Utah Admin. Code R539-1-5 - Services for People with Physical Disabilities

Current through Bulletin 2022-07, April 1, 2022

(1) The division shall only offer services for a physical disability to an eligible applicant with a disability as defined in Subsection 62A-5-101(9).
(2) An eligible applicant must meet the following requirements:
(a) have a qualifying physical disability expected to last for a continuous period of 12 months or longer;
(b) have the functional loss of two or more limbs;
(c) have a need for a personal assistance service to accomplish an activity of daily living or an instrumental activity of daily living;
(d) be 18 years of age or older;
(e) be medically stable;
(f) be capable of selecting, training, and supervising a personal attendant;
(g) have at least one available personal attendant trained or willing to be trained;
(h) live in a safe residence that can accommodate the personnel and equipment needed to adequately and safely care for the person;
(i) be capable of managing personal financial and legal matters;
(j) have three or more functional limitations as described in Subsection R539-1-4(3)(a) through R539-1-4(3)(g); and
(k) be a resident of the state.
(3) The division shall:
(a) determine if an applicant is eligible for non-waiver services within 90 days of receiving needed documentation; and
(b) keep eligibility documentation in the applicant's electronic record.
(4) The division shall use the following documents to determine eligibility:
(a) Physical Disabilities Services Application Form 3-1 Part B signed by the licensed physician attesting to each eligibility requirement; and
(b) the Minimum Data Set-Home and Community-based (MDS-HC).
(5) An applicant shall submit to the division the documentation needed to determine eligibility.
(a) If needed documentation is not submitted within 90 days of initial contact, the division shall change the intake case status to inactive and send the applicant written notification of an intake status change to inactive.
(b) An applicant may reactivate the intake case by submitting any needed documentation.
(c) An applicant must update eligibility documentation as needed.
(6) The division shall notify an applicant of the eligibility determination by mailing a Notice of Agency Action Form 522-I and a Hearing Request Form 490S.
(a) The Notice of Agency Action Form 522-I indicates:
(i) the eligibility determination; and
(ii) placement on the waiting list, when applicable.
(b) An applicant may challenge the eligibility determination by filing a written request for an administrative hearing before the Department of Human Services, Office of Administrative Hearings.
(7) The division shall annually re-determine eligibility for each person receiving a service. If a person receiving a service is determined to be ineligible, the division shall develop a transition plan to discontinue each service that ensures any health and safety need is met.
(8) A person who receives a non-waiver service may have their non-waiver service package reduced or terminated because of:
(a) a division budget shortfall;
(b) a reduced legislative allocation; or
(c) a reevaluation of eligibility.
(9) Section R539-1-5 does not apply to an applicant who meets the eligibility criteria for intellectual disability and related conditions or brain injury as described in Sections R539-1-4 and R539-1-6, respectively.

Notes

Utah Admin. Code R539-1-5
Amended by Utah State Bulletin Number 2016-22, effective 10/25/2016 Amended by Utah State Bulletin Number 2020-08, effective 4/8/2020 Amended by Utah State Bulletin Number 2020-22, effective 11/9/2020 Amended by Utah State Bulletin Number 2022-05, effective 2/22/2022

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