Eligibility For Services And Supports

To receive services and supports paid for by federal or state funds from SRS/MH&DD, persons must meet specific eligibility criteria outlined in this section. It is the responsibility of the CDDO to ensure persons supported by developmental disability funds administered by SRS/MH&DD meet these criteria, however, the CDDO may also hold each of its affiliates responsible for ensuring this. Use of SRS/MH&DD administered developmental disability funds to provide services and supports to persons who do not meet the eligibility criteria may result in recoupment of those funds from the CDDO.

Consistent with L. 1995, Chap. 234 (Substitute for H.B. 2458) persons who are mentally retarded or otherwise developmentally disabled are those whose condition presents an extreme variation in capabilities from the general population which manifests itself in the developmental years resulting in a need of life long interdisciplinary services. This identifies those who, among all person with disabilities, are the most disabled as defined below:

Mental Retardation means substantial limitations in present functioning that is manifested during the period from birth to age 18 years and is characterized by significantly sub-average intellectual functioning existing concurrently with deficits in adaptive behavior including related limitations in two or more of the following applicable adaptive skill areas:

1. Communication
2. Self-care
3. Home living
4. Social Skills
5. Community use
6. Self-direction
7. Health and Safety
8. Functional Academics
9. Leisure
10. Work

Other developmental disability means a condition such as autism, cerebral palsy, epilepsy, or other similar physical or mental impairment (or a condition which has received a dual diagnosis of mental retardation and mental illness) and is evidenced by a severe, chronic disability which:

1. Is attributed to a mental or physical impairment or a combination of mental and physical impairments. AND
2. is manifest before the age of 22, AND
3. is likely to continue indefinitely, AND
   
4. results in substantial limitations in any three or more of the following areas of life functioning:
   1. self-care,
   2. understanding and the use of language,
   3. learning and adapting
   4. mobility
   5. self-direction in setting goals and undertaking activities to accomplish those goals,
   6. living independently
   7. economic self-sufficiency, AND
      
      To further clarify substantial functional limitations refer to The Eligibility Determination Instrument (EDI) available from MH&DD. This instrument is designed to assist assessing specific areas in which a person demonstrates substantial functional limitations. There is an EDI for adults and one for children.
      
5. reflects a need for a combination and sequence of special, interdisciplinary or genetic care, treatment or other services which are lifelong, or extended in duration and are individually planned and coordinated. AND
   
6. does not include individuals who are solely severely emotionally disturbed or seriously and persistently mentally ill or have disabilities solely as a result as a result of infirmities of aging.

For children under the age of six, developmental disability means a severe, chronic disability which:

1. is attributable to a mental or physical impairment or a combination of mental and physical impairments, AND
   
2. is likely to continue indefinitely, AND
   
3. results in at least three developmental delays as measured by qualified professionals using appropriate diagnostic instruments or procedures, AND
   
4. reflects a need for a combination and sequence of special, interdisciplinary or generic care, treatment or other services which are lifelong, or extended in duration are individually planned and coordinated, AND
   
5. does not include individuals who are solely severely emotionally disturbed or seriously and persistently mentally ill.

PROCEDURES:

1. Community Developmental Disability Organization shall assure that all persons served with MH&DD funds meet one of the above definitions unless otherwise approved by MH&DD in writing.
   
2. In order to receive ICF/MR or HCBS/MR services, person must meet additional eligibility criteria outlined in MH&DD Policy HCBS/MR90-1 and the HCBS/MR handbook.
   
3. If there is a difference of opinion MH&DD/Developmental Disabilities reserves the right to request a third party review.
   
4. Persons shall have the right to a reconsideration of the eligibility determination by requesting such, in writing, from MH&DD.
   
5. If upon reconsideration, the determination is unchanged, persons shall have the right to an appeal, which must be filed within 30 days by writing:

Administration Hearings Section
Credit Union One Bldg.
610 W. 10th, 2nd Floor
Topeka, KS 66612