Medicaid Home and Community Based Services HCBS Program

Medicaid Home and Community Based Services (HCBS) Program Comparison Chart AIDS/HIV Age Target Population No age limit Diagnosis of AIDS/HIV Level of Care (LOC) Required* Care Coordinator Maximum Dollars Available Per Month (As determined by Level of Care) HCBS Program Manager HCBS Regional Specialists Where to apply? Determination of financial eligibility Determination of level of NF or Hospital Children’s Mental Health Brain Injury Age 1 month or older Diagnosis of brain injury per Iowa Administrative Code (IAC) 83 definitions Under age 18 Diagnosis of serious emotional disturbance NF, SNF, or ICF/ID Brian Wines (515) 256 -4661 $3, 013. 08 excluding cost of Case Management & HVM Le. Ann Moskowitz (515) 256 -4653 Health & Disability Age 65 or older Age 65 or over Hospital Case Manager or or Community Based Case Community Manager Based Case Manager $1876. 80 Elderly Under age 65 Blind or disabled SSI-related coverage groups NF or SNF NF , SNF, or ICF/ID Case Manager or Integrated Health Home Care Coordinator or Community Based Case Manager $2, 006. 34 excluding cost of Environmental Modification Case Manager or Community Based Case Manager Le. Ann Moskowitz Le Howland (515) 256 -4653 (515) 256 -4642 NF $1, 365. 78 SNF $2, 792. 65 excluding cost of Case Management & HVM Intellectual Disability Physical Disability No age limit Age 18 through 64 Physical disability as determined by Disability Determination Services Primary disability of intellectual disability determined by a psychologist or psychiatrist ICF/ID Case Manager or Community Based Case Manager ICF/ID – NF $959. 50 Amount based SNF $2, 792. 65 ICF/ID $3, 742. 93 on services upper limits excluding cost of HVM Le Howland (515) 256 -4642 NF or SNF Case Manager or Community Based Case Manager $705. 84 excluding cost of HVM Brian Wines Le Howland (515) 256 -4661 (515) 256 -4642 bwines@dhs. state. ia. lmoskow@dhs. state. i lhowlan@dhs. state. ia. bwines@dhs. state. ia. lhowlan@dhs. state. ia. us us us Visit www. dhs. iowa. gov/ime/members/medicaid-a-to-z/hcbs-contacts for a listing of HCBS Regional Specialist assignments. Local DHS income maintenance office or online at: https: //dhsservices. iowa. gov/apspssp/ssp. portal DHS income maintenance worker. Review of Medicaid eligibility is completed every 12 months. Revised: May 30, 2018 Iowa Medicaid Enterprise (IME) Medical Services or Managed Care Organization (MCO). Completed at least once every 12 months or when there is a significant change in the member’s situation or condition.

Provider Enrollme nt Initial Date of Eligibility For More Informati on Providers must enroll with Iowa Medicaid Enterprise (IME) and MCOs to be providers of service. Providers must be fully enrolled and be authorized in a service plan prior to service provision. Waiver eligibility effective date will be determined when the following eligibility requirements are completed: financial (income & resource) eligibility is determined and level of care is established. Waiver services provided before approval of eligibility for the waiver, or prior to service plan authorization, cannot be paid. Visit http: //dhs. iowa. gov/ime/members/medicaid-a-to-z/hcbs *NF (Nursing Facility), SNF (Skilled Nursing Facility), ICF/ID (Intermediate Care Facility for the Intellectually Disabled) Services by Program Adult Day Care AIDS/HIV Brain Injury x x Children’s Mental Health Elderly Health & Disability Intellectual Disability x x x Assistive Devices x Assisted Living x Behavioral Programming x Case Management Services x x Chore Consumer Choices Option (CCO) Consumer Directed Attendant Care (CDAC) Counseling x x x x Day Habilitation x Emergency Response x x Environmental Modifications and Adaptive Devices Family and Community Support Family Counseling & Training Home Delivered Meals x x x Home Health Aide x x x Homemaker x x x x Home/Vehicle Modifications x x x In-home Family Therapy Interim Medical Monitoring & Treatment (IMMT) Pgm. Comparison_HCBS. doc (rev. 5/30/18) Mental Health Outreach Physical Disability x x x 2 of 3 x x

Nursing x Nutritional Counseling Prevocational Services Respite: Individualized, group, specialized Senior Companion Services by Program Supported Community Living (SCL) Specialized Medical Equipment Supported Community Living: Residential-Based (RBSCL) for children Supported Employment (SE) Transportation Pgm. Comparison_HCBS. doc (rev. 5/30/18) x x x x Health & Disability Intellectual Disability x AIDS/HIV Brain Injury Children’s Mental Health Elderly x Physical Disability x x x x 3 of 3 x x