Iowa Admin. Code r. 441-25.15 - Eligibility, diagnosis, and functional assessment criteria
(1)
Eligibility for mental health services. An individual must
comply with all of the following requirements to be eligible for mental health
services under the regional service system :
b. The individual is at least 18 years of
age.
c. The individual is a
resident of this state.
d. The
individual has had at any time during the preceding 12-month period a mental
health, behavioral, or emotional disorder or, in the opinion of a mental health
professional , may now have such a diagnosable disorder. The diagnosis shall be
made in accordance with the criteria provided in the most recent Diagnostic and
Statistical Manual of Mental Disorders published by the American Psychiatric
Association (published 2013, with all changes and updates approved by the
American Psychiatric Association through September 2023 incorporated herein)
and shall not include the manual's "V" codes identifying conditions other than
a disease or injury. The diagnosis shall also not include substance-related
disorders, dementia, antisocial personality, or developmental disabilities,
unless co-occurring with another diagnosable mental illness.
e. The results of a standardized functional
assessment support the need for mental health services of the type and
frequency identified in the individual 's case plan. The standardized functional
assessment methodology shall be designated for mental health services by the
director in consultation with the state commission . A functional assessment
must be completed within 90 days of application for services.
(2)
Eligibility for
children's behavioral health services . An individual must comply with
all of the following requirements to be eligible for children's behavioral
health services under the regional service system :
a. The individual is a child under 18 years
of age.
b. The child 's custodial
parent is a resident of the state of Iowa, and the child is physically present
in the state.
d. The child has been diagnosed with a
serious emotional disturbance . A serious emotional disturbance diagnosis is not
required to access comprehensive facility and community -based crisis services
according to Iowa Code section
225C.66(4)
"b."
(3)
Eligibility for intellectual
disability services . An individual must comply with all of the
following requirements to be eligible for intellectual disability services
under the regional service system :
b. The individual is at least 18 years of
age.
c. The individual is a
resident of this state.
e. The results of
a standardized functional assessment support the need for intellectual
disability services of the type and frequency identified in the individual 's
case plan. The standardized functional assessment methodology shall be
designated for intellectual services by the director in consultation with the
state commission . A functional assessment must be completed within 90 days of
application for services.
(4)
Other conditions of eligibility
for intellectual disability services .
a. An individual who is 17 years of age, is a
resident of this state, and is receiving publicly funded children 's services
may be considered eligible for services through the regional service system
during the three-month period preceding the individual 's eighteenth birthday in
order to provide a smooth transition from children 's to adult
services.
b. An individual less
than 18 years of age and a resident of the state may be considered eligible for
those intellectual disability services made available to all or a portion of
the residents of the region of the same age and eligibility class under the
county management plan of one or more counties of the region applicable prior
to formation of the region . Eligibility for services under this paragraph is
limited to availability of regional service system funds without limiting or
reducing core services, and if part of the approved regional service system
management plan .
(5)
Eligibility for brain injury services. An individual must
comply with all of the following requirements to be eligible for brain injury
services under the regional service system , if such services were provided to
the same class of individuals by a county in the region prior to regional
formation.
b. The individual is at least 18 years of
age.
c. The individual is a
resident of this state.
e. The results of
a standardized functional assessment support the need for brain injury services
of the type and frequency identified in the individual 's case plan. The
standardized functional assessment methodology used is the methodology approved
for brain injury services by the director in consultation with the state
commission . A functional assessment must be completed within 90 days of
application for services.
(6)
Other conditions of eligibility
for brain injury services. An individual who is 17 years of age, is a
resident of this state, and is receiving publicly funded children 's services
may be considered eligible for services through the regional service system
during the three-month period preceding the individual 's eighteenth birthday in
order to provide a smooth transition from children 's to adult
services.
(7)
Eligibility
for developmental disability services .
a. Until funding is designated for other
service populations, eligibility for the core service domains shall be as
identified in Iowa Code section
225C.65(2)
"b."
b. If a
county in a region was providing services to an eligibility class of
individuals with a developmental disability other than intellectual disability
prior to formation of the region , the class of individuals shall remain
eligible for the services provided when the region is formed, providing that
funds are available to continue such services without limiting or reducing core
services. The individual must also meet the requirements in paragraphs
25.15(7)"c," "d," "e" and "f."
d. The individual is at least 18 years of
age.
e. The individual is a
resident of this state.
f. The
individual has a diagnosis of a developmental disability other than an
intellectual disability as defined in rule
441-24.1 (225C).
Notes
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