DSPD State Eligibility is part of the core documentation that maintains the person’s ability to remain in DSPD services. State Eligibility provides answers to whether or not the person continues to reside in Utah, that they continue to have a qualifying diagnosis for their service type, that they continue to have the minimum number of functional limitations required, and the case contains the appropriate assessments by their service type. If the person is found to no longer satisfy any one of those conditions, then their services can be discontinued. The process for removing someone from services is an entirely different process than documenting a change in their eligibility. The information below documents the eligibility conditions and requirements that must be satisfied for Intellectual Disabilities (ID), Related Condition (RC) and Acquired Brain Injury (ABI) service types.
"Not Eligible" Decisions:
The Eligibility worker can record a “Not Eligible” decision anytime the supporting documentation described above indicates the person does not (or no longer) qualifies for services. A comment must be recorded with the decision that justifies/explains it.
The person must demonstrate that they continue to satisfy the residency criteria while receiving services (i.e. they do so by having a resident address in Utah). If they do, the question must be answered as “Yes” regardless of the service type they have.
Additionally, applicants legal guardian must be a resident of the state of Utah.
The person must have documentation that the diagnosis they have qualifies them for services. If a new assessment provides new details about a more current diagnosis, then the Support Coordinator should enter the new assessment in USTEPS in both the assessment/evaluation screen and diagnosis screen. Then they should consult with the eligibility worker regarding the meaning of the new diagnosis.
If the person is diagnosed with other conditions that may or may not be related to eligibility (i.e. diabetes, heart disease, mental health, etc.), the SC can enter the information directly into USTEPS. A valid secondary diagnosis is one that has corroborating documentation, such as an ICD code from a credentialed professional.
A functional limitation represents a deficit the person has in a major life activity that they cannot perform on their own without substantial support. The types and classifications of functional limitations are dependent upon the person’s age and type of service eligibility. For Example, ABI has a set of limitations that are somewhat different than those of ID/RC. The system requires the source/documentation of the functional limitation to be recorded with the designation of if the functional limitation does or does not apply to the Person.
Assessments provide detailed information about the person’s condition, diagnosis, etc. They also contribute some information about the person’s functional limitations. In some cases, more than one type of assessment is required to fully understand the scope of the person’s limitations and deficits.