Aging and Disability Services Council Sharon Swift Butterworth ...

adaptive aid or minor home modification is requested in accordance with the requirements in
Subchapter F. The proposed amendment also states that DADS reviews an IPC to determine if
the requirements in new §45.218, regarding service limits, are met.
The proposed amendment to §45.214 clarifies that if transition assistance services are on an IPC,
the amount must be within the current service limit. In addition, the proposed amendment
reorganizes subsection (d) to describe the process a CMA must follow if a requested CLASS
Program service does not meet the criteria in subsection (b), the requirements in subsection (f),
or exceeds the service limit for transition assistance services. The proposed amendment to
subsection (d) includes the process a CMA must follow if a service on a proposed IPC exceeds a
service limit in proposed new §45.218(b). Further, the amendment to §45.214 deletes
information regarding denial of an individual's request for enrollment or CLASS Program
service, because that information is duplicated in §45.216, and adds a new subsection referencing
§45.216.
The proposed amendment to §45.216 provides that DADS, as part of its review of a proposed
enrollment IPC, reviews a completed Request for an Exception to Service Limit form if the IPC
includes a service described in new §45.218(b) in an amount that exceeds the service limit. The
proposed amendment reverses the order of subsections (c) and (d) to create a more logical
sequence. Further, the proposed amendment reorganizes the language in subsection (e) that
describes the process DADS follows in denying a requested CLASS Program service and
modifying an individual's IPC and adds that the basis for such denial or modification includes
exceeding the service limit for transition assistance services or DADS denial of a request for an
exception to a service limit described in new §45.218(b).
Proposed new §45.218 establishes service limits (the maximum amount of services an individual
in the CLASS Program may receive without being granted an exception), effective through
August 31, 2013, for the following CLASS Program services: adaptive aids, dental treatment,
behavioral support, minor home modifications, occupational therapy, physical therapy,
prevocational services, respite, speech therapy, and specialized therapies. The proposed new
section states the current service limit for transition assistance services and that this service is not
subject to an exception granted by DADS. Further, the proposed new section lists the service
limits that are effective September 1, 2013, for adaptive aids, dental treatment, minor home
modifications, respite, and transition assistance services.
Proposed new §45.219 describes the exception process by which a CMA (based on information
from an individual, LAR, the CMA, or DSA) requests that DADS allow an individual to receive
services in excess of the service limits described in new §45.218(b). The proposed new section
also provides that the current limits for adaptive aids, dental treatment, minor home
modifications, and respite remain in place even if DADS grants an exception to the new, lower
service limits.
The proposed amendment to §45.223 includes the process a CMA must follow if a service on a
proposed IPC exceeds a service limit described in proposed new §45.218(b). The proposed
amendment reorganizes subsection (e) that describes the process a CMA must follow if a
requested CLASS Program service does not meet the criteria in subsection (b), the requirements
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