Section R414-510-3 - Eligibility Requirements for the Transition Program(1) Waiver services are available to an individual who:(a) receives ICF benefits under the Medicaid State Plan;(b) has been diagnosed with an intellectual disability or a related condition;(c) meets ICF level-of-care criteria defined in Section R414-502-8;(d) meets state funding eligibility criteria for DSPD found in Subsection 26B-6-402(6); and(e) has at least a 12-month length-of-stay in any Medicaid-certified, privately owned ICF or nursing facility located in the state.(2) The department allows break-in-stay exceptions for: (a) inpatient hospitalization;(b) admission to a nursing facility; or(c) due to the closure of an ICF where an individual resides;(3) The department may also allow break-in-stay exceptions: (a) due to substantiated findings of abuse; and(b) neglect or exploitation of an individual that occurred while residing in the current ICF.(4) To request a length-of-stay exception for the reasons noted in Subsection (3)(a)(b), an individual or representative shall submit a written request to the department and include the rationale for the request, including the anticipated risk if the individual remains in the ICF.(5) The department shall provide a written determination to approve or deny the request within ten business days of receiving it.Utah Admin. Code R414-510-3
Amended by Utah State Bulletin Number 2015-20, effective 9/29/2015Amended by Utah State Bulletin Number 2018-16, effective 7/27/2018Amended by Utah State Bulletin Number 2019-15, effective 7/15/2019Amended by Utah State Bulletin Number 2021-11, effective 5/12/2021Adopted by Utah State Bulletin Number 2024-01, effective 1/1/2024