PURPOSE: The Department of Health

1. (DOH) provides low-protein formula, a special dietary product, to individuals diagnosed as having phenylketonuria (PKU), maple syrup urine disease (MSUD) and other metabolic conditions as approved by the Newborn Screening Standing Committee. This rule establishes the criteria by which the Formula Distribution Program accepts clients for service.

2. (1) Conditions of eligibility for the Formula Distribution Program (FDP) include:

   1. (A) A client must be diagnosed as having phenylketonuria (PKU), maple syrup urine disease (MSUD) or other metabolic condition as approved by the Newborn Screening Standing Committee. The diagnosis must be made by a physician who practices at a metabolic treatment center;
   2. (B) A client must be a resident of Missouri and cannot reside in a state facility;
   3. (C) A client must be financially eligible for FDP as defined by this rule;

   4. (D) The physician treating the client must submit the following information to the department:

      1. 1. A letter requesting the client be put

on the FDP;

1. 2. The name and address of the client;

and

1. 3. A prescription, signed by the treating

physician, stating the name of the low-protein formula, a special dietary product, the individual will be using; and

1. (E) Financial eligibility guidelines for enrollment in the FDP shall be based upon the Poverty Income Guidelines as established by the United States Department of Health and Human Services. Determination of individual client eligibility shall be based upon the following:

   1. 1. Total adjusted gross income shall not

exceed one hundred and eighty-five percent (185%) of the federal poverty income guidelines for the family size as stated in subsection (1)(E) of this rule;

1. 2. Size of family unit shall be the num-

ber of persons in the household, including the responsible party(ies) and dependents allowable by the Internal Revenue Service as federal income tax exemptions. If there is more 19 CSR 40-7

than one (1) eligible FDP client in the household, the total family size shall be increased by one (1) unit for each additional client. The family size may be increased by two (2) additional family members per affected child for the cost of low-protein formula, a special dietary product; and

1. 3. Funding to eligible clients may be

adjusted by the department based on available funding.

1. (2) This rule expires on June 30, 2002.

AUTHORITY: sections 191.300– 191.380, RSMo (1994 and Supp. 1995).* Original rule filed Aug. 15, 1996, effective Jan. 30, 1997.

*Original authority: 191.300–191.310, RSMo (1985); 191.315, RSMo (1985), amended 1993, 1995; 191.317–191.325, RSMo (1985); 191.331, RSMo (1965), amended 1985, 1992, 1993, 1995; 191.335, RSMo (1979); 191.340, RSMo (1979), amended 1985; 191.360–191.362, RSMo (1983); and 191.365–191.380, RSMo (1985).