Iowa 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 Rescinded IAB 12/6/95, effective 2/1/96.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 30 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rescinded and eligibility may continue.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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