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(a) Personal care services may be provided only to a recipient who is living in the recipient's personal residence and meets the requirements of this section.
(b) The following living situations are specifically excluded as a recipient's personal residence for the purposes of Medicaid reimbursement for personal care services:
(1) a licensed skilled or intermediate care facility or hospital;
(2) a licensed intermediate care facility for the mentally retarded;
(3) a foster home licensed under AS 47.32, except for recipients in a licensed foster home who are receiving residential habilitation services under 7 AAC 43.1000 - 7 AAC 43.1110;
(4) an assisted living home licensed under AS 47.32 and AS 47.33;
(5) a residence where personal care services are already paid in a contractual agreement;
(6) an acute care hospital.
(c) The department will not pay for transportation, room, or board for a personal care assistant to travel with a recipient away from the recipient's municipality of residence. However, the department will pay for a recipient's approved services for up to two weeks annually while the recipient is away from the recipient's municipality of residence, unless additional time is required based on documented medical necessity or for education not available in this state, if
(1) the department authorizes the travel before it begins; and
(2) as specified in the recipient's PCAT, the need cannot be met during the travel period by any means other than by being accompanied by a personal care assistant.
(d) Repealed 4/1/2006.
(e) Repealed 4/1/2006.
(f) In this section, "personal residence" means the dwelling that the recipient considers to be the recipient's established or principal home and to which, if absent, the recipient intends to return. A "personal residence" can be real or personal property, fixed or mobile, and located on land or water, if the living conditions are appropriate for the care of the recipient, including adequate sanitary conditions for hand washing and waste disposal.
History: Eff. 11/6/86, Register 100; am 6/27/92, Register 122; am 7/1/95, Register 134; readopt 8/7/96, Register 139; am 3/1/98, Register 145; 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
Editor's note: Effective 8/7/96, Register 139, the Department of Health and Social Services readopted 7 AAC 43.760 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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Last modified 7/05/2006