Exception to Policy Review

What criteria is used to decide if an exception to policy will be granted?

An exception to policy is granted when the item or service being requested would improve the quality of life of a consumer at no additional cost to the state, or when it would result in savings to the state.

The criteria used to decide if an exception to policy can be approved is:

• Is there an extreme need for an item or service?
• Are there exceptional circumstances that justify an exception to policy?
• Would an exception to policy result in net savings to the state?
• Have all other possible sources been exhausted?
• What is the cost to the state and are there funds in the Department's budget?

Who decides if an exception to policy will be granted?

An exception to policy is granted at the discretion of the Director of the Department of Human Services.

What can I do if I disagree with an exception to policy recommendation?

If you disagree with an exception to policy recommendation, you can ask to have your request reconsidered. You may write a letter or complete the Petition for Exception to Policy form.

Petition for Exception to Policy form

Please   answer all questions on this form and be sure to be specific. Complete the Petition for Exception form online.

Once the form is completely filled out, click the submit button at the bottom of the form. Your request will be sent directly to the Appe  als Section.

If you have additional documentation that will help support your request, please mail, fax or e-mail the information to the Appeals Section so it can be used when making a decision on your request.

If the request is medical in nature, please provide documentation to prove that the item or service is medically necessary. You will need to include the costs or proposed savings of the request.

Mail, fax or email the additional documentation to:

Department of Human Services

Appeals Section
1305 E Walnut Street, 5th Floor
Des Moines, IA 50319
FAX: 515-564-4118

Email: exceptions@dhs.state.ia.us