Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 125 - Medicaid Coverage; Personal Care Services and Home Health Care Services
Article 1 - Personal Care Services
7 AAC 125.010 - Purpose and scope of personal care services; coverage limitations
Universal Citation: 7 AK Admin Code 125.010
Current through November 28, 2024
(a) The purpose of 7 AAC 125.010 - 7 AAC 125.199 is to establish standards, requirements, and procedures for the personal care services program.
(b) The department will authorize and pay for personal care services that are
(1) provided
to a recipient that
(A) experiences
functional limitations that
(i) are the result
or the recipient's physical condition;
(ii) are confirmed by an assessment of the
recipient conducted in accordance with
7
AAC 125.020; and
(iii) cause the recipient to be unable to
perform, independently or with an assistive device, the activities specified in
7
AAC 125.030;
(B) meets the application requirements of
7
AAC 125.012; and
(C) following an assessment under
7
AAC 125.020 is determined, because of the recipient's
functional limitations, to need a level of assistance specified in
7
AAC 125.020(c);
(2) administered in accordance with a service
level authorization for personal care services established under
7
AAC 125.024;
(3) administered by a provider, certified in
accordance with
7
AAC 125.060, that is chosen by the recipient to
provide the recipient's agency-based or consumer-directed personal care
services; and
(4) provided by a
personal care assistant that
(A) meets the
requirements of7 AAC 125.090;
and
(B) is not the spouse of the
recipient, the parent of a minor child who is the recipient, an individual with
a duty to support the recipient under state law, the recipient's
representative, or the representative's designee that was appointed in
accordance with
7
AAC 125.100(c), unless an individual
named in this subparagraph is a court-appointed guardian to a ward and a court
authorizes the guardian under
AS
13.26.311(c) to provide
personal care services.
(c) After review of a complete application submitted in accordance with 7 AAC 125.012, the department will not further process a recipient's application if the department finds that the recipient
(1) does not describe a physical condition
that affects the recipient's capacity to perform activities covered under
7
AAC 125.030, or does not indicate specific activities
for which the recipient needs physical assistance;
(2) has submitted an application during the
previous 365-day period, but does not describe a material change under
7
AAC 125.012(c);
(3) lives in a location where personal care
services are not available, or where personal care services cannot be secured
from an individual that is qualified and willing to provide physical assistance
for the recipient through a consumer-directed personal care services
program;
(4) lives in a residence
that does not meet the requirements of
7
AAC 125.050(a);
(5) requests physical assistance only with
lADLs that are the responsibility of an individual listed under
7
AAC 125.040(a)(14)(A);
(6) requests assistance with IADLs only, but
shares a residence with other recipients, and the requested assistance would
duplicate services as specified in
7
AAC 125.040(a)(14)(B);
(7) has indicated on the application
submitted in accordance with
7
AAC 125.012 that natural supports meet the recipient's
needs for physical assistance with the activities in
7
AAC 125.030, unless the department determines, based
on review of the materials submitted with the application, that an assessment
is necessary because the recipient might need a level of assistance indicated
in 7 AAC 125.020(c)
and the natural supports would not be available at times to provide the
assistance needed; or
(8) is a
child that requests physical assistance with activities that fall within the
range of activities a legally responsible parent or guardian would perform on
behalf of a same age child in accordance with
AS
47.10.014, and that child is
(A) under six years of age; or
(B) at least six years of age and under 18
years of age, unless the department determines, based on the application, that
(i) the need for assistance with ADLs or the
activities specified in
7
AAC 125.030(d) is related solely to
the child's disability, and is not due primarily to the child's age;
or
(ii) the frequency, scope, and
duration of assistance required by the child is not typical of a same-age child
that does not have a disability.
Authority:AS 47.05.010
AS 47.07.030
Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
