Iowa Admin. Code r. 641-56.5

Current through Regsiter Vol. 46, No. 26, June 12, 2024

Rule 641-56.5 - Application process

(1) The applicant must authorize the department of human services to provide the applicant's brain injury services waiver application materials to the brain injury services program.

(2) The department of human services will provide the department the application materials, which shall include but are not limited to the waiver application and any denial letter, financial assessment, and functional assessment regarding the person in an agreed-upon format.

(3) The department will determine eligibility within 45 days of receipt of complete application materials.

a. After determining if the applicant's service needs fit within the scope of the brain injury services program, the department shall inform the discharge planner or case manager on behalf of the applicant or the applicant's legal representative of the applicant's eligibility.

b. The case manager shall establish an interdisciplinary team for each consumer and, with the team, identify the consumer's plan based on the consumer's needs and desires as well as the availability and appropriateness of services. The case manager shall notify the department of the service plan.

c. The date of eligibility for applicants deemed eligible for the cost-share component will be the date when both the service eligibility and financial eligibility assessments have been completed.

d. Notification of eligibility shall be mailed or given to the applicant or the applicant's legal representative within seven days of the date eligibility determination is completed.

(4) After determining an applicant's eligibility, if no payment slot is available, the brain injury services program shall enter the applicant on a waiting list according to the following:

a. The date a completed Form 470-2927 or 470-2927(S), Health Services Application, is date-stamped in the county department of human services office. If more than one application is received on the same date, applicants shall be entered on the waiting list on the basis of the applicant's month of birth, with January designated as month one.

b. As slots become available, applicants shall be selected from the waiting list based on their order on the waiting list to maintain the number of persons approved for participation in the program.

(5) The consumer or the consumer's legal representative shall complete and sign Iowa department of human services Form 470-3349, Brain Injury Functional Assessment, indicating the consumer's choice of caregiver.

(6) The case manager for the consumer will initiate development of the consumer's service plan and commencement of services. All service plans must be approved by the program administrator.

(7) The department will not pay the cost of services provided to a consumer prior to approval of eligibility.

(8) The program administrator shall make the final determination as to whether program funding will be authorized under the cost-share component.

Iowa Admin. Code r. 641-56.5