Functional Assessment Review and Appeals
Rule
An initial functional assessment must be completed upon Intellectual and Developmental Disabilities (I/DD) eligibility determination and annually thereafter for recipients of Home and Community Based Services (HCBS). Annual assessments must occur within 365 days of the last assessment.
The Johnson County Community Developmental Disabilities Organization (CDDO) is responsible for ensuring that all individuals receiving (HCBS I/DD) waiver services in Johnson County have a completed annual functional assessment. Changes to the assessment only occur at the time of the individual’s annual assessment, unless a re-assessment is granted due to the individual experiencing a life-altering event that is likely to continue and may require additional staff support.
Request for Local Review
Every effort is made to capture accurate, complete information at the time of the assessment. All supporting documentation is required at the time of the assessment. Anything concerning the previous assessments are strictly historical and no longer relevant to the current year. If there is concern that information in the assessment scoring is inaccurate, you may request a review of the assessment by contacting the CDDO Director, in writing, within 14 days of receiving notification of the MR4.
Request for Appeal from State
If the result of the assessment is a tier change between 1 and 5, the individual continues to be eligible for HCBS IDD waiver services and has no appeal rights.
If the assessment results in a Tier 0, the individual has been found ineligible for HCBS IDD waiver funding and has a right to appeal.
A Request for a State Fair Hearing
A request for a state fair hearing must be made in writing and signed within 30 days of receipt of the Notice of Action (NOA) of the Tier 0 finding. State fair hearing requests must be sent to:
Get Help from your Case Manager
If you have a targeted case manager, they should assist you in preparing for this meeting. Documentation that you might need includes the following:
- Diagnosis
- Prescribed and Over the Counter (OTC) medications
- Special Diet
- Special Health Care Procedures
- Individual Education Plan
- Person Centered Support Plan
- Behavior Intervention Plan
- Behavior Tracking Data sheets
- Seizure Tracking Data sheets
Functional Assessment FAQs
What is the Functional Assessment?
The current functional assessment tool used by the State of Kansas for the HCBS I/DD waiver services is called the Basic Assessment and Services Information System or BASIS. The BASIS is a two part functional assessment which includes the Information Section (name, address, guardian information, etc.) and the Assessment Section (medical conditions, medications, mobility, motor skills, cognitive abilities, communication, behaviors, self-care and living skills.) The data collected is transferred electronically to the State of Kansas. The State will score each BASIS Functional Assessment and then send a tier score of 1 through 5 back to the CDDO for each individual. The functional assessment determines eligibility for HCBS I/DD waiver, the level of care and funding for services.
Who needs to have the Functional Assessment completed?
An initial functional assessment must be completed upon I/DD eligibility determination and annually thereafter for recipients of HCBS. Additionally, individuals who scored Tier 0 or were ineligible for the HCBS I/DD waiver on their last assessment will also have an annual assessment. Annual assessments must occur within 365 days of the last assessment.
Who should attend the Functional Assessment meeting?
The person served should be present at every Assessment unless there are special circumstances such as illness or hospitalization. It is important to remember that the person served always has the option of leaving the Functional Assessment meeting should they feel uncomfortable with answering the questions. Individuals within the person’s Circle of Support are encouraged to attend, which could include: parents, legal guardians, service providers, or other individuals that would have data to report from the past 12 months.
When and where will the Functional Assessment meeting be held?
Meetings occur annually, and assessments must be entered within 365 days of the previous assessment. Functional assessment meetings must be held in areas that provide a confidential and HIPAA compliant environment.
Why is my input so important?
It is important that all functional assessment questions are answered honestly and accurately. All answers impact scoring of assessments. All supporting documentation is required at the time of the annual reassessment and will not be accepted once the meeting has been completed.