A service plan shall be prepared for each HCBS intellectual
disability waiver consumer.
Development. The service plan shall be developed by the
interdisciplinary team, which includes the consumer, and, if appropriate, the
legal representative, consumer's family, case manager or service worker,
service providers, and others directly involved.
Retention. The service
plan shall be stored by the case manager for a minimum of three
Interdisciplinary team meeting. The interdisciplinary team
meeting shall be conducted before the current service plan expires.
Information in plan.
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.
For supported community living:
(1) The consumer's living environment at the
time of waiver enrollment.
number of hours per day of on-site staff supervision needed by the
(3) The number of other
waiver consumers who will live with the consumer in the living unit.
An identification and
justification of any restriction of the consumer's rights including, but not
(1) Maintenance of personal
(2) Self-administration of
d. The name
of the service provider responsible for providing each service.
e. The service funding source.
f. The amount of the service to be received
by the consumer.
consumer has elected the consumer choices option and, if so:
(1) The independent support broker selected
by the consumer; and
financial management service selected by the consumer.
h. A plan for emergencies and identification
of the supports available to the consumer in an emergency.
For members receiving daily supported
community living, day habilitation or adult day care: the following standard
scores from the most recently completed SIS assessment:
(1) Score on subsection 1A: Exceptional
Medical Support Needs.
(2) Score on
subsection IB: Exceptional Behavioral Support Needs.
Sum total of standard scores on the
1. Subsection 2A: Home
2B: Community Living Activities;
Subsection 2E: Health and Safety Activities; and
4. Subsection 2F: Social
Medicaid case manager shall ensure that the consumer's case file contains the
consumer's service plan and documentation supporting the diagnosis of mental
The plan shall be approved through the Individualized
Services Information System (ISIS). Services shall be entered into ISIS based
on the service plan.
a. Services must be
authorized and entered into ISIS before the plan implementation date.
b. The department has 15 working days after
receipt of the summary and service costs in which to approve the services and
service cost or request modification of the service plan unless the parties
mutually agree to extend that time frame.
c. If the department and the service worker
or case manager are unable to agree on the terms of the services or service
cost within 10 days, the department has final authority regarding the services
and service cost.
Iowa Admin. Code r. 441-83.67
ARC 9650B, lAB 8/10/11,
effective 10/1/11; ARC 0191C, lAB 7/11/12, effective 7/1/12; ARC 0359C, lAB
10/3/12, effective 12/1/12
December 6, 2017/Volume XL, Number 12, effective
May 9, 2018/Volume XL, Number 23, effective