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AIDS/HIV HCBS Waiver - Iowa

The AIDS / HIV HCBS waiver pays for services for people with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV) infection who would otherwise require care in a medical institution.

To be eligible for the AIDS / HIV waiver, a person must meet all of the following requirements:

·           Be diagnosed by a physician as having AIDS or HIV infection. The Iowa Foundation for Medical Care (IFMC) is responsible for verifying the applicant’s diagnosis.

·           Be certified by IFMC in need of the level of care that would, but for the HCBS program, otherwise be provided in either a:

·                        Nursing facility

·                        Skilled nursing facility

·                        Hospital

·           Require at least one HCBS service quarterly, as determined by the service worker, client, and interdisciplinary team.

·           Has service needs that do not exceed the cap established for the HCBS AIDS / HIV program.

·           Has a case plan in place. The service worker is responsible for developing the case plan in consultation with the interdisciplinary team. The case plan includes the frequency of waiver services and the providers or types of providers that will deliver the services.

·           Be eligible for Medicaid under one of the coverage groups listed below.

·                        SSI or SSI-related. The person must meet all of the standard SSI eligibility requirements. Under the AIDS / HIV waiver, the disability determination process is different, in that IFMC verifies the AIDS or HIV diagnosis and determines level of care to meet the disability requirement.

·                        FMAP-related. The person must meet all of the standard FMAP eligibility requirements.

·                        Medically Needy, if the level of care is hospital level.

·                        300% group or eligible for SSI but living in a medical institution.

See Also:

·           HCBS Waivers Overview

·           Overview of Medical Assistance in Iowa

·           Welcome and Introduction to Benefits in Iowa

Source: Iowa Dept of Human Services Employees Manual

Title 8 Medicaid

·                        Chapter N, pages 21 & 22

Regulation citations: 441 IAC, Chapter 83, Division III

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