The Human Services Department hereby proposes to amend Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code section 249A.4.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 249A.4.Purpose and Summary    The Department is proposing this rule making for the dental program to clarify that payment will be made for emergency services as defined in the federal regulations set forth in 42 CFR 438.114 as amended to April 7, 2022. This proposed rule making also sets an annual benefit maximum for members 21 years of age or older of $1,000 per state fiscal year for coverage of dental services as set forth in rule 441—78.4(249A). Preventive, diagnostic, emergency, anesthesia, removable dentures, and related services do not count toward the annual benefit amount.Fiscal Impact    This rule making aligns rules with waiver and State Plan Amendment policies. Based on analysis by the Iowa Medicaid actuary and incorporated within current capitation rates, it is anticipated this rule making will result in a cost savings to the State. This change is already in effect, and savings have been incorporated into the Medicaid budget.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 441—1.8(17A,217).Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on May 24, 2022. Comments should be directed to:Nancy Freudenberg Department of Human Services Hoover State Office Building, Fifth Floor 1305 East Walnut Street Des Moines, Iowa 50319-0114 Email: appeals@dhs.state.ia.usPublic Hearing    No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    The Revenue Department hereby proposes to amend Chapter 68, “Motor Fuel and Undyed Special Fuel,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 421.14 and 452A.59.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 452A.3.Purpose and Summary    This proposed rule making amends subrule 68.2(1) to adjust the excise tax rate on biodiesel blended fuel rated B-11 or higher from 30.4¢ per gallon (ending June 30, 2022) to 30.1¢ per gallon (beginning July 1, 2022), pursuant to the formula prescribed by Iowa Code section 452A.3. The distribution percentage for biodiesel blended fuel rated B-11 or higher for calendar year 2021 is 57.75 percent, a decrease from the 2020 distribution percentage of 61.49 percent. As a result, pursuant to Iowa Code section 452A.3(3)“a”(2), in fiscal year 2023, the excise tax rate for biodiesel blended fuel rated B-11 or higher will decrease as noted above. Tax rates for all other fuel types will remain unchanged for fiscal year 2023.Fiscal Impact    Under the excise tax rates applicable for fiscal year 2023, as proposed in this rule making and as required by statute, it is estimated that, accounting for refunds, collections will be $142.43 million, resulting in a decrease of $1.42 million in revenues.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to rule 701—7.28(17A).Public Comment    Any interested person may submit written or oral comments concerning this proposed rule making. Written or oral comments in response to this rule making must be received by the Department no later than 4:30 p.m. on May 24, 2022. Comments should be directed to:Tim Reilly Department of Revenue Hoover State Office Building P.O. Box 10457 Des Moines, Iowa 50306 Phone: 515.782.0535 Email: tim.reilly@iowa.govPublic Hearing    No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making action is proposed:

    The Transportation Department hereby proposes to amend Chapter 511, “Special Permits for Operation and Movement of Vehicles and Loads of Excess Size and Weight,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 307.12 and 321E.29B.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 321.454, 321.456, 321.457, 321.463, 321E.2, 321E.8, 321E.10, 321E.14 and 321E.29B.Purpose and Summary    This proposed rule making updates Chapter 511 to conform the rules with 2021 Iowa Acts, House File 869, sections 1 through 3. This legislation was effective on January 1, 2022.    2021 Iowa Acts, House File 869, established new Iowa Code section 321E.29B, which allows a motor carrier to request, and the Department to issue, an annual permit for a vehicle transporting overweight loads of fluid milk products on the primary roads and primary road extensions in cities, including on the interstate, as long as the vehicle does not exceed a gross weight of 96,000 pounds or the maximum dimensions specified in Iowa Code sections 321.454 through 321.457. Federal law 23 U.S.C. Section 127 authorizes states to issue special permits for overweight vehicles carrying fluid milk products, including on the interstate system. Prior to the enactment of Iowa Code section 321E.29B, the Department was not authorized to issue an annual permit that allowed transportation of overweight loads of fluid milk on the interstate system.Fiscal Impact    This rule making has no fiscal impact to the State of Iowa beyond any impact anticipated by the legislation.Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 761—Chapter 11.Public Comment    Any interested person may submit written comments concerning this proposed rule making or may submit a written request to make an oral presentation at a public hearing. Written comments or requests to present oral comments in response to this rule making must be received by the Department no later than 4:30 p.m. on May 24, 2022. Comments should be directed to:Tracy George Department of Transportation DOT Rules Administrator, Government and Community Relations 800 Lincoln Way Ames, Iowa 50010 Email: tracy.george@iowadot.usPublic Hearing    If requested, a public hearing to hear oral presentations will be held on May 26, 2022, via conference call at 10 a.m. Persons who wish to participate in the conference call should contact Tracy George before 4:30 p.m. on May 24, 2022, to facilitate an orderly hearing. A conference call number will be provided to participants prior to the hearing.    Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.    Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact Tracy George and advise of specific needs.    The public hearing will be canceled without further notice if no oral presentation is requested.Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    The Transportation Department hereby proposes to amend Chapter 540, “Transportation Network Companies,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code sections 307.12 and 321N.2.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code chapter 321N.Purpose and Summary    This proposed rule making relates to permitting and regulation of transportation network companies (TNCs) and TNC drivers. The proposed amendments align with existing legal authority and Department practice, eliminate outdated or irrelevant requirements or options, and accommodate modern procedures.    Updates are proposed to various rules throughout the chapter to correct the Department’s contact and submission information for TNC permits and other required submissions. The proposed amendments adjust the fee payment methods in subrule 540.4(2) to eliminate outdated language and instead use language that will encompass all acceptable payment methods.    The subrule addressing supporting documentation for a TNC permit is proposed to be amended to clarify that a current copy of the TNC’s certificate of good standing must be submitted with the application if the TNC is incorporated or organized.    Finally, the proposed rule making adds a new rule to implement existing statutory authority regarding review of TNC records by the Department. Pursuant to Iowa Code section 321N.2(5), the Department is authorized to examine TNC records for the purposes of enforcing the requirements of Iowa Code chapter 321N. The proposed rule outlines the types of records that will be requested by the Department and how those records may be submitted.Fiscal Impact    This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any, pursuant to 761—Chapter 11. Public Comment    Any interested person may submit written comments concerning this proposed rule making or may submit written request to make an oral presentation at a public hearing. Written comments or requests to present oral comments in response to this rule making must be received by the Department no later than 4:30 p.m. on May 24, 2022. Comments should be directed to: Tracy George Department of Transportation DOT Rules Administrator, Government and Community Relations 800 Lincoln Way Ames, Iowa 50010 Email: tracy.george@iowadot.us Public Hearing    If requested, a public hearing to hear oral presentations will be held on May 26, 2022, via conference call at 1 p.m. Persons who wish to participate in the conference call should contact Tracy George before 4:30 p.m. on May 24, 2022, to facilitate an orderly hearing. A conference call number will be provided to participants prior to the hearing.    Persons who wish to make oral comments at the public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rule making.    Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact Tracy George and advise of specific needs.     The public hearing will be canceled without further notice if no oral presentation is requested. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making actions are proposed:

    The Director of the Workforce Development Department hereby proposes to amend Chapter 24, “Claims,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is proposed under the authority provided in Iowa Code section 96.11.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code sections 96.1A(37), 96.3, and 96.4.Purpose and Summary    This proposed rule making clearly defines how unemployment insurance benefit weeks are impacted when a recipient is working part time and reporting wages earned.Fiscal Impact     This rule making has no fiscal impact to the State of Iowa. Jobs Impact    After analysis and review of this rule making, no impact on jobs has been found.Waivers    Any person who believes that the application of the discretionary provisions of this rule making would result in hardship or injustice to that person may petition the Department for a waiver of the discretionary provisions, if any. Public Comment    Any interested person may submit written comments concerning this proposed rule making. Written comments in response to this rule making must be received by the Department no later than 4:30 p.m. on May 24, 2022. Comments should be directed to: Jeffrey Koncsol Iowa Workforce Development 1000 East Grand Avenue Des Moines, IA 50319-0209 Email: jeffrey.koncsol@iwd.iowa.govPublic Hearing     No public hearing is scheduled at this time. As provided in Iowa Code section 17A.4(1)“b,” an oral presentation regarding this rule making may be demanded by 25 interested persons, a governmental subdivision, the Administrative Rules Review Committee, an agency, or an association having 25 or more members. Review by Administrative Rules Review Committee    The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rule making by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rule making at its regular monthly meeting or at a special meeting. The Committee’s meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).    The following rule-making action is proposed:

    The Human Services Department hereby amends Chapter 77, “Conditions of Participation for Providers of Medical and Remedial Care,” Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services,” and Chapter 79, “Other Policies Relating to Providers of Medical and Remedial Care,” Iowa Administrative Code.Legal Authority for Rule Making    This rule making is adopted under the authority provided in Iowa Code section 249A.4.State or Federal Law Implemented    This rule making implements, in whole or in part, Iowa Code section 249A.4.Purpose and Summary    The Department is updating rules for Integrated Health Homes and for Chronic Condition Health Homes based on the deficiencies identified in the audit completed in 2019 by the Office of Inspector General (OIG) for the Health Home (HH) programs for state fiscal years 2013 through 2016.    The amendments clarify the standards and requirements for the delivery of HH services. The audit recommended the Department improve its monitoring of the HH programs to ensure that HH providers comply with federal and state requirements for maintaining documentation to support the services for which the providers billed and received payments. The audit also recommended the Department revise the state plan to define the documentation requirements that HH providers must follow to bill and receive higher in-home health payments for intensive services and educate providers on these requirements. Recommendations were also made that the state plan be revised to define the documentation requirements the HH providers must follow to bill and receive payments for outreach services and also educate providers on these requirements.    State plan amendments have now been submitted and approved. The Department developed an ongoing audit process to be completed by Iowa Medicaid and the managed care organizations that ensure the HH services are appropriately documented. Iowa Medicaid hosted a face-to-face training and plans additional opportunities for training providers on core services and documentation. Monthly webinars, biannual face-to-face training and individual technical assistance based on provider needs have been implemented.Public Comment and Changes to Rule Making    Notice of Intended Action for this rule making was published in the Iowa Administrative Bulletin on February 23, 2022, as ARC 6206C. The Department received 50 comments from five respondents on the proposed rule making. The comments and corresponding responses from the Department are divided by chapter below.    Chapter 77—General Requirements    Comment 1: One respondent commented that the rules say “‘Integrated health homes’ means a provider enrolled to integrate” and that “provider” should be changed to “team of health care professionals.” (Subrule 77.47(1), regarding definitions)    Response 1: The definition of “team of health care professionals” as stated in the State Plan Amendment (SPA) also includes the lead entity. The SPA defines the term as “a team of health professionals that includes physicians and other professionals, including nurse care managers, care coordinators, and peer support specialists or family peer support specialists.” No changes have been made based on this comment.    Comment 2: One respondent commented that “a provider” should be changed to “an interdisciplinary team member” in the definition of “integrated health homes.” (Subrule 77.47(1), regarding definitions)    Response 2: The definition of “team of health care professionals” as stated in the SPA also includes the lead entity. The SPA defines the term as “a team of health professionals that includes physicians and other professionals, including nurse care managers, care coordinators, and peer support specialists or family peer support specialists.” No changes have been made based on this comment.    Comment 3: One respondent commented that the self-assessment requirement should be changed from “An integrated health home must complete a self-assessment when enrolling as a new health home and annually thereafter” to “An integrated health home must complete a self-assessment when enrolling as a new health home,” as the self-assessment is technically not part of the SPA and has created a more restrictive environment. (Subrule 77.47(3), regarding integrated HH provider qualifications)    Response 3: This is not a new requirement. Completion of the initial and annual self-assessments has been a requirement since implementation of the HH program in 2013. This subrule is implementing established policy and is consistent with other program oversight activities; therefore, no changes have been made based on this comment.    Comment 4: One respondent commented that previous provider definitions have allowed Iowa-accredited providers of mental health services, not only Commission on Accreditation of Rehabilitation Facilities (CARF)-accredited providers, to deliver integrated HH services. (Subrule 77.47(3), regarding integrated HH provider qualifications)    Response 4: The Department recognizes that providers accredited in accordance with 441—Chapter 24 to deliver services to individuals with mental illness are also qualified to deliver integrated HH services. The Department has revised paragraph 77.47(3)“a” by adding the following subparagraph:    “(8) Provider accredited under 441—Chapter 24 to deliver services to persons with mental illness.”    Comment 5: One respondent commented on subparagraph 77.47(5)“b”(1) to say that “nurse” needed to be deleted or “care coordinator” added, or the sentence changed to read “The health home is responsible for assisting members with…” or “The health home must ensure that the nurse care manager is responsible for assisting members with…” (Subrule 77.47(5), regarding HH general requirements)    Response 5: The Department agrees with the comment and has revised subparagraph 77.47(5)“b”(1) to add the words “oversight of the service, including.” The subparagraph now reads as follows:    “(1) The health home must ensure that the nurse care manager is responsible for oversight of the service, including assisting members with medication adherence, appointments, referral scheduling, tracking follow-up results from referrals, understanding health insurance coverage, reminders, transition of care, wellness education, health support or lifestyle modification, and behavior changes.”    Comment 6: One respondent commented that subparagraphs 77.47(3)“f”(1) and (2) and paragraph 77.47(4)“b” were inconsistent with role titles. (Subrules 77.47(3), regarding integrated HH provider qualifications, and 77.47(4), regarding lead entity qualifications)    Response 6: The Department agrees with the comment and has revised the catchwords of subparagraph 77.47(4)“b”(2) by replacing “nurse care coordinators” with “nurse care managers.” The Department has also revised the catchwords of subparagraph 77.47(2)“g”(2) by replacing “dedicated care manager” with “nurse care manager.”    Comment 7: One respondent commented on subparagraph 77.47(5)“a”(2) to say that “other social determinants of health” should be deleted from “The health home must complete status reports to document the member’s housing, legal status, employment status, education, custody, and other social determinants of health, as applicable.” (Subrule 77.47(5), regarding HH general requirements)    Response 7: Whole person care includes social health and environmental health. Federal guidance states that the social needs of the member need to be addressed through the delivery of HH service. This is not a new guideline for HH service providers and is a best practice in the delivery of whole person care. No changes have been made based on this comment.    Comment 8: One respondent commented on subparagraph 77.47(5)“a”(6) to say that “annually” should be removed from “The health home must initially and annually provide letters of support from at least one area hospital and two area primary care practices.” (Subrule 77.47(5), regarding HH general requirements)    Response 8: The Department agrees with this comment and has revised subparagraph 77.47(5)“a”(6) to require the HH to submit the letters of support initially at the time of enrollment and then again during the federally required reenrollment period. The subparagraph has been revised to read as follows:    “(6) The health home must, at the time of enrollment and reenrollment, provide letters of support from at least one area hospital and two area primary care practices that agree to collaborate with the health home on care coordination and hospital and emergency department notification.”    Comment 9: One respondent commented on subparagraph 77.47(5)“a”(8) to say that “fragmentation” should be removed from “The health home must be responsible for preventing fragmentation or duplication of services provided to members.” (Subrule 77.47(5), regarding HH general requirements)    Response 9: The Department acknowledges that the specific word “fragmentation” is not included in the SPA; however, the intent of whole person care is to avoid fragmentation by ensuring continuity of care for the member. Therefore, no changes have been made based on this comment.    Comment 10: One respondent commented that subrule 77.47(5) is inconsistent with paragraph 78.53(2)“e.”    Response 10: The Department agrees with the comment and has revised subparagraph 77.47(5)“b”(5) to read as follows:    “(5) The health home must communicate with the member, authorized representative, and the member’s family and caregivers in a culturally appropriate manner for the purposes of assessment of care decisions, including the identification of authorized representatives.”    Comment 11: One respondent commented on paragraph 77.47(5)“c” to suggest that the word “must” be replaced with “encourage” in “The health home must use email, text messaging, patient portals and other technology to communicate with members.” (Subrule 77.47(5), regarding HH general requirements)    Response 11: The Department agrees with the comment and that the member may choose the member’s preferred method of communication and has revised the second sentence of paragraph 77.47(5)“c” to read as follows:    “The health home must use email, text messaging, patient portals and other technology to communicate with members based on the member’s preferred method of communication.”    Comment 12: One respondent commented that subparagraphs 77.47(5)“d”(4) and (5) need to be clarified, since “meetings” is inconsistent with the SPA. (Subrule 77.47(5), regarding HH general requirements)    Response 12: The Department disagrees with the comment. The intent of the use of the word “meetings” is to be inclusive of in-person, virtual, or telephonic meetings. No changes have been made based on this comment.    Comment 13: One respondent commented on subparagraph 77.47(5)“d”(5) to say that “with lead entities and the department” is inconsistent with the SPA and not included in the SPA language and, as such, would appear to add an additional requirement upon the HH. (Subrule 77.47(5), regarding HH general requirements)    Response 13: The Department disagrees with this comment. This language is not new and has remained consistent within the SPA since the implementation of the program. The SPA states, “Agree to participate in or convene ad hoc or scheduled meetings to plan and discuss implementation of goals and objectives for practice transformation with ongoing consideration of the unique practice needs for adult members with SMI and child members with SED and their families.” No changes have been made based on this comment.    Comment 14: One respondent commented on subparagraph 77.47(5)“d”(5) to say that “adult members with a serious emotional disturbance” needs to be changed to “adult members with a serious mental illness” in the phrase “practice transformation, with ongoing consideration of the unique practice needs for adult members with a serious emotional disturbance and child members with a serious emotional disturbance and those members’ families.” (Subrule 77.47(5), regarding HH general requirements)     Response 14: The Department agrees with this comment and has revised subparagraph 77.47(5)“d”(5) to read as follows:    “(5) The health home must participate in or convene ad hoc or scheduled meetings with lead entities and the department to plan and discuss implementation of goals and objectives for practice transformation, with ongoing consideration of the unique practice needs for adult members with a serious mental illness and child members with a serious emotional disturbance and those members’ families.”    Comment 15: One respondent recommended that HH providers have access to the data in real time to make necessary adjustments regarding the sentence “The health home must participate in ongoing process improvement on clinical indicators and overall cost-effectiveness.” (Subrule 77.47(5), regarding HH general requirements)    Response 15: As a condition of participation in the HH program, HHs are required to have electronic medical health records that are meaningfully used. When this standard is met and the HH has an operational electronic medical health record, the HH will have access to more real-time data to use as part of its quality improvement program. No changes have been made based on this comment.    Chapter 78—Definitions, Covered Services, and Patient-Centered Care Plan    Comment 1: One respondent recommended all references to “patient-centered” should be changed to “person-centered” for consistency and clarity. (Subrule 78.53, regarding HH services)     Response 1: The Department agrees with the comment and has revised subrules 78.53(1) and 78.53(2) and paragraph 78.53(5)“c” to change all references to “patient-centered” to “person-centered.” Paragraph 78.53(5)“d” was not updated, since another change superseded that portion of the rule that contained the “patient-centered” wording.    Comment 2: One respondent stated that “‘78.53 (1) Definitions (2) Covered services (5) c. PCSP and patient-centered care plan (5) d. Core Services’ should be revised since they are not all-inclusive and fail to include the option for a referral by the family, authorized caregivers and legal guardians or representatives, etc.” (Subrule 78.53(4), regarding member identification and enrollment)     Response 2: The Department agrees with the comment and has revised paragraph 78.53(4)“a” to read as follows:    “a. Eligible members are identified through a referral from the department, lead entity, primary care provider, hospital, other providers, the member, or the member’s authorized representative.”     Comment 3: One respondent stated, “How the member presented to the health home, including the referral. Delete this section as this is not a requirement of eligibility, so why is there a documentation requirement?” (Subrule 78.53(5), regarding HH documentation)    Response 3: The requirement is included because the source of referrals for HH services assists the HH with understanding the population at a community level and identifies any need for targeted outreach. No changes have been made based on this comment.    Comment 4: One respondent stated, “Identified needs and plan to assess for eligibility. Delete this section as this is requiring documentation on how the health home plans to determine if the member is eligible. Eligibility is dictated by the mental health professional assessment of functional impairment and as such is outside of the purview and control of the health home.” (Paragraph 78.53(5)“a,” regarding HH documentation)    Response 4: The HH is responsible for verifying member eligibility for HH services. When the HH does not have the documentation to substantiate that a member is eligible for HH services, the HH will document in the member’s service record that the HH will verify the member’s eligibility by obtaining the required documentation that substantiates the member has a qualifying diagnosis that makes the member eligible for HH services. No changes have been made based on this comment.    Comment 5: One respondent stated, “Documentation that the member is eligible for health home services. If a member is not eligible, the health home must document the plan to support the member. Delete — a documentation requirement for a health home for a plan of services for an individual that is not eligible for the health home services should not be a requirement placed upon the health home.” (Subrule 78.53(5), regarding HH documentation)    Response 5: If the member being referred for HH services is not clinically eligible for the HH services, the HH will make appropriate referrals to other community services for which the member may be eligible. No changes have been made based on this comment.    Comment 6: One respondent stated, “Plan to complete the comprehensive assessment. Delete — there is already an entire section (b. Comprehensive Assessment) devoted to this, so this is duplicative and appears as a task in futility requiring a health home to document how they are going to fulfill a required task.” (Subrule 78.53(5), regarding HH documentation)    Response 6: To ensure that the member receives comprehensive coordinated care, the HH will document the plan to obtain appropriate historical records from providers and the member at the time of intake. The team should identify the information needed and the professionals from whom they will need to obtain the information to complete the comprehensive assessment and the social history for the eligible member. No changes have been made based on this comment.    Comment 7: One respondent stated, “Documentation of eligibility and member’s agreement to continue participation in the program, obtained on an annual basis. Delete or clarify. Isn’t it implied if a member meets with the health home and goes through the extensive steps to revise and update their annual care or service plan, that the member intends to continue to participate in the program?” (Subrule 78.53(5), regarding HH documentation)    Response 7: The Department agrees with this comment. The completed annual assessment demonstrates that the member agrees to continue participation. The Department has revised subparagraph 78.53(5)“a”(9) by removing “and member’s agreement to continue participation in the program, obtained on an annual basis,” to read as follows:    “(9) Documentation of continued eligibility, reviewed annually and maintained in the member’s service record.”    Comment 8: One respondent stated, “This section needs clarified. This is limiting and lacks flexibility to provide immediate services or one-time needs: ‘Core services. Documentation must reflect monthly provision of one of the six core health home services as outlined in subrule 78.53(2), based on the member’s identified needs in the member’s patient-centered care plan or person-centered service plan.’” (Subrule 78.53(5), regarding HH documentation)    Response 8: The Department agrees with this comment and has revised paragraph 78.53(5)“d” by deleting “based on the member’s identified needs in the member’s patient-centered care plan or person-centered service plan.” The paragraph now reads as follows:    “d. Core services. Documentation must reflect monthly provision of one of the six core health home services as outlined in subrule 78.53(2).”    Comment 9: Regarding a reference to paragraph 78.53(5)“e” in subparagraph 78.53(6)“a”(3), one respondent stated, “78.53(5)‘e’ applies to ICM [Integrated Care Management] services and does not apply to non-ICM members.” (Subrule 78.53(6), regarding payment)    Response 9: The Department agrees with this comment and has revised subparagraph 78.53(6)“a”(3) to remove the reference to paragraph 78.53(5)“e” for clarification. The subparagraph now reads as follows:    “(3) The health home maintains the documentation outlined in subrule 78.53(5).”    Chapter 79—Services    Comment 1: One respondent stated, “Need to add ‘if relevant’ at the end of each of the services identified in points 1 through 10 so as not to imply documentation required for services that may not be applicable to the respective members.” (Subparagraph 79.3(2)“d”(40), regarding HH services)    Response 1: The Department agrees with the comment as it applies to one of the items and has revised subparagraph 79.3(2)“d”(40) by adding “if relevant” to numbered paragraph “5,” which now reads as follows:    “5. Comprehensive transitional care plan, including appropriate follow-up, if relevant.”    Summary    Based on these comments, changes from the Notice were made to the following rule subparts: