Iowa Admin. Code r. 61-9.35 - Computation of benefit categories
The
(1)
Medical care .
Compensation may be paid for the reasonable expenses of medical care provided
to eligible crime victims by, or under the supervision of, a person licensed by
the state under Iowa Code chapter 147, 148, 148A, 148E, 149, 151, 152C, or 153.
When preexisting medical conditions are treated during crime -related medical
care , the program may reduce payment to a percentage equal to the portion of
the medical care determined to be directly related to the compensable crime .
Medical care expenses include the following:
a.
Medical care sanctioned by
sovereign nations and tribes. Compensation may be paid for medical
care rendered in accordance with a method of healing sanctioned by a
state-recognized or federally recognized sovereign nation or tribe.
b.
Medical counseling costs.
Compensation may be paid for counseling provided under the direct supervision
of a psychiatrist or other physician and shall be applied toward the medical
benefit maximum.
c.
Medical
care for homicide victim survivors. Compensation may be paid to a
spouse, child, parent, sibling, or person related by blood or affinity to a
homicide victim for the same types of medical care that are allowable for
primary victims, including but not limited to hospital and physician care,
psychiatric care, prescriptions, and transportation expenses related to injury
from the crime .
d.
Medical
equipment and property alteration. Compensation may be paid for
equipment and property alteration that are prescribed as medically necessary
care due to injury from the crime .
e.
Medical supplies.
Compensation may be paid for medical care supplies and incidental supplies
necessary for medical care due to injury from the crime .
f.
Medical care for
pregnancy. Compensation may be paid for medical care costs related to
pregnancy resulting from the crime of sexual abuse . Eligible expenses for the
care of the victim shall be paid. Expenses incurred for the care of a newborn
child are not compensable.
g.
Medical devices. Compensation may be paid for the replacement
of a medical device including but not limited to a sight or hearing device,
dentures, a prosthetic device, a wheelchair, and medication that was taken,
lost or destroyed during the crime .
h.
Transportation for medical
emergency. Compensation may be paid for the reasonable cost of
transportation in a medical emergency by private vehicle at the per-mile rate
established by the department of administrative services for state employees
using a privately owned vehicle for state business. Mileage will be based on
mileage calculation from the most current map published by the department of
transportation. Transportation within a city limit will be based on the
program 's estimate of mileage from the location of the injured victim to the
medical facility.
i.
Transportation for nonemergency care. Compensation may be paid
for the cost of transportation by commercial vehicle or by private car for
nonemergency medical care and counseling received outside of the victim 's
county of residence . Transportation provided by private vehicle for
nonemergency care will be reimbursed at the per-mile rate established by the
department of administrative services for state employees using a privately
owned vehicle for state business. Mileage will be based on mileage calculation
from the most current map published by the department of
transportation.
j.
Transportation medical benefit. Compensation may be paid for
transportation from the applicable medical care or counseling benefit category.
The available funds to the victim from the applicable benefit category will be
reduced by the amount of compensation paid for transportation.
k.
Health insurance.
Compensation may be paid for premiums to continue a health insurance policy
that was provided in whole or in part by the victim 's employer prior to the
crime and the employment ceased as a result of the crime .
(2)
Medical care records.
When compensation for medical care is requested, the provider shall submit
medical records that document the care provided and show that the medical care
is for injury from crime .
(3)
Mental health counseling . Compensation may be paid for the
reasonable costs of up to 12 mental health counseling sessions for eligible
crime victims and survivors of a homicide victim with the provision of a
treatment plan and certification as defined in paragraph
9.35(4)"a." Costs for those 12 sessions will be paid in full
if the crime is noted in the treatment plan. If preexisting mental health
issues are addressed during crime -related counseling sessions following the
initial 12 visits, the program may reduce payment to a percentage equal to the
portion of the counseling determined to be directly related to the compensable
crime .
The mental health
a.
Master's
level counselor. Compensation may be paid for mental health counseling
provided by a person holding at least a master's degree in a mental health or
counseling field including but not limited to social work, psychology, guidance
and counseling , behavioral sciences, art therapy, marriage and family therapy,
child life therapy, and advanced mental health registered nursing.
b.
Supervised mental health
counselor. Compensation may be paid for mental health counseling
provided by a counselor who does not have a master's degree but is under the
supervision of a counselor with a master's degree. The supervising mental
health counselor must sign the session notes that must be submitted for review
by the program .
c.
Intern
mental health counselors. Compensation may be paid for mental health
counseling provided by an intern candidate for a master's degree when the
counseling is provided within a course of professional education and the intern
is supervised by a provider eligible for compensation .
d.
Out-of-state providers.
Compensation may be paid to mental health counselors outside Iowa who provide
services to victims of crime eligible for the Iowa program if the mental health
counselor meets the professional licensure criteria of the state in which the
counselor works.
(4)
Mental health counseling records. When compensation for mental
health counseling is requested, the provider shall complete verification forms
related to the counseling as follows:
a.
Treatment plan and certification form. Information submitted
on the treatment plan and certification form shall include but not be limited
to a summary of the initial evaluation, any preexisting mental health diagnoses
currently being treated, current diagnoses, issues addressed, counseling goals,
expected length of counseling services, and certification of the percentage of
mental health counseling directly related to issues arising from the
victimization.
b.
Treatment
progress and certification form. At six-month intervals for the
duration of the crime -related mental health counseling , the provider shall
submit a treatment progress and certification form. Information on the form
shall include progress on previously stated goals of counseling , current goals,
current diagnosis, expected length of additional counseling , and certification
of the percentage of mental health counseling directly related to issues
arising from the victimization.
c.
Session notes. The program may require submission of session
notes to determine if the mental health counseling is directly related to the
crime when:
(1) The counseling expenses for a
victim exceed $3,000.
(2) The
provider has not completed the treatment and certification plan with statement
of the percentage of treatment directly related to the crime .
(3) The counseling begins, or is provided,
more than one year after the crime .
(4) The treatment plan or progress summary
indicates that the victim is receiving treatment for a diagnosis or issue not
exacerbated by the crime .
(5)
Counseling with the
perpetrator. Compensation for mental health counseling that includes
the perpetrator of the crime may be payable when the perpetrator takes part
only to take responsibility for the crime and apologize to the victim and, at
the request of the victim , the victim is allowed to confront the perpetrator
regarding the effects of the crime ; or where treatment is
court-ordered.
(6)
Family
counseling . Compensation for family mental health or victim service
counseling may be paid only for sessions where the victim is present and the
focus of the session is to assist the victim in recovery from a compensable
crime .
(7)
Lost wages or
income. Compensation may be paid for reasonable lost wages or income
when an eligible crime victim is unable to work as the result of physical or
emotional injury from a crime , as a result of cooperation with the
investigation or prosecution of the crime , or due to health and safety concerns
related to maintaining employment. Lost wages or income due to crime is
determined as follows:
a.
Gross wage
computed. Lost wages are computed as the gross rate of pay multiplied
by the number of scheduled hours of work missed, decreased by 25 percent
pursuant to the definition of "lost wages or income" in rule
61-9.26 (915).
b.
Variable income. Income
that is variable shall be computed based on the average income earned during a
minimum 28-day period within the three months preceding the crime . Estimated
earnings not supported by past income statements shall not be
accepted.
c.
Self-employment and small business income. Self-employed
persons or small business employees must provide federal or state income tax
forms for the most recent year completed or verification of average income for
a minimum of the past six months. Work estimates, labor contracts, and
affidavits from individual employers may be used to establish wages.
d.
Vacation, sick, holiday,
bereavement, and annual leave. Lost wages or income paid shall not be
reduced by vacation, sick, holiday, bereavement, or annual leave available or
used by the victim due to the crime .
e.
Calculation when rate of pay
cannot be established. In the event employment can be verified but the
rate of pay cannot be established through pay stubs, state or federal tax
forms, or bank statements, compensation shall be calculated at the current
state minimum wage rate on the basis of an eight-hour workday.
(8)
Lost wages or income
as the result of physical or emotional injury from a crime .
Compensation for lost wages or income incurred within the first two weeks
following the crime shall be paid to an eligible crime victim without an
authorized disability statement. Compensation for lost wages or income incurred
within the first 30 days following the crime may be paid to an eligible
survivor of a deceased victim without a disability statement. A victim seeking
lost wages for a period of time longer than two weeks, or an eligible survivor
seeking lost wages for longer than 30 days under Iowa Code section
915.86(10),
shall submit a disability statement from a licensed medical provider for a
physical injury or an injury related to mental health, or from a licensed
mental health provider as included in paragraphs 9.35(3)"a"
through "d" for an injury related to mental health.
Compensation shall be made for lost wages or income under the following
circumstances:
a.
Lost
income. Compensation may be paid when the victim cannot work due to
injury from crime .
b.
Lost
hire income. Compensation may be paid when the victim has been hired
by an employer but is unable to begin employment because of injury due to the
crime , until released to work. Required documentation includes a signed
affidavit by the employer.
c.
Employment ceases. Compensation may be paid when the victim is
terminated from employment as a result of crime -related injuries, until
released to seek work.
d.
Unemployment eligible. Compensation may be paid for the
difference between the victim 's gross wage and the unemployment benefit when
the victim is terminated from employment because of injury from crime and is
found to be eligible for unemployment benefits.
e.
Unemployment
ineligibility. Compensation may be paid for the amount of the victim 's
unemployment benefit when the victim is rendered ineligible for unemployment
benefits because of injury from the crime , until the victim is released to
work.
f.
Workers'
compensation benefit eligible. Compensation may be paid for the
difference between the victim 's gross wage and the workers' compensation
benefit when the victim is unable to work because of injury from the crime and
is found to be eligible for workers' compensation benefits.
g.
Medical and counseling
appointments. Compensation may be paid to a primary victim , the parent
or guardian of a minor-aged primary victim , or the caretaker of a dependent
adult primary victim for wages lost due to medical care or counseling
appointments for the victim .
(9)
Lost wages or income for
cooperation in an investigation and prosecution. Compensation may be
paid for lost wages or income incurred by an eligible primary victim , survivor
of a deceased victim as described in Iowa Code section
915.86(8),
parent or guardian of a minor-aged primary victim , or caretaker of a dependent
primary victim while cooperating with the investigation and prosecution of the
crime , including but not limited to participation at identification sessions,
arraignment, deposition, plea agreement meetings, trial, sentencing, parole and
probation hearings, and sexually violent predator civil commitment
proceedings.
(10)
Lost
wages or income due to health or safety concerns related to maintaining
employment. Compensation for lost wages or income shall be paid to an
eligible crime victim for up to 30 days following an event that compromises the
health or safety of the victim including but not limited to the approved crime ,
stalking, or harassment. Compensation for lost wages or income beyond 30 days
may be extended at the discretion of the program administrator, the director ,
or the board .
(11)
Residential crime scene cleanup. Compensation may be paid for
the reasonable costs of an eligible victim or applicant for cleaning a
residential crime scene, which includes a home, or a private vehicle if the
vehicle serves as the primary residence , in which the crime was committed.
Cleaning a residential crime scene means to remove, or attempt to remove, from
the crime scene blood, dirt, stains, or other debris caused by the crime or the
processing of the crime scene. Compensation shall be paid for the reasonable
out-of-pocket cost of cleaning supplies, equipment rental and labor and the
value of property that is essential to the victim and that is held by law
enforcement for evidentiary purposes. Cleaning a residential crime scene does
not include replacement or repair of property damaged in the crime .
(12)
Loss of support.
Compensation for loss of support may be paid for the dependents of an eligible
homicide victim or of a victim disabled for a period of 60 days or more when
the applicant documents that the dependent relied on the victim wholly or
partially for physical care or financial support.
a.
Period of dependency.
Compensation may be paid for loss of support for the remaining period of
dependency, up to the limits established in Iowa Code section
915.86(7), in
an amount equal to the lost wages or income the victim was earning at the time
of death or disability. The amount of compensation shall be subject to
reduction by the amount of collateral sources designated as support pursuant to
Iowa Code section 915.87(1).
b.
Dependent care.
Compensation may be paid for loss of support at the current hourly rate of the
Iowa minimum wage for dependent care provided by a person other than the victim
if the victim was providing physical care to the dependent at the time of the
crime .
(13)
Clothing and bedding. Compensation may be paid for clothing
and bedding held as evidence by law enforcement. Compensation shall not be made
for a deceased victim 's clothing that is held as evidence.
(14)
Funeral, burial, and memorial
expenses. Compensation may be paid for reasonable expenses incurred
for the funeral and burial or cremation for an eligible victim who has died as
the result of a crime committed against the victim . An estate may be reimbursed
for this benefit if the application is filed by the victim 's surviving spouse,
children, parents, or siblings or by a person cohabiting with or related by
blood or affinity to the victim . This benefit cannot be used if there are no
surviving eligible applicants. Life insurance will only be considered a
collateral source if there is a specific funeral expense clause in the life
insurance policy. The following expenses may be paid up to the maximum expense
established in Iowa Code section
915.86:
a.
Funeral service.
Compensation may be paid for expenses related to funeral and burial or
cremation preparation and services. Funeral services may also include a
memorial service or items commemorating the deceased victim .
b.
Burial plot and vessel.
Compensation may be paid for the cost of a burial plot, vault, casket, urn, or
other permissible vessel.
c.
Burial effects. Compensation may be paid for miscellaneous
funeral and burial expenses including, but not limited to, flowers, burial
clothing for the victim , transportation of the victim 's body, and travel and
lodging expenses for survivors of the deceased victim as described in Iowa Code
section 915.86 with priority for the
surviving spouse, children, and parents of the victim . Documentation must be
provided for all miscellaneous funeral and burial expenses.
(15)
Dependent
care.
a. Compensation may be paid
for reasonable costs of dependent care incurred by a primary victim , the parent
or caretaker of a dependent primary victim , or the survivor of a deceased
victim to attend medical or counseling appointments or criminal justice
proceedings. Dependent care expenses may be paid for the parent or caretaker of
a primary victim to attend the parent's or caretaker's own medical or mental
health appointments.
b.
Compensation may include but is not limited to expenses for care provided by a
day care center, private residential child care, a relative who is not a tax
dependent , a before- or after-school program , custodial elder care, an adult
day care center, a nanny, or an au pair. Expenses may be paid up to the maximum
benefit established in Iowa Code section
915.86(13).
(16)
Residential
security.
a. Compensation may be
paid for reasonable costs incurred by a victim , the victim 's parent or
caretaker, or the survivor of a deceased victim to install new residential
security items, or to replace inadequate or damaged residential security items,
not to exceed the maximum expense established in Iowa Code section
915.86(14).
b. Compensation may be paid for doors, locks,
windows, security cameras, security systems or devices, or other reasonable
expenses that provide for the safety of the victim or the security of the
residence .
(17)
Transportation and lodging expenses. Compensation may be paid
for reasonable transportation and lodging expenses incurred by the victim ,
secondary victim , parent or guardian of the victim , or survivor of a deceased
victim for medical and counseling services, criminal justice proceedings, or
funeral activities, not to exceed the benefit limit established in Iowa Code
section 915.86(15).
a. Use of a privately owned vehicle shall be
paid at the per-mile rate established by the department of administrative
services for state employees using a private vehicle for state
business.
b. Commercial vehicle
transportation shall be paid at the cost incurred by, or on behalf of, an
eligible applicant .
Notes
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