Steps for completing an application:
Those seeking services for persons with and intellectual disability through the Department of Mental Health should:
1. Contact the Division of Intellectual Disabilities Call Center at 1-8000-361-4491.
2. Within the next business day, an initial contact form will be faxed to the local designated 310 case management agency of other designated point of entry.
3. Once contacted by the 310 case management agency you will need to do the following:
a.Describe the needs and preferences of the person for whom services are being requested.
b.Provide the point of contact with information on the person’s current situation, personal and family history, and the person’s Medicaid eligibility status.
4. Additional information will need to be completed by the designated 310 case management agency to be enrolled on the Statewide Waiver Waiting List.
- Criticality summary completed within 90 days prior to application.
- A psychological evaluation with the IQ range of the person seeking services to be placed on the waiting list (IQ score below 70 documented by a standardized intelligence test) to include a review of all past intellectual assessments and IQ scores.
- Documentation that the person in need of services has challenges with adaptive functioning significant limitations in the person’s effectiveness in meeting the standards of maturation, learning, personal independence, and/or social responsibility that are expected for his or her age level and cultural group, as determined by clinical assessment, and usually, standardized scales.
- Currently the ICAP is used for documentation for the requirement above. When there is cause to question the ICAP score and additional clinical adaptive functioning assessment and other documentation may be requested.
- Documentation that the person’s level of adaptive and intellectual functioning occurred prior to the age of 18.
- Developmental history. Documentation of family and person’s historical information.
About Administrative Review Options for Applicants
Once the Case Management agency has provided a complete application to the Regional Community Service Office, the Division will make a determination of eligibility. Note that if the application has to be sent back to the Case Management agency for more information it is not considered complete. The Division will make a determination concerning a complete application no later than 10 business days after receiving it.
If the applicant is determined eligible, his or her name will be added to the statewide waiver waiting list. All eligible applicants will be added to the waiting list first, even if they are subsequently placed in service the same day. The applicant will receive a memorandum (an Initial Notification of Preliminary Determination of Eligibility) from the Division stating the person has been added to the waiting list and indicating the service groups for which the applicant is shown to be waiting. This notification will also explain how the waiting list works. A second page describes how to request a review if the application disagrees with being entered on the waiting list of with the specified services groups.
The instructions for requesting a review are very specific as to whom the applicant should contact, that the request must be in writing, and that the request needs to be received within 15 days after the date the notification was sent to the applicant. This will describe the review process itself. First review is with the Regional Community Service Office, and then, if there is still disagreement, the second review is with the Associate Commissioner of the Division of Intellectual Disabilities. Also described are the types of reviews that may occur (in-person interview, teleconference, or just a review of documents) and who can participate with intellectual disabilities.
If the applicant is determined ineligible the applicant will receive a memorandum regarding denial of eligibility. This notification will state that the applicant’s application has been denied and it will specify the reason why it has been denied. It will describe the statutory and/or regulatory requirement that has not been met. Then, this notification will describe the process of appeal. This begins with a written request from the applicant, either to the Division of Intellectual Disabilities or to the Alabama Medicaid Agency, and there are specific timelines involved with each. If the applicant appeals first to the Division of Intellectual Disabilities he or she will be entitled to a review by the Associate Commissioner, which will produce a written determination. If the individual is dissatisfied with that determination he or she has the right to appeal to the Alabama Medicaid Agency, and the notification includes instructions how to proceed to make that appeal. Note that the applicant is not required to appeal first to the Division of Intellectual Disabilities but may appeal initially to the Medicaid Agency. The notification fully explains the process of appeal to both agencies, not matter which agency the applicant approaches first.
Region 1 Community Services-North Alabama. Decatur, Alabama 256-552-3720
Region 2 Community Services-West Central Alabama. Tuscaloosa, Alabama 205-554-4155
Region 3 Community Services-South Alabama. Mobile, Alabama 251-478-2760
Region 4 Community Services-Central Alabama. Wetumpka, Alabama 334-514-4300
Region 5 Community Services-East Alabama. Birmingham, Alabama 205-916-0400