Chapter 83. MEDICAID WAIVER SERVICES

A service plan shall be prepared for health and disability waiver members 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)…

Members in the HCBS intellectual disability waiver program 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] 441—83.71 to 83.80 Reserved. These rules are intended to implement Iowa Code sections 249A.3 …

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…

To be eligible for brain injury waiver services a member must meet 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.…

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…

Members who are financially eligible under 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 ded…

A complete financial redetermination of eligibility for brain injury 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…

Services allowable under the brain injury waiver are case management, respite, personal emergency response, supported community living, behavioral programming, family counseling and training, home and vehicle modification, specialized medical equipment, prevocational services, tr…

A service plan will be prepared and utilized for each HCBS BI waiver 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 invo…

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…

Notice of adverse action will be given in accordance with rule 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—83.90 to 83.100 Reserved. These rules are intended to implement Iowa Code sections 2…

Notice of adverse action will be given in accordance with rule 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—83.10 to 83.20 Reserved. These rules are intended to implement Iowa Code sections 24…