R539-1-6. Services for People with Brain Injury

(1) The division shall only offer services for a brain injury to an eligible applicant with a disability as defined in Subsections 26B-6-401(3) and 26B-6-401(9). (2) An eligible applicant shall meet the following requirements: (a) have a documented diagnosis of a qualifying acquired neurological brain injury from a medical professional whose scope of licensure includes the ability to render diagnoses; (b) be 18 years of age or older; (c) have three or more functional limitations; (d) score between 36 and 136 on the Comprehensive Brain Injury Assessment Form 4-1; and (e) be a state resident. (3) For the exclusive purposes of this type of disability, functional limitations are defined as: (a) "Memory" or "cognition" means an applicant's brain injury resulted in a substantial problem with recall of information, concentration, attention, planning, sequencing, executive level skills, or orientation to time and place. (b) "Activities of daily life" means an applicant's brain injury resulted in substantial dependence on another individual to move, eat, bathe, toilet, shop, prepare a meal, or pay a bill. (c) "Judgment" and "Self-protection" means the applicant's brain injury resulted in substantial limitation of the ability to: (i) provide personal protection; (ii) provide a necessity including food, shelter, clothing, mental health care, or any other health care; (iii) obtain a service necessary for health, safety, or welfare; or (iv) comprehend the nature and consequence of remaining in a situation of abuse, neglect, or exploitation. (d) "Control of emotion" means the applicant's brain injury resulted in substantial limitation of the ability to regulate mood, anxiety, impulsivity, agitation, or socially appropriate conduct. (e) "Communication" means the applicant's brain injury resulted in substantial limitation in language fluency, reading, writing, comprehension, or auditory processing. (f) "Physical health" means the applicant's brain injury resulted in substantial limitation of the normal process and working of the human body. (g) "Employment" means the applicant's brain injury resulted in substantial limitation in obtaining and maintaining a gainful occupation without ongoing support. (4) The division determines eligibility. (a) The division shall determine if an applicant is eligible for acquired brain injury services within 90 days of receiving eligibility documentation. (b) The division shall keep supporting documentation in the applicant's electronic record. (5) The division shall use the following supporting documentation to determine eligibility: (a) documentation of a diagnosis of a qualifying acquired brain injury diagnosis signed by a medical professional whose scope of licensure includes the ability to render diagnoses; and (b) Comprehensive Brain Injury Assessment Form 4-1, parts A through L. (6) This section does not apply to an applicant who meets the eligibility criteria for an intellectual disability and related conditions or physical disability as described in Sections R539-1-4 and R539-1-5.