Iowa Admin. Code r. 441-83.107 - Individual service plan
An individualized
(1)Information in plan. The
plan shall be in accordance with 441-subrule 24.4(3) and shall additionally
include the following information to assist in evaluating the program :
a. A listing of all services received by a
consumer at the time of waiver program enrollment.
b. The name of all providers responsible for
providing all services.
c. All
service funding sources.
d. The
amount of the service to be received by the consumer .
e. Whether the consumer has elected the
consumer choices option and, if so:
(1) The
independent support broker selected by the consumer ; and
(2) The financial management service selected
by the consumer .
f. A
plan for emergencies and identification of the supports available to the
consumer in an emergency.
(2)Annual assessment . The
IME medical services unit or a managed care organization shall review the
member's need for continued care annually and recertify the member's need for
long-term care services, pursuant to paragraph 83.102(1)"h"
and the appeal process at rule
441-83.109 (249A),
based on the appropriate information submission tool as listed in paragraph
83.102(1)"h" and other supporting documentation as relevant.
a. The IME medical services unit or the
member's managed care organization shall be responsible for annual
redetermination of the level of care.
b. The managed care organization must submit
documentation to the IME medical services unit for all reassessments, performed
at least annually, which indicate a change in the member's level of care. The
IME medical services unit shall make a final determination for any
reassessments which indicate a change in the level of care. If the level of
care reassessment indicates no change in level of care, the member is approved
to continue at the already established level of care.
(3)Case file. Rescinded IAB
8/7/02, effective 10/1/02.
Notes
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