16 Del. Admin. Code § 25000-25250

Current through Register Vol. 28, No. 7, January 1, 2025

Section 25000-25250 - GENERAL LEVEL OF CARE FACTORS

1. The assessment of whether a child's profile is consistent with a qualifying level of care is influenced by multiple considerations. Material criteria include the following mental, physical, familial, and environmental factors:

a. chronological and developmental age of child;

b. nature and severity of disease or medical condition(s);

c. symptomatology or functional limitations attributable to disease or medical condition (s);

d. stability of disease process or medical condition(s);

e. physical environment;

f. availability and profile of primary caregiver(s);

g. potential for harm, regression, or developmental delay in absence of services;

h. extent of assistance necessary for child to engage in activities of daily living ("ADLs")

i. extent of monitoring or supervision necessary to minimize potential for harm due to mental or physical health risks (e.g. suicide; elopement; self injurious behaviors; seizure); and

j. extent to which professional or specialized personnel (e.g. nurse; therapist) are necessary to provide monitoring, assistance, or services.

2. Since some debilitating diseases and medical conditions (quadriplegia; profound mental retardation) are highly correlated with a qualifying level of care, the Division may adopt presumptive eligibility guidelines to expedite processing of such applications.

16 Del. Admin. Code § 25000-25250