7 AAC 43.750. Purpose and scope of personal care services

(a) The purpose of personal care services is to enable an individual, of any age, whose needs would otherwise result in placement in an acute care hospital or nursing facility or loss of that individual's employment solely related to activities of daily living (ADL) to remain at home or prevent job loss.

(b) Personal care services must be provided by either an agency-based or consumer-directed program and must

(1) be provided to an enrolled Medicaid recipient;

(2) be approved in the recipient's PCAT service plan as provided in 7 AAC 43.751;

(3) receive prior authorization from the department before service is provided; and

(4) be provided by an individual who is not an immediate family member of the recipient or a legal representative and who is a personal care assistant

(A) selected by the recipient and employed by a personal care agency enrolled in the consumer-directed program under 7 AAC 43.786; or

(B) employed by a personal care agency enrolled in the agency-based program under 7 AAC 43.787; and

(5) be supported by a form that

(A) is provided by the department;

(B) identifies the recipient's diagnosis; and

(C) is completed by a physician, a physician assistant, or an advanced nurse practitioner, who is licensed in this state or practicing or employed in a federally or tribally owned or leased health facility in this state.

(c) The department may authorize personal care services for up to a 12-month period. Reauthorization by the department for personal care services will be done on an annual basis and based upon a PCAT.

History: Eff. 11/6/86, Register 100; am 6/27/92, Register 122; readopt 8/7/96, Register 139; am 10/21/98, Register 148; am 10/1/2001, Register 159; am 1/1/2002, Register 160; am 6/19/2004, Register 170; am 4/1/2006, Register 177

Authority: AS 47.05.010

AS 47.07.030

Editor's note: The form referenced in 7 AAC 43.750(b) (5) may be obtained from the Department of Health and Social Services, Division of Senior and Disabilities Services, 3601 C Street, Suite 310, Anchorage, Alaska 99503.

Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.750 in its entirety, without change, under AS 47.05 and AS 47.07. Executive Order No. 72 transferred certain rate-setting authority to the department.

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