Section 16.03.10.322 - AGED AND DISABLED WAIVER SERVICES: ELIGIBILITYThe Department provides waiver services to eligible participants: to prevent unnecessary institutional placement; to provide for the greatest degree of independence possible; to enhance the quality of life; to encourage individual choice; and to achieve and maintain community integration. For a participant to be eligible, the Department must find that the participant:
01.Has a Disabling Condition. Requires services due to a disabling condition that impairs their mental or physical function or independence; and02.Safe in a Non-Institutional Setting. Be capable of being maintained safely and effectively in a non-institutional setting; and03.Requires Such Services. Would, in the absence of such services, require the level of care provided in a Nursing Facility.04.Functional Level for Adults. Based on the results of the assessment, the level of impairment of the individual will be established by the Department or its contractor. In determining need for nursing facility care an adult must require the level of assistance listed in Subsections 322.04 through 322.07 of this rule, according to the formula described in Subsection 322.08 of this rule.05.Critical Indicator - 12 Points Each.a. Total assistance with preparing or eating meals.b. Total or extensive assistance in toileting.c. Total or extensive assistance with medications that require decision making prior to taking, or assessment of efficacy after taking.06.High Indicator - 6 Points Each.a. Extensive assistance with preparing or eating meals.b. Total or extensive assistance with routine medications.c. Total, extensive or moderate assistance with transferring.d. Total or extensive assistance with mobility.e. Total or extensive assistance with personal hygiene.f. Total assistance with supervision from Section II of the Uniform Assessment Instrument (UAI).07.Medium Indicator - 3 Points Each. a. Moderate assistance with personal hygiene.b. Moderate assistance with preparing or eating meals.c. Moderate assistance with mobility.d. Moderate assistance with medications.e. Moderate assistance with toileting.f. Total, extensive, or moderate assistance with dressing.g. Total, extensive or moderate assistance with bathing.h. Extensive or moderate assistance with supervision from Section II No. 18 of the UAI.08.Nursing Facility Level of Care, Adults. In order to qualify for nursing facility level of care, the individual must score twelve (12) or more points in one (1) of the following ways.a. One (1) or more critical indicators = Twelve (12) points.b. Two (2) or more high indicators = Twelve (12) points.c. One (1) high and two (2) medium indicators = Twelve (12) points.d. Four (4) or more medium indicators = Twelve (12) points.Idaho Admin. Code r. 16.03.10.322