Children’s Dd Hcbs State Plan Option: Eligibility Determination

Eligibility also applies to Family-Directed Community Supports (FDCS). (7-1-26) 01. Eligibility Determination. A participant is eligible for the children's DD HCBS state plan option from birth through age seventeen (17), when they have a DD and a demonstrated need for these services. (7-1-26) 02. Individualized Budget Methodology. The following categories are used to determine individualized budgets for children with DD. (7-1-26) a. Level I. Children meeting DD criteria. (7-1-26) b. Level II. Children who qualify based on functional limitations when their composite full-scale IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 582 Page 139 standard score of less than fifty (50) or have an overall standard score up to fifty-three (53) when combined with a maladaptive behavior score of greater than one (1) to less than two (2) standard deviations from the mean. (7-1-26) c. Level III. Children who qualify based on functional limitations with a composite full-scale standard score less than fifty (50) with an autism spectrum disorder diagnosis. (7-1-26) d. Level IV. Children who qualify based on maladaptive behaviors when their maladaptive behavior score is two (2) standard deviations or greater from the mean. (7-1-26) 03. Annual Re-Evaluation. Budgets are re-evaluated annually or at the request of the participant, the Department when there are documented changes that may support placement in a different budget category. (7-1-26) 04. Lapse in Service. For participants re-applying for services, the assessor evaluates whether assessments are current and accurately describe the status of the participant. (7-1-26)