Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost

What this rule requires your agency to do

• 1A service plan must be developed by a qualified case-management provider, must include only the least-costly services available to meet the member's needs, must be completed before services are provided, and must be reviewed at least annually and on any significant change (subrule 83.22(2)"c").(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)
• 2Members under the elderly waiver will receive case management from a provider qualified under rule 441—77.38, and the case manager must establish an interdisciplinary team for the member (subrule 83.22(2)"a" and "b").(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)
• 3The interRAI-HC assessment must be completed when the person applies, upon request to report a significant change, and annually for reassessment; the department determines the initial level of care and the department or MCO redetermines it annually (subrule 83.22(1)"d").(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)
• 4The service plan must contain measurable goals, interventions, responsible parties, desired outcomes, a description of any restrictions on the member's rights with a plan to restore them, and a list of all Medicaid and non-Medicaid services with provider, funding source, and amount (subrule 83.22(2)"d").(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)
• 5To be eligible for elderly waiver services a person must be 65 or older, an Iowa resident, Medicaid-eligible as if in a medical institution under 441—Chapter 75, and certified as needing the intermediate or skilled level of care based in part on the interRAI-Home Care assessment (subrule 83.22(1)).(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)
• 6Elderly waiver services will not be provided when the person is an inpatient in a medical institution (subrule 83.22(1)"d"(3)).(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)
• 7The service plan must include a plan for emergencies incorporating the member's risk assessment, the emergency backup support and crisis response system identified by the interdisciplinary team, and emergency backup staff designated by providers (subrule 83.22(2)"d"(11)).(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)
• 8For the consumer choices option, the member must reside in a living arrangement other than a residential care facility (subrule 83.22(1)"f").(Iowa Administrative Code 441—83.22(249A) — HCBS Elderly Waiver Eligibility, Service Plan, and Cost)