Determinations of medical eligibility for Home and Community Based Waiver Services for the Mentally Retarded (HCBW/MR) is made through referral to the DHS DDSD case manager.

• (1) Referral. If the county receives an application, Form K-13 is forwarded to the DDSD case manager, who is responsible for securing a HCBW/MR medical determination and a disability decision, if needed.
• (2) Initial request. If the initial request is through DDSD, Form K-13 is forwarded to the county for completing the application process.
• (3) Plan of care packet. The DDSD case manager submits the necessary information to LOCEU for medical determination and a disability decision if needed.
• (4) County notification. LOCEU notifies the county and DDSD case manager of determination by updating the MEDATS file.
• (5) Procedures for an individual returning home. If referral is from a public ICF/MR for an individual returning to the home, the DDSD case manager forwards to the worker the medical eligibility determination for HCBW/MR along with the latest application form and redetermination of eligibility form used to determine eligibility for institutional care. A new application will not be required. A case number will be assigned retaining the application date, certification date and redetermination of eligibility date.
• (6) Determination of continued eligibility for HCBW/MR. The case manager is responsible for assuring that the individual's needs are re-evaluated and that recertification is established annually. Determination of continued medical eligibility is not necessary unless there is a significant change in the client's condition. The DDSD cases manager will notify LOCEU if this is the case.