States may apply the categorical determination at 42 CFR 483.130(h), to address a decision not to provide specialized services to individuals with dementia and intellectual disability. “(h) Categorical determinations: Dementia and ID. The State intellectual disability authority may make categorical determinations that individuals with dementia, which exists in combination with intellectual disability or a related condition, do not need specialized services.”
A categorical determination for dementia and intellectual disability can be applied at the Level I screening, but the categorical must be determined at the Level II phase of PASRR. The evaluator can terminate the evaluation if they determine there is clear evidence of the dementia diagnosis being primary and the intellectual disability being secondary. Lacking clear evidence, it is not appropriate to stop the Level II evaluation.