Those seeking services for persons with intellectual disabilities through ADMH should:
Once the 310 agency has provided a complete application to the regional community services office, the division will make a determination of eligibility no later than 30 business days after receipt. Note: if the application has to be sent back to the 310 agency for more information, it is not considered complete.
If the applicant is determined eligible, his/her name will be added to the waiting list. The applicant will receive a memorandum (an Initial Notification of Preliminary Determination of Eligibility) from the division stating they have been added to the waiting list 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 applicant disagrees with being entered on the waiting list or with the specified service 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. The review process — first review is with the regional community services office, and then, if there is still disagreement, the second review is with the Associate Commissioner of the Division of Developmental 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 the applicant in the review.
A third page describes the eligibility requirements for the Medicaid Home and Community Based Waiver Programs for individuals with intellectual disabilities.
If the applicant is determined ineligible, the applicant will receive a memorandum regarding the denial of eligibility. This notification will state that the application has been denied specifying the reason why (it will describe the statutory and/or regulatory requirement that has not been met).
The appeal process — begins with a written request from the applicant, either to the Division of Developmental Disabilities or to the Alabama Medicaid Agency, with specific timelines involved for each. If the applicant appeals first to the Division of Developmental Disabilities, he or she will be entitled to a review by the Associate Commissioner, who will produce a written determination. If the individual is dissatisfied with that determination, he/she has the right to appeal to the Alabama Medicaid Agency. The notification fully explains the process of appeal to both agencies. Note: the applicant is not required to appeal first to the Division of Developmental Disabilities but may appeal initially to the Medicaid Agency.