1902. ELIGIBILITY REQUIREMENTS

1902 ELIGIBILITY REQUIREMENTS 1902.1 Any person who currently receives services from DDS/DDA and who meets the following requirements shall be eligible to receive Waiver services: Has a special income level up to three hundred percent (300%) of the SSI federal benefit, or is aged and disabled with income up to one hundred percent (100%) of the federal poverty level, or is medically needy as set forth in 42 C.F.R. § 435.320, 435.322, 435.324 and 435.330; Has a developmental disability or an intellectual disability as defined in Section 1999; Is eighteen (18) years of age or older; Is a resident of the District of Columbia as defined in D.C. Official Code § 7-1301.03(22); Has a Level of Care (“LOC”) determination that the person requires services furnished in an Intermediate Care Facility for Individuals with Intellectual Disabilities (“ICF/IID”) or is a person with related conditions pursuant to the criteria set forth in § 1902.4; and Meets all other eligibility criteria applicable to Medicaid recipients including citizenship and alienage requirements. Waiver services shall not be furnished to a person who is an inpatient of a hospital, ICF/IID, or nursing facility. Each person enrolled in the Waiver shall be re-certified annually as having met all of the eligibility requirements as set forth in § 1902.1 for continued participation in the Waiver. 1902.4 A person shall meet the LOC determination set forth in § 1902.1(e) if one (1) of the following criteria has been met, taking into consideration the standard error of measurement for the intelligence quotient (“IQ”) test: The person’s primary disability is an intellectual disability with an IQ of fifty-nine (59) of less; or The person’s primary disability is an intellectual disability with an IQ of sixty (60) to seventy (70), and the person has at least one (1) of the following conditions: (1) Mobility deficits; (2) Sensory deficits; (3) Chronic health needs; (4) Behavioral challenges; (5) Autism; (6) Cerebral Palsy; (7) Epilepsy; or (8) Spina Bifida. The person’s primary disability is an intellectual disability with an IQ of sixty (60) to seventy (70), or the person has a developmental disability, either of which results in substantial functional limitations in at least three (3) of the following major life activities: Self-care; Understanding and use of language; Functional academics; Social skills; Mobility; Self-direction; Capacity for independent living; or Health and safety. SOURCE: Final Rulemaking published at 51 DCR 10207 (November 5, 2004); as amended by Final Rulemaking published at 61 DCR 4406 (May 2, 2014); as amended by Final Rulemaking published at 63 DR 10445 (August 12, 2016); as amended by Final Rulemaking published at 71 DCR 010372 (August 16, 2024). District of Columbia Municipal Regulations Public Welfare 29 DCMR § 1902