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4 TITLE 16 HEALTH AND SAFETY DELAWARE ADMINISTRATIVE CODE ·Convalescent Care not to exceed 30 days - PAS nurses will track this exemption and initiate Level II PASRR evaluation prior to expiration if continued NF stay is warranted. ·Terminal Illness – a life expectancy of 6 months or less if the illness runs its normal course. ·Medical dependency with a severe physical illness. No further evaluation is needed at this time. ·There are indicators of mental illness, mental retardation/related conditions – Needs complete PASRR Assessment (Level II). 4. DMMA will coordinate the Level II screening for all Medicaid and non-Medicaid individuals. DMMA PAS nurse will gather data for Level II PASRR screening. Data is reviewed with DMMA Nurse Supervisor for approval to continue with the Level II screening. 5. The individual and/or legal representatives must receive written notice that further evaluation is needed. The notice must inform them that the individual is being referred for Level II Evaluation to DSAMH due to mental illness indicators or to DDDS due to mental retardation/related condition. 6. An Independent Psychiatric Consultant (IPC) will complete the Level II Evaluation for those with mental illness/indicators. The IPC will assess individual and review documentation to verify whether or not there is a serious MI. DDDS will assess individual and review documentation to verify whether or not diagnostic criteria of mental retardation or related conditions are met. The Level II evaluation may be terminated at any time if the evaluator determines that no Mental Illness is present. 7. DDDS will complete the Level II Evaluation for those with mental retardation/indicators. DDDS will assess individual and review documentation to verify whether or not diagnostic criteria of mental retardation or related conditions are met. The Level II evaluation may be terminated at any time if the evaluator determines that no Mental Retardation [or related conditions] is present. 8. DSAMH or DDDS Determines Need For Specialized Services and /or NF Services. DSAMH will review IPC’s recommendations and determine need for Specialized Services and/or NF services. 9. DMMA is notified by DSAMH/DDDS of final determination. 10. DMMA will send final determination letter to: ·Individual/applicant; ·Legal Representative; ·Admitting or retaining NF; ·Attending Physician; ·Discharging hospital – if exemption is not applicable. Final PASRR determinations will be issued by DMMA. 14 DE Reg. 895 (03/01/11) 20103 Financial Eligibility Determination In accordance with section 1413(b)(1)(A) of the Affordable Care Act, the agency must accept an application from the applicant, an adult who is in the applicant's household, as defined in 42 CFR §435.603(f), or family, as defined in section 36B(d)(1) of the United States Code (U.S.C.), an authorized representative, or if the applicant is a minor or incapacitated, someone acting responsibly for the applicant, and any documentation required to establish eligibility - (1) Through commonly available electronic means; (2) By telephone; (3) Via mail; (4) In person The Application, Affidavit of Citizenship and Responsibility Statement must be signed by the individual or a representative of their choice. For individuals who are minors or incapacitated a signature is required by someone acting responsibly on the applicant's behalf. The date of application is the date the application is received by LTC Medicaid Office. 42 CFR 435.906; 42 CFR 435.907(a) and Social Security Act 1943(b) 9 DE Reg. 997 (12/01/05) 22 DE Reg. 66 (07/01/18)