Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.20 - Community Personal Assistance Services
Section 10.09.20.03 - Participant Eligibility

Universal Citation: MD Code Reg 10.09.20.03

Current through Register Vol. 51, No. 19, September 20, 2024

A. To participate in the Program, the participant shall:

(1) Be determined by the Department to need assistance with one or more activities of daily living;

(2) Be eligible for Medicaid under an eligibility coverage group described in COMAR 10.09.24, except for Regulations .03C, .03-1-.03-3, and .05-2; and

(3) Reside at home.

B. To be eligible for participation, a participant shall have an active plan of service. The plan of service shall:

(1) Be based on:
(a) The evaluation and recommended plan of care; and

(b) Consultation with the applicant or participant;

(2) Address the applicant's or participant's health and safety needs;

(3) Specify the services needed to safely support the participant in the community, including a plan for receiving personal assistance services in case of an emergency;

(4) Specify the provider agency providing personal assistance services; and

(5) Include the signature of the:
(a) Participant or, when applicable, the individual's representative;

(b) Supports planner; and

(c) Personal assistance provider agency listed within the plan of service.

C. A participant's eligibility for services shall be re-evaluated by the Department every 12 months, or more frequently if needed due to a significant change in the participant's condition or needs.

D. Participant eligibility shall be terminated if the participant:

(1) No longer meets the required level of care;

(2) No longer resides at home;

(3) Is without personal assistance services for 30 consecutive calendar days;

(4) Voluntarily chooses, or the participant's legal representative chooses on the participant's behalf, to disenroll from the Program;

(5) Moves to another state;

(6) Is an inpatient for 30 consecutive days or more in an institutional setting, including but not limited to a chronic hospital or nursing facility; or

(7) Dies.

Disclaimer: These regulations may not be the most recent version. Maryland 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.