R414-520-3. Eligibility Requirements

  (1) The Department uses the following criteria to determine waiver eligibility:

  (a) An assessment of a child's ability to perform age-appropriate activities of daily living and that child's level of independence in the performance of the activity; and

  (b) An evaluation to determine whether a child meets nursing facility level of care in accordance with Section R414-502-3.

  (2) For a child who meets the criteria in Subsection R414-520-3(1), a point value is attributed to the initial application and annual re-evaluation that includes the following:

  (a) Current medical providers;

  (b) Condition or diagnosis;

  (c) Date of last medical visit;

  (d) Documentation of more than three months of dependence on medical devices, treatments, therapies, or subspecialty services to reach a minimum medical score; and

  (e) An evaluation of the impact on the parents or guardians who have provided care to the medically complex child during the last 12 months.