Eligibility for Behavioral Health Personal Care Attendant Services
(1)To be eligible for Behavioral Health personal care attendant services, an individual shall:
(a)Demonstrate the need for assistance from a qualified provider due to a disabling behavioral health condition with personal care services and meet the eligibility criteria described in this rule;
(b)Be a current recipient of a Medicaid OHP full benefit package.
(2)An individual is not eligible to receive Behavioral Health personal care attendant services if:
(a)The individual is receiving personal care services from a licensed 24-hour residential services program (such as an adult foster home, residential treatment home, or residential treatment facility);
(b)The individual is in a prison, hospital, sub-acute care facility, nursing facility, or other medical institution;
(c)The individual’s assessed service needs are being met under other Medicaid-funded home and community-based service options of the individual’s choosing.
(3)Behavioral health personal care attendant services are not intended to replace routine care commonly needed by an infant or child typically provided by the infant’s or child’s parent.
(4)Behavioral health personal care attendant services may not be used to replace other non-Medicaid governmental services.
(5)The Authority may close the eligibility and authorization for Behavioral Health personal care attendant services if an individual fails to:
(a)Employ a provider that meets the requirements in this rule;
(b)Receive personal care from a qualified provider paid by the Authority for 30 continuous calendar days or longer.
(6)Behavioral health personal care attendant services may not duplicate other Medicaid services.
(7)Individuals eligible for Behavioral Health personal care attendant services as described shall apply through the local community mental health program or agency contracted with AMH.
Rule 410-172-0790 — Eligibility for Behavioral Health Personal Care Attendant Services,