441—25.63 (426B) Application process.
	 25.63(1) Applicants. A county may be eligible for risk pool assistance when the county demonstrates that it meets the conditions in this subrule.
	  a.   	 Basic eligibility.
	 (1) 	 The county complies with the requirements of Iowa Code section 331.439.
	 (2) 	 The county levied the maximum amount allowed for the county’s services fund under Iowa Code section 331.424A for the fiscal year of application.
	 (3) 	 At the close of the fiscal year that immediately preceded the fiscal year of application, the county’s services fund ending balance under generally accepted accounting principles was equal to or less than 20 percent of the county’s actual gross expenditures for that fiscal year.
	  b.   	 Circumstances indicating need for assistance. Risk pool assistance is needed for one or more of the following purposes:
	 (1) 	 To continue support for mandated services.
	 (2) 	 To avoid the need for reduction or elimination of:
	  1. 	 Critical services, creating risk to a consumer’s health or safety;
	  2. 	 Critical emergency services, creating risk to the public’s health or safety;
	  3. 	 Services or other support provided to an entire disability category; or
	  4. 	 Services or other support provided to maintain consumers in a community setting, creating risk of placement in a more restrictive, higher-cost setting.
	 25.63(2) Application procedures.
	  a.   	 Format for submission. The county shall submit the application package electronically or send an original plus 15 copies to the division. Facsimiles are not acceptable.
	  b.   	 Deadline. The division must receive the application no later than 4:30 p.m.	on January 25 of each year; or, if January 25 is a holiday, Saturday or Sunday, the division must receive the application no later than 4:30 p.m.	on the first working day thereafter. An application received before January 11 shall be considered a preapproval application and shall receive an initial decision on eligibility before the funding decision is made.
	  c.   	 Signature. The application shall be signed and dated by both the chairperson of the county board of supervisors and the central point of coordination administrator.
	  d.   	 Notice of receipt. Staff of the division shall notify each county of receipt of the county’s application.
	  e.   	 Content. The application package shall include the following forms:
	 (1) 	 Form 470-3723, Risk Pool Application.
	 (2) 	 Form 634C, Service Area 4 Supporting Detail (pages 1 to 8).
	 (3) 	 Form 638R, Statement of Revenues, Expenditures, and Changes in Fund Balance—Actual and Budget (pages 1 and 2).
	 (4) 	 If the budget has been amended, Form 653A-R, Record of Hearing and Determination on the Amendment to County Budget (sheet 2), for both the current fiscal year budget, as last amended, and the prior fiscal year gross services fund expenditures.
	 25.63(3) Request for additional information. Staff shall review all applications for completeness. If an application is not complete, staff of the division shall contact the county within four working days after January 25 or the first working day thereafter, if January 25 is a holiday, Saturday or Sunday, to request the information needed to complete the application. The county shall submit the required information within five working days from the date of the division’s request for the additional information.