Application for HCBS AIDS/HIV waiver services.
process as specified in rules
(249A) shall be followed.
Application for services. Rescinded IAB 12/6/95, effective
Applications for the
HCBS AIDS/HIV waiver program shall be processed in 30 days unless one or more
of the following conditions exist:
application is pending because the department has not received information,
which is beyond the control of the client or the department.
(2) The application is pending because a
level of care determination has not been made although the completed assessment
has been submitted to the IME medical services unit.
(3) Rescinded IAB 3/7/01, effective
shall be mailed or given to the applicant on the date when income maintenance
eligibility and level of care determinations and the consumer service plan are
c. An applicant must be
given the choice between HCBS AIDS/HIV waiver services and institutional care.
The applicant, parent, guardian, or attorney in fact under a durable power of
attorney for health care shall sign the assessment and indicate that the
applicant has elected home- and community-based services.
d. Waiver services provided prior to approval
of eligibility for the waiver cannot be paid.
Effective date of
a. The effective date
of eligibility for the AIDS/HIV waiver for persons who are already determined
eligible for Medicaid is the date on which the income and resource eligibility
and level of care determinations are completed.
The effective date of eligibility for the
AIDS/HIV waiver for persons who qualify for Medicaid due to eligibility for the
waiver services and to whom 441-subrule 75.1(7) and rule
(249A) do not apply is the date on which income and resource eligibility and
level of care determinations are completed.
Eligibility for the waiver continues until
the recipient has been in a medical institution for 120 consecutive days for
other than respite care or fails to meet eligibility criteria listed in rule
Recipients who are inpatients in a medical institution for 120 or more
consecutive days for other than respite care shall be reviewed for eligibility
for other Medicaid coverage groups and terminated from AIDS/HIV waiver services
if found eligible under another coverage group. The recipient 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
person's condition has not substantially changed, the denial may be rescinded
and eligibility may continue.
The effective date of eligibility for the AIDS/HIV waiver for persons who
qualify for Medicaid due to eligibility for the waiver services and to whom the
eligibility factors set forth in 441-subrule 75.1(7) and, for married persons,
(249A) have been satisfied is the date on which the income eligibility and
level of care determinations are completed but shall not be earlier than the
first of the month following the date of application.
For the purposes of attributing resources as provided in
(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.
Iowa Admin. Code r. 441-83.43
ARC 0306C, IAB 9/5/12,
January 06, 2016/Volume XXXVIII, Number 14, effective
July 5, 2017/Volume XL, Number 01, effective
August 2, 2017/Volume XL, Number 3, effective