Current through Bulletin 2024-18, September 15, 2024
(1) The division shall only offer services
for a physical disability to an eligible applicant with a disability as defined
in Subsection
62A-5-101(9).
(2) An eligible applicant must meet the
following requirements:
(a) have a qualifying
physical disability expected to last for a continuous period of 12 months or
longer;
(b) have the functional
loss of two or more limbs;
(c) have
a need for a personal assistance service to accomplish an activity of daily
living or an instrumental activity of daily living;
(d) be 18 years of age or older;
(e) be medically stable;
(f) be capable of selecting, training, and
supervising a personal attendant;
(g) have at least one available personal
attendant trained or willing to be trained;
(h) live in a safe residence that can
accommodate the personnel and equipment needed to adequately and safely care
for the person;
(i) be capable of
managing personal financial and legal matters;
(j) have three or more functional limitations
as described in Subsection
R539-1-4(3)(a)
through
R539-1-4(3)(g);
and
(k) be a resident of the
state.
(3) The division
shall:
(a) determine if an applicant is
eligible for non-waiver services within 90 days of receiving needed
documentation; and
(b) keep
eligibility documentation in the applicant's electronic
record.
(4) The division
shall use the following documents to determine eligibility:
(a) Physical Disabilities Services
Application Form 3-1 Part B signed by the licensed physician attesting to each
eligibility requirement; and
(b)
the Minimum Data Set-Home and Community-based (MDS-HC).
(5) An applicant shall submit to the division
the documentation needed to determine eligibility.
(a) If needed documentation is not submitted
within 90 days of initial contact, the division shall change the intake case
status to inactive and send the applicant written notification of an intake
status change to inactive.
(b) An
applicant may reactivate the intake case by submitting any needed
documentation.
(c) An applicant
must update eligibility documentation as needed.
(6) The division shall notify an applicant of
the eligibility determination by mailing a Notice of Agency Action Form 522-I
and a Hearing Request Form 490S.
(a) The
Notice of Agency Action Form 522-I indicates:
(i) the eligibility determination;
and
(ii) placement on the waiting
list, when applicable.
(b) An applicant may challenge the
eligibility determination by filing a written request for an administrative
hearing before the Department of Human Services, Office of Administrative
Hearings.
(7) The
division shall annually re-determine eligibility for each person receiving a
service. If a person receiving a service is determined to be ineligible, the
division shall develop a transition plan to discontinue each service that
ensures any health and safety need is met.
(8) A person who receives a non-waiver
service may have their non-waiver service package reduced or terminated because
of:
(a) a division budget shortfall;
(b) a reduced legislative allocation;
or
(c) a reevaluation of
eligibility.
(9) Section
R539-1-5 does not apply to an applicant who meets the eligibility criteria for
intellectual disability and related conditions or brain injury as described in
Sections
R539-1-4 and
R539-1-6,
respectively.
