Section 16.03.10.726 - SERVICE COORDINATION: ELIGIBILITY: INDIVIDUALS UP TO THE AGE OF TWENTY-ONETo be eligible for children's service coordination, a participant must meet the following requirements in Subsections 726.01 through 726.03. Eligibility is determined initially and annually by the Department based on information provided by the service coordination agency or the family. All information necessary to make the eligibility determination must be received by the Department twenty (20) business days prior to the anticipated start date of any service coordination services. The eligibility determination will be made by the Department prior to the initiation of initial and ongoing plan development and services.
01.Age. From the age of thirty-seven (37) months through the month in which their twenty-first birthday occurs.02.Diagnosis. Must have special health care needs requiring medical and multidisciplinary rehabilitation services identified by a physician or other practitioner of the healing arts to prevent or minimize a disability.03.Need Assistance. Medicaid-reimbursed service coordination services are not available for participants whose needs can be met by other service coordination or case management resources, including paid and non-paid sources. The participant must have needs for service coordination for one (1) or more of the following problems:a. The condition has resulted in a level of functioning below normal age level in one (1) or more life areas such as school, child care setting, family, or community;b. The child is at risk of placement in a more restrictive environment or the child is returning from an out of home placement as a result of the condition;c. There is danger to the health or safety of the child or the parent is unable to meet the needs of the child;d. Further complications may occur as a result of the condition without provision of service coordination services; ore. The child requires multiple service providers and treatments.Idaho Admin. Code r. 16.03.10.726