Iowa Admin. Code r. 441-83.128 - Adverse service actions
(1)
Denial. An application for children's mental health waiver
services shall be denied when the department determines that:
a. The consumer is not eligible for or in
need of waiver services.
b. Needed
services are not available or received from qualified providers.
c. Service needs exceed the limit on
aggregate monthly costs established in 83.122(6)"c" or are not
met by the services provided.
(2)
Termination. A
consumer's participation in the children's mental health waiver program may be
terminated when the department determines that:
a. The provisions of 441-paragraph
130.5(2)"a," "b," "c," "g," or "h"
apply.
b. The costs of the
children's mental health waiver services for the consumer exceed the aggregate
monthly costs established in 83.122(6)"c."
c. The consumer receives care in a hospital,
nursing facility, psychiatric hospital serving children under the age of 21, or
psychiatric medical institution for children for 120 days in any one
stay.
d. The physical or mental
condition of the consumer requires more care than can be provided in the
consumer's own home, as determined by the consumer's case manager or integrated
health home care coordinator.
e.
Service providers are not available.
(3)
Reduction. Reduction of
services shall apply as specified in 441-paragraphs
130.5(3)"a" and"b."
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.