Section 7 AAC 125.010 - Purpose and scope of personal care services; coverage limitations(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.Eff. 2/1/2010, Register 193; am 3/1/2011, Register 197; am 1/26/2012, Register 201; am 7/22/2017,Register 223, October 2017Authority:AS 47.05.010
AS 47.07.030