Chapter 83. MEDICAID WAIVER SERVICES

83.62(1) Application for HCBS intellectual disability waiver services. The application process as specified in rules 441—76.1(249A) through 441—76.6(249A) will be followed. 83.62(2) Approval of application. a. Applications for the HCBS intellectual disability waiver program will …

contribute a predetermined client participation amount to the costs of the services. 83.63(1) Computation of client participation. Client participation will be computed by deducting an amount for the maintenance needs of the individual that is 300 percent of the maximum SSI grant…

disability waiver services will be completed at least once every 12 months. In years in which an interRAI assessment is not completed, the core standardized assessment contractor shall conduct a review in collaboration with the case manager, documenting any changes in the member’…

are supported community living, respite, personal emergency response system, nursing, home health aide, home and vehicle modification, supported employment, consumer-directed attendant care, interim medical monitoring and treatment, transportation, adult day care, day habilitatio…

waiver member. 83.67(1) Development. The service plan will be developed by the interdisciplinary team that includes the member, and, if appropriate, the legal representative, member’s family, case manager or service worker, service providers, and others directly involved. 83.67(2…

83.68(1) Denial. An application for services will be denied when it is determined by the department that: a. The applicant is not eligible for the services. b. Service needs exceed the service unit or reimbursement maximums. c. Service needs are not met by the services provided. …

441—16.2(17A). The right to appeal shall be given in accordance with 441—Chapter 2506. [ARC 0318D, IAB 5/27/26, effective 7/1/26]

in accordance with 441—paragraph 90.4(1)“b.” Service plans for both children and adults shall be completed every 12 months or when there is significant change in the person’s situation or condition. 83.7(1) The service plan shall include the frequency of the health and disability…

may be eligible for a rent subsidy. More information can be found in 265—Chapter 24. [ARC 0318D, IAB 5/27/26, effective 7/1/26]

These rules are intended to implement Iowa Code sections 249A.3 and 249A.4. DIVISION V—BRAIN INJURY WAIVER SERVICES

83.8(1) Denial. An application for services will be denied when it is determined by the department that: a. The client is not eligible for or in need of services. b. Needed services are not available or received from qualified providers. c. Service needs exceed the aggregate mont…

“Adaptive” means age-appropriate skills related to taking care of one’s self and the ability to relate to others in daily living situations. These skills include limitations that occur in the areas of communication, self-care, home living, social skills, community use, self-direc…

eligibility criteria and be determined to need a service allowable under the program. 83.82(1) Eligibility criteria. All of the following criteria must be met. The person must: a. Have a diagnosis of brain injury. b. Be eligible for Medicaid under supplemental security income (SS…

83.83(1) Application for financial eligibility. The application process as specified in rules 441—76.1(249A) through 441—76.6(249A) shall be followed. 83.83(2) Approval of application for eligibility. a. Applications for the determination of ability of the member to have all medi…

441—paragraph 75.6(4)“b” (the 300 percent group) must contribute a predetermined participation amount to the cost of brain injury waiver services. 83.84(1) Computation of client participation. Client participation will be computed by deducting an amount for the maintenance needs …

waiver will be completed at least once every 12 months. A redetermination of continuing eligibility factors will be made when a change in circumstances occurs that affects eligibility in accordance with rule 441—83.82(249A). A redetermination will contain the components listed in…

management, respite, personal emergency response, supported community living, behavioral programming, family counseling and training, home and vehicle modification, specialized medical equipment, prevocational services, transportation, supported employment, adult day care, member…

member. The service plan will be developed by an interdisciplinary team that includes the member, and, if appropriate, the legal representative, member’s family, case manager, providers, and others directly involved. The service plan will be stored by the case manager for a minim…

83.88(1) Denial. An application for services will be denied when it is determined by the department that: a. The member is not eligible for the services because all of the medically necessary service needs cannot be met in a home- or community-based setting. b. Service needs exce…

441—16.2(17A). The right to appeal will be given in accordance with 441—Chapter 2506. [ARC 0318D, IAB 5/27/26, effective 7/1/26]

441—16.2(17A). The right to appeal will be given in accordance with 441—Chapter 2506. [ARC 0318D, IAB 5/27/26, effective 7/1/26]

These rules are intended to implement Iowa Code sections 249A.3 and 249A.4. DIVISION VI—PHYSICAL DISABILITY WAIVER SERVICES