28,413	31,448- 34,850	35,672- 39,366	36,365- 39,709	37,066- 40,061	37,762- 40,408
90%	20,944- 22,999	28,414- 31,220	34,851- 38,243	39,367- 43,053	39,710- 43,053	40,062- 43,053	40,409- 43,053
100%	23,000 & above	31,221 & above	38,244 & above	43,054 & above	43,054 & above	43,054 & above	43,054 & above

13-002 Code Vt. R. 13-100-002-X