ARC 8504B
HUMAN SERVICES DEPARTMENT[441]
Adopted and Filed
Pursuant to the authority of Iowa Code section 249A.4, the Department of Human Services amends Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services,” Iowa Administrative Code.
These amendments require measurement of a child’s mental health functioning level by a licensed practitioner of the healing arts with a standardized instrument before Medicaid remedial services are initiated and every six months thereafter. The remedial services provider would be required to submit the results of the testing as part of the request for prior authorization for continued remedial services.
Federal regulations for rehabilitation services specify that the provider must demonstrate that the child is making progress for the services to continue. These amendments require the use of standardized measurement tools to make the evaluation of progress more uniform and to make evaluations more effective at identifying the need for changes in strategies or interventions.
These amendments do not provide for waivers in specified situations. The clinician may choose the most appropriate standardized measurement tool, in cooperation with staff of the Iowa Plan for Behavioral Health, but standardized assessment will be required to meet federal requirements for demonstrating progress.
Notice of Intended Action on these amendments was published in the Iowa Administrative Bulletin on October 21, 2009, as ARC 8247B. Two persons submitted comments and questions about the proposed amendments.
Concerns identified were the choice and cost of assessment instruments, how the instrument would be administered, and how the results of the instrument would be used in the authorization of remedial services. The Iowa Plan for Behavioral Health contractor is offering and prefers the Consumer Health Inventory for Children, a functional measure completed from the child’s or family’s perspective. Administering the instrument is part of the clinician’s billable time. The authorization decisions will be made on the comprehensive behavioral health assessment, including the clinician’s interview, the results of the instrument and the results of an outcome tool over time.
The Council on Human Services adopted these amendments on January 13, 2010. These amendments are identical to those published under Notice of Intended Action.
These amendments are intended to implement Iowa Code section 249A.4.
These amendments shall become effective on March 22, 2010.
Editor’s Note: Pursuant to recommendation of the Administrative Rules Review Committee published in the Iowa Administrative Bulletin, September 10, 1986, the text of these amendments [78.12] is being omitted. These amendments are identical to those published under Notice as ARC 8247B, IAB 10/21/09.
[Filed 1/13/10, effective 3/22/10]
[Published 2/10/10]
[For replacement pages for IAC, see IAC Supplement 2/10/10.]