The following limits apply to the state-funded individual and family services (IFS) program:

(1) State-funded IFS program services are limited to available funding.

(2) A state-funded IFS program service must address an unmet need identified in your person-centered service plan (PCSP).

(3) Any item reimbursed with state funds under the IFS program must not duplicate or replace items provided to you under private insurance or medicaid.

(4) State-funded IFS program services are authorized only after you have requested and have been denied other resources available to you through private insurance, school, the division of vocational rehabilitation, child development services, medicaid, including personal care and community first choice, and other supports.

(5) All state-funded IFS program service payments must be agreed to by you and the developmental disabilities administration (DDA) in your PCSP.

(6) To receive reimbursement for goods or services purchased for a DDA client, the purchaser must have a reimbursement contract with DDA.

(7) DDA does not pay for treatment that is experimental or investigational under WAC 182-531-0550.

(8) DDA does not cover vitamins or supplements.

(9) Your choice of qualified providers and services may be limited to the most cost-effective option that meets your assessed need.

(10) Services must not be provided after a client's death.

(11) DDA's authorization period begins when you have agreed to be in the state-funded IFS program and your PCSP is effective.

(12) If you have not accessed a state-funded IFS program service at least once per plan year, DDA will disenroll you from the state-funded IFS program.

(13) The state-funded IFS program must not pay for psychological evaluations or testing, or DNA testing.

(14) You may receive state-funded IFS program services in a recognized out-of-state bordering city on the same basis as in-state services. Recognized bordering cities include:

(a) Coeur d'Alene, Moscow, Sandpoint, Priest River, and Lewiston, Idaho, and

(b) Portland, The Dalles, Hermiston, Hood River, Rainier, Milton-Freewater, and Astoria, Oregon.

PDFWAC 388-832-0333

What limits apply to state-funded IFS program services?