441—83.125 (249A) Redetermination. The department shall redetermine a consumer’s eligibility for the children’s mental health waiver at least once every 12 months or when there is significant change in the consumer’s situation or condition.
	 83.125(1) Eligibility review. Every 12 months, the local office shall review a consumer’s eligibility in accordance with procedures in rule 441—76.7(249A). The review shall verify:
	  a.   	 Continuing eligibility factors as specified in rule 441—83.122(249A).
	  b.   	 The existence of a current service plan meeting the requirements listed in rule 441—83.125(249A).
	 83.125(2) Continuation of eligibility. A consumer’s waiver eligibility shall continue until one of the following conditions occurs.
	  a.   	 The consumer fails to meet eligibility criteria listed in rule 441—83.122(249A).
	  b.   	 The consumer is an inpatient of a medical institution for 30 or more consecutive days.
	 (1) 	 After the consumer has spent 30 consecutive days in a medical institution, the local office shall terminate the consumer’s waiver eligibility and review the consumer for eligibility under other Medicaid coverage groups. The local office shall notify the consumer and the consumer’s parents or legal guardian through Form 470-0602, Notice of Decision.
	 (2) 	 If the consumer returns home after 30 consecutive days but no more than 60 days, the consumer must reapply for children’s mental health waiver services, and the IME medical services unit must redetermine the consumer’s level of care.
	  c.   	 The consumer does not reside at the consumer’s natural home for a period of 60 consecutive days. After the consumer has resided outside the home for 60 consecutive days, the local office shall terminate the consumer’s waiver eligibility and review the consumer for eligibility under other Medicaid coverage groups. The local office shall notify the consumer and the consumer’s parents or legal guardian through Form 470-0602, Notice of Decision.
	 83.125(3) Payment slot. When a consumer loses waiver eligibility, the consumer’s assigned payment slot shall revert for use to the next consumer on the waiting list.