Support Services for Adults with Developmental ... - DHS home

level for which the individual would be eligible should the
change in benefit level remain in effect for 12 calendar months.
The monthly benefit level shall be applied each month for the
remainder of the plan year in which the individual's change in
benefit level occurred, from the date the change occurred.
(B) In the case of an individual with an ISP developed for a
partial plan year, the monthly benefit level shall be 1/12 of the
annual benefit level for which the individual would be eligible
should the individual's ISP be in effect for 12 calendar months.
The monthly benefit level shall be applied each month during
which the ISP of less than 12 months' duration is in effect.
(c) Estimates of the cost for each unique support service purchased
with support services funds must be based on the Department's
Support Services Rate Ranges for costs of frequently used services.
(A) Notwithstanding the Department's Support Services Rate
Ranges, final costs for any support service purchased with
support services funds may not exceed local usual and
customary charges for these services as evidenced by the
brokerage's own documentation.
(B) The brokerage must establish a process for review and
approval of all cost estimates exceeding the Department's
Support Services Rate Ranges and must monitor the
authorized ISP involved for continued cost effectiveness.
(4) EXCEPTIONS TO BASIC BENEFIT FINANCIAL LIMITS. Exceptions to
the basic benefit annual support services fund limit may be only as follows.
(a) Individuals with extraordinary long-term need as demonstrated by
a score of 60 or greater on the Basic Supplement Criteria Inventory
(Form DHS 0203) may have access to a basic supplement in order to
purchase necessary supports.
(A) For Medicaid recipients choosing services under the
Support Services Waiver, the basic supplement must result in a
plan year cost that is not greater than the individual cost limit.
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