1. (1) While DDA may review your eligibility at any time, DDA will review your eligibility:

   1. (a) At age 19 when the most recent eligibility determination was completed before age 16.
   2. (b) At age 19 when determined eligible with another neurological or other condition similar to intellectual disability and academic delays were used as evidence of substantial functional limitations.
   3. (c) Before authorization of any DDA-paid service if one is not currently receiving paid services and the most recent eligibility determination was before June 1, 2005.
   4. (d) If the evidence used to make the most recent eligibility determination is insufficient, contains an error, or appears fraudulent.
   5. (e) If new information becomes available that does not support the current eligibility determination.
   6. (f) If you are determined eligible due solely to enrollment in the fee-for-service (FFS) medically intensive children's program (MICP) but you are no longer eligible for FFS MICP services.
2. (2) DDA will notify you in writing at least six months before your eligibility review date.

3. (3) When a review occurs and there is insufficient information to determine your eligibility, DDA can disenroll you:

   1. (a) On your 20th birthday if it is an age 19 review; or

   2. (b) 90 days after the information is requested, if the review is because:

      1. (i) A paid service is requested;
      2. (ii) The evidence used to make the most recent eligibility determination is insufficient, contains an error, or appears fraudulent;
      3. (iii) New information is available that does not support the current eligibility determination; or
      4. (iv) You are no longer eligible for FFS MICP services under chapter 182-551 WAC.

[Statutory Authority: RCW 71A.10.020, 71A.16.020, and 74.08.090. WSR 24-18-040, s 388-823-1010, filed 8/27/24, effective 10/7/24. Statutory Authority: RCW 71A.16.020 and 71A.16.040. WSR 24-01-119, § 388-823-1010, filed 12/19/23, effective 1/19/24. Statutory Authority: RCW 71A.12.030. WSR 19-14-119, § 388-823-1010, filed 7/3/19, effective 8/3/19. Statutory Authority: RCW 71A.12.030 and 71A.10.020. WSR 18-15-046, § 388-823-1010, filed 7/13/18, effective 8/13/18. Statutory Authority: RCW 71A.12.030, 71A.12.120 and 74.08.090. WSR 14-12-046, § 388-823-1010, filed 5/29/14, effective 7/1/14. Statutory Authority: RCW 71A.12.030, 71A.12.040, and 74.08.090. WSR 14-07-028, § 388-823-1010, filed 3/10/14, effective 4/10/14. Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. WSR 05-12-130, § 388-823-1010, filed 6/1/05, effective 7/2/05.]