La. Admin. Code tit. 50 § XXI-11103

Current through Register Vol. 50, No. 11, November 20, 2024

Section XXI-11103 - Participant Qualifications and Admissions Criteria

A. The Children's Choice Waiver is available to individuals who:

1. are from birth through age 20;

2. have a developmental disability as specified in R.S. 28:451.2;

3. are on the registry unless otherwise specified in §11105 and §11107;

4. meet all of the financial and non-financial Medicaid eligibility criteria for a home and community-based services (HCBS) waiver;

5. meet the requirements for an intermediate care facility for persons with intellectual/developmental disabilities (ICF/ID) level of care, which requires active treatment of a developmental disability under the supervision of a qualified developmental disability professional;

6. meet the assurance requirements that the health and welfare of the individual can be maintained in the community with the provision of children's choice services;

7. have justification, as documented in the approved plan of care, that the children's choice services are appropriate, cost effective and represent the least restrictive environment for the individual;

8. are residents of Louisiana; and

9. are citizens of the United States or a qualified alien.

B. The plan of care must be sufficient to assure the health and welfare of the waiver applicant/participant in order to be approved for waiver participation or continued participation.

C. Participants who are currently receiving Children's Choice Waiver services who reach their eighteenth birthday and remain enrolled in school may continue receiving Children's Choice Waiver services until their twenty-first birthday at which time they will transition to the most appropriate OCDD adult waiver as long as they remain eligible for waiver services.

D. Participants who are currently receiving Children's Choice Waiver services and reach their eighteenth birthday and choose to no longer attend school may transition to a Supports Waiver anytime between their eighteenth birthday and their twenty-first birthday based on a person-centered planning process.

1. Participants who transition to a Supports Waiver will continue receiving Supports Waiver services after their twenty-first birthday as long as they remain eligible for waiver services.

2. Children's Choice Waiver recipients who reach their twenty-first birthday will transfer into the most appropriate OCDD adult waiver as long as they remain eligible for waiver services.

La. Admin. Code tit. 50, § XXI-11103

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 35:1892 (September 2009), amended LR 39:2498 (September 2013), Amended by the Department of Health, Bureaus of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 432524 (12/1/2017).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.