Current through September 21, 2024
(a) Eligibility
under this Chapter is limited to persons who complete the application process
and who meet the following requirements for clinical eligibility and financial
eligibility. In addition, in order to be eligible for the waiver, all persons
shall be:
(i) A United States Citizen as
determined by the Department of Family Services.
(ii) A resident of Wyoming as determined by
the Department of Family Services.
(iii) Under 21 years of age.
(b) Clinical eligibility criteria.
An applicant is considered clinically eligible if he or she has:
(i) A diagnosis of mental retardation as
determined by a psychologist, or
(ii) A diagnosis of a related condition as
determined by a physician and functional limitations verified by a
psychologist, and
(iii) An
Inventory for Client and Agency Planning (ICAP) age adjusted services score
equal to or less than 70, or
(iv)
An adaptive behavior quotient of 0.50 or below for children birth through age
5, or
(v) An adaptive behavior
quotient of 0.70 or below for individuals age 6 through age 20, and
(vi) A completed LT-MR-104 that verifies that
the participant or applicant meets the ICF/MR level of care.
(c) Financial eligibility.
Eligibility for covered services is limited to persons who meet the income and
resource criteria set forth in the waiver and in the rules and policies of the
Wyoming Medicaid program, as determined by the Department of Family
Services.
(d) Application process.
(i) A completed application on a form
required by the Division shall be submitted to the Division.
(A) An application is valid for one year.
After that time, if necessary documentation has not been received so that the
Division can determine clinical eligibility, the applicant shall be required to
re-apply.
(B) Once an applicant has
been determined to be clinically eligible and has been placed on a wait list,
he/she does not need to re-apply.
(ii) Selection of individually-selected
service coordinator.
(A) After an applicant
requests services pursuant to this Chapter, the Division shall provide the
applicant with a list of individually-selected service coordinators in the
area(s) he or she wishes to receive services.
(B) The applicant, family, or guardian shall
select and meet with an individually-selected service coordinator from that
list. Once both the applicant and the individually-selected service coordinator
have agreed to work together, the individually-selected service coordinator
shall notify the Division of that selection on a form designated by the
Division.
(e)
Determination of clinical eligibility. A person shall not receive covered
services unless that person is clinically eligible. The determination of a
person's clinical eligibility shall be made as follows:
(i) Psychological evaluation.
(A) The applicant and the
individually-selected service coordinator shall arrange for a psychological
evaluation to determine whether the applicant has a diagnosis of mental
retardation or a related condition.
(B) If the applicant has a diagnosis of
mental retardation or a related condition, he or she shall be further assessed
pursuant to (ii)(B) of this Section to determine clinical
eligibility.
(C) The Division may
obtain a second opinion on a psychological evaluation from a contracted expert
in order to confirm or deny that an applicant has a related
condition.
(ii)
Inventory for Client and Agency Planning.
(A)
An individual who has a diagnosis of mental retardation or related condition as
determined by the psychological evaluation shall be assessed to determine his
or her functional capacity.
(B)
Assessments shall be performed by a third party, under contract to the
Division, who is qualified to perform such assessments using the Inventory for
Client and Agency Planning (ICAP).
(iii) LT-MR-104. The individually-selected
service coordinator shall complete the LT-MR-104 that verifies that the
participant or applicant meets the ICF/MR level of care.
(f) Notification of determination of clinical
eligibility.
(i) The Division shall determine
clinical eligibility within 60 calendar days of receipt of the psychological
assessment. If additional data or review is needed to determine eligibility,
the Division shall notify the applicant in writing that the process will take
an additional 30 calendar days.
(ii) If the applicant does not have a
diagnosis of mental retardation or related condition, the applicant does not
meet the clinical eligibility requirements.
(iii) If an applicant does not meet the ICAP
service score or adaptive behavior quotient, the applicant does not meet the
clinical eligibility requirements.
(iv) If the applicant does not meet the
ICF/MR level of care as determined by the LT-MR-104, the applicant does not
meet the clinical eligibility requirements.
(A) If an applicant is determined not to meet
clinical eligibility criteria, the applicant or the applicant's legal guardian
shall be notified in writing within 15 business days.
(B) An applicant determined to not meet
clinical eligibility requirements, may appeal the decision pursuant to Chapter
1.
(v) If an applicant
is determined to be clinically eligible, the applicant or applicant's legal
representative will be notified in writing that:
(A) There is a funding opportunity available,
or
(B) There is not a funding
opportunity available but the applicant is placed on the Division's waiting
list, as specified in Section 13 of this Chapter.
(vi) Once an individual is notified that
there is a funding opportunity available, financial eligibility shall be
determined by the Department of Family Services.
(g) Loss of eligibility.
(i) A participant shall be determined to no
longer be eligible when the participant:
(A)
Does not meet clinical eligibility when re-tested, or
(B) Does not meet financial eligibility
requirements as determined by the Department of Family Services, or
(C) Changes residence to another state,
or
(D) Turns 21 years of
age.
(ii) Services to a
participant determined to not meet clinical eligibility requirements shall be
terminated no more than 45 days after the determination is made.
(A) If an applicant is determined not to meet
clinical eligibility criteria, the applicant or the applicant's legal guardian
shall be notified in writing within 15 business days.
(B) A participant determined to not meet
eligibility requirements may appeal the decision pursuant to Chapter
1.
(iii) A participant
may be denied waiver placement and may be required to reapply when the
participant:
(A) Voluntarily does not receive
waiver services or case management services, which includes a monthly home
visit at the residence of the child, for three consecutive months.
(B) Is in a nursing home, hospital, or
residential treatment facility for six consecutive months.
(C) Is in an out-of-state placement for six
consecutive months.
(iv)
Upon written notification of the denial of waiver placement:
(A) The participant may submit, in writing,
reasons why he/she should still be considered eligible for the
services.
(B) This request shall be
reviewed by the Waiver Manager and the Division Administrator.
(v) If the participant is
determined not to be eligible for services due to one of the criteria in (iii)
of this section, the participant or the participant's legal guardian shall be
notified in writing within 15 business days.
(A) The participant may appeal the decision
pursuant to Chapter 1.