Iowa Admin. Code r. 441-83.23 - Application
(1)
Application for HCBS elderly waiver. The application process
as specified in rules
441-76.1 (249A) to
441-76.6
(249A) shall be followed.
(2)
Application for services. Rescinded IAB 12/6/95, effective
2/1/96.
(3)
Approval of
application.
a. Applications for the
elderly waiver program shall be processed in 3 0 days unless the worker can
document difficulty in locating and arranging services or circumstances beyond
the worker's control. In these cases a decision shall be made as soon as
possible.
b. Decisions shall be
mailed or given to the applicant on the date when both service and income
maintenance eligibility determinations are completed.
c. An applicant must be given the choice
between elderly waiver services and institutional care. The applicant,
guardian , or attorney in fact under a durable power of attorney for health care
shall sign the information submission tool specified in
83.22(1)"d," indicating that the applicant has elected waiver
services.
d. Waiver services
provided prior to approval of eligibility for the waiver cannot be
paid.
(4)
Effective date of eligibility.
a. The effective date of eligibility is the
date on which the income eligibility and level of care determinations are
completed.
b. Eligibility for
persons whose income exceeds supplemental security income guidelines shall not
exist until the persons require care in a medical institution for a period of
30 consecutive days and shall be effective no earlier than the first day of the
month in which the 30-day period begins.
c. Eligibility continues until the consumer
has been in a medical institution for 120 consecutive days for other than
respite care or fails to meet eligibility criteria listed in rule
441-83.22 (249A).
Consumers who are inpatients in a medical institution for 120 or more
consecutive days for other than respite care shall be terminated from elderly
waiver services and reviewed for eligibility for other Medicaid coverage
groups. The consumer will be notified of that decision through Form 470-0602,
Notice of Decision. If the consumer returns home before the effective date of
the notice of decision and the consumer 's condition has not substantially
changed, the denial may be rescinded and eligibility may continue.
(5)
Attribution of
resources. For the purposes of attributing resources as provided in
rule
441-75.5
(249A), the date on which the waiver applicant met the level of care criteria
in a medical institution as established by the peer review organization shall
be used as the date of entry to the medical institution . Only one attribution
of resources shall be completed per person. Attributions completed for prior
institutionalizations shall be applied to the waiver application.
Notes
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