No. 28719 (Amendment): R539-2-4. Waiting List

DAR File No.: 28719
Filed: 05/08/2006, 09:19
Received by: NL

 

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment is to provide the Division of Services for People with Disabilities and the Department of Health with the authority to make limited exceptions to the priority rankings on the Division Waiting List for services.

 

Summary of the rule or change:

To preserve the Medicaid Waiver and state-wide service infrastructure, exceptions may be made to the person's ranking on the waiting list when authorized by the Division Director and the Department of Health. Federal law requires that services must be provided statewide.

 

State statutory or constitutional authorization for this rule:

Sections 62A-5-102 and 62A-5-103, and 42 U.S.C. 1396(a)(1)

 

Anticipated cost or savings to:

the state budget:

This amendment will not increase cost or savings. The goal of the rule amendment is to assure cost neutrality by allowing the Division and Department of Health to make some decisions about the ranking on the waiting list that preserve cost neutrality. The same number of individuals will be served. This rule affects the priority of individuals on the waiting list but will not increase or decrease the services received in total or the amount of funding expended.

 

local governments:

After a careful review of potential costs or savings to local governments, the Division has determined that local governments will not be affected. Services are provided directly to persons served by the Division. Priority on the waiting list is established solely by the Division. Local governments are not involved in establishing priority on the waiting list, providing the services or acting as intermediaries and will not experience additonal costs or savings.

 

other persons:

After a careful review of potential costs or savings to other persons, the Division has determined that other persons will not be affected. Services are provided directly to persons served by the Division. Other persons are not involved in establishing priority on the waiting list, providing the services or acting as intermediaries and will not experience additional costs or savings.

 

Compliance costs for affected persons:

After a careful review of potential compliance costs or savings to affected persons, the Division has determined that affected persons will not have any compliance costs. The only exception would be if an affected person elects to hire a representative or an attorney to represent them in any aspect of the Division priority process, then an affected person would incur those costs.

 

Comments by the department head on the fiscal impact the rule may have on businesses:

This amendment assures that the Division can meet the overall requirements of the Medicaid Waiver, and support the businesses who are contract providers in all areas of the state who assist people with disabilities. Lisa-Michele Church, Executive Director

 

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Human Services
Services for People with Disabilities
120 N 200 W
SALT LAKE CITY UT 84103-1500

 

Direct questions regarding this rule to:

Steven Bradford at the above address, by phone at 801-538-4197, by FAX at 801-538-4279, or by Internet E-mail at [e-mail]

 

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

07/03/2006

 

This rule may become effective on:

07/11/2006

 

Authorized by:

George Kelner, Director

 

 

RULE TEXT

R539. Human Services, Services for People with Disabilities.

R539-2. Service Coordination.

R539-2-4. Waiting List.

(1) Pursuant to Subsection 62A-5-102(3), the Division shall determine a Person's eligibility for service, followed by a determination of that Person's priority relative to others who are also eligible. Each region shall use a standardized Needs Assessment to score and prioritize the Person's level of need. Persons with the highest scores shall receive support first. The Support Coordinator shall assess with the Person the array of services that may be needed. If funding is not immediately available, the Person shall be placed on a waiting list for support. Persons who have been determined eligible for the Division's Medicaid Waivers can choose to wait for Division Support services or seek services available through Medicaid in an approved facility.

(2) If the Person requires, and could use, support services on the day of intake, the Person has an immediate need; otherwise, the Person has a future need.

(3) A Needs Assessment Form 2-2 shall be completed for all Persons with an immediate need for support services. The Needs Assessment calculates the score of each Person by using the following criteria:

(a) severity of the disabling condition;

(b) needs of the Person and/or family;

(c) length of time on the waiting list, if applicable;

(d) appropriate alternatives available; and

(e) other factors determined by the Region to reflect accurately on the Person's need:

(i) family composition;

(ii) skills and stress of primary caregiver;

(iii) finances and insurances;

(iv) ability to be self-directing;

(v) special medical needs;

(vi) problem behaviors;

(vii) protective service issues;

(viii) resources/supports needed;

(ix) projected deterioration issues; and

(x) time on immediate need waiting list.

(4) The Region Needs Assessment Committee determines the Person's score, rank orders the scores, and enters the Person's name and score on the statewide waiting list.

(5) A Person's ranking may change if the Person's needs change or as Needs Assessments are completed for new Applicants.

(6) No age limitations apply to a Person placed on the waiting list for community living support or family support.

(7) To preserve the Medicaid Waiver and state-wide service infrastructure, exceptions may be made to the person's ranking on the waiting list when authorized by the Division Director and the Department of Health.

 

KEY: services, people with disabilities

Date of Enactment or Last Substantive Amendment: [May 17, 2005]2006

Authorizing, and Implemented or Interpreted Law: 62A-5-102; 62A-5-103