Section 388-823-1010 - When will DDA review my eligibility to determine if I continue to meet the eligibility requirements for DDA?(1) While DDA may review your eligibility at any time, DDA will review your eligibility: (a) At age 19 when the most recent eligibility determination was completed before age 16.(b) At age 19 when determined eligible with another neurological or other condition similar to intellectual disability and academic delays were used as evidence of substantial functional limitations.(c) Before authorization of any DDA-paid service if one is not currently receiving paid services and the most recent eligibility determination was before June 1, 2005.(d) If the evidence used to make the most recent eligibility determination is insufficient, contains an error, or appears fraudulent.(e) If new information becomes available that does not support the current eligibility determination.(f) If you are determined eligible due solely to enrollment in the fee-for-service (FFS) medically intensive children's program (MICP) but you are no longer eligible for FFS MICP services.(2) DDA will notify you in writing at least six months before your eligibility review date.(3) When a review occurs and there is insufficient information to determine your eligibility, DDA can disenroll you: (a) On your 20th birthday if it is an age 19 review; or(b) 90 days after the information is requested, if the review is because: (i) A paid service is requested;(ii) The evidence used to make the most recent eligibility determination is insufficient, contains an error, or appears fraudulent;(iii) New information is available that does not support the current eligibility determination; or(iv) You are no longer eligible for FFS MICP services under chapter 182-551 WAC.Wash. Admin. Code § 388-823-1010
Amended by WSR 14-07-028, filed 3/10/14, effective 4/10/2014Amended by WSR 14-12-046, Filed 5/29/2014, effective 7/1/2014Amended by WSR 18-15-046, Filed 7/13/2018, effective 8/13/2018Amended by WSR 19-14-119, Filed 7/3/2019, effective 8/3/2019Amended by WSR 24-01-119, Filed 12/19/2023, effective 1/19/2024Amended by WSR 24-18-040, Filed 8/27/2024, effective 10/7/2024Reviser's note: The bracketed material preceding the section above was supplied by the code reviser's office.
Reviser's note:RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. WSR 05-12-130, § 388-823-1010, filed 6/1/05, effective 7/2/05.