Iowa Admin. Code r. 441-83.23

Current through Register Vol. 47, No. 11, December 11, 2024

Rule 441-83.23 - Application

(1)Application for HCBS elderly waiver. The application process as specified in rules 441-76.1 (249A) to 441-76.6 (249A) shall be followed.

(2)Application for services. Rescinded IAB 12/6/95, effective 2/1/96.

(3)Approval of application.

a. Applications for the elderly waiver program shall be processed in 3 0 days unless the worker can document difficulty in locating and arranging services or circumstances beyond the worker's control. In these cases a decision shall be made as soon as possible.

b. Decisions shall be mailed or given to the applicant on the date when both service and income maintenance eligibility determinations are completed.

c. An applicant must be given the choice between elderly waiver services and institutional care. The applicant, guardian, or attorney in fact under a durable power of attorney for health care shall sign the information submission tool specified in 83.22(1)"d," indicating that the applicant has elected waiver services.

d. Waiver services provided prior to approval of eligibility for the waiver cannot be paid.

(4)Effective date of eligibility.

a. The effective date of eligibility is the date on which the income eligibility and level of care determinations are completed.

b. Eligibility for persons whose income exceeds supplemental security income guidelines shall not exist until the persons require care in a medical institution for a period of 30 consecutive days and shall be effective no earlier than the first day of the month in which the 30-day period begins.

c. Eligibility continues until the consumer has been in a medical institution for 120 consecutive days for other than respite care or fails to meet eligibility criteria listed in rule 441-83.22 (249A). Consumers who are inpatients in a medical institution for 120 or more consecutive days for other than respite care shall be terminated from elderly waiver services and reviewed for eligibility for other Medicaid coverage groups. The consumer will be notified of that decision through Form 470-0602, Notice of Decision. If the consumer returns home before the effective date of the notice of decision and the consumer's condition has not substantially changed, the denial may be rescinded and eligibility may continue.

(5)Attribution of resources. For the purposes of attributing resources as provided in rule 441-75.5 (249A), the date on which the waiver applicant met the level of care criteria in a medical institution as established by the peer review organization shall be used as the date of entry to the medical institution. Only one attribution of resources shall be completed per person. Attributions completed for prior institutionalizations shall be applied to the waiver application.

Iowa Admin. Code r. 441-83.23

ARC 0306C, IAB 9/5/12, effective 11/1/12

Amended by IAB January 06, 2016/Volume XXXVIII, Number 14, effective 1/1/2016

Amended by IAB July 5, 2017/Volume XL, Number 01, effective 8/9/2017

Amended by IAB August 2, 2017/Volume XL, Number 3, effective 9/6/2017