Application for HCBS intellectual disability waiver services.
The application process as specified in rules
(249A) shall be followed.
Rescinded IAB 6/5/96, effective 8/1/96.
Approval of application.
a. Applications for the HCBS intellectual
disability waiver program shall be processed in 30 days unless the case manager
or worker can document difficulty in locating and arranging services or other
circumstance beyond the worker's control. In these cases a decision shall be
made as soon as possible.
Decisions shall be mailed or given to the applicant on the date when both
service and income maintenance eligibility determinations are
c. An applicant shall be
given the choice between HCBS waiver services and ICF/ID care. The case manager
or worker shall have the consumer or legal representative indicate the
consumer's choice of care.
intellectual disability waiver services provided before eligibility for the
waiver is approved shall not be reimbursed by the HCBS waiver
e. Services provided when
the person is a consumer of group foster care services or is an inpatient in a
medical institution shall not be reimbursed.
f. HCBS intellectual disability waiver
services are not available in conjunction with other Medicaid waiver services
or group foster care services.
Rescinded IAB 5/6/09, effective 7/1/09.
Effective date of
a. Deeming of parental
income and resources ceases the month following the month in which a person
requires care in a medical institution.
The effective date of eligibility for the
waiver for persons who are already determined eligible for Medicaid is the date
on which the person is determined to meet the criteria set forth in rule
The effective date of
eligibility for the waiver for persons who qualify for Medicaid due to
eligibility for the waiver services is the date on which the person is
determined to meet criteria set forth in rule
when the eligibility factor set forth in 441-subrule 75.1(7) and for married
persons, in rule
(249A) have been satisfied.
Eligibility continues until the consumer fails to meet eligibility criteria
listed in rule
Consumers who are inpatients in a medical institution for 120 consecutive days
shall receive a review by the interdisciplinary team to determine additional
inpatient needs for possible termination from the HCBS program. Consumers shall
be reviewed for eligibility under other Medicaid coverage groups. The consumer
or legal representative shall participate in the review and receive formal
notification 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 needs can still be met by the HCBS waiver
services, the denial may be rescinded and eligibility may continue.
e. Eligibility and service
reimbursement are effective through the last day of the month of the previous
annual service plan staffing meeting and the corresponding long-term care need
Attribution of resources.
For the purposes of attributing
resources as provided in rule
(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. 441-83.62
ARC 7741B, lAB 5/6/09,
effective 7/1/09; ARC 9650B, lAB 8/10/11, effective 10/1/11
September 30, 2015/Volume XXXVIII, Number 07, effective
August 2, 2017/Volume XL, Number 3, effective