ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations

What this rule requires your agency to do

• 1Instrumental activities of daily living may not exceed one-third of the total time allocated per two-week period, or a maximum of six hours per two-week period, whichever is less, and are authorized only when medical/functional need for ADL assistance is demonstrated ((3)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)
• 2PAS may not include skilled services requiring professional medical training unless permitted under 37-8-103, MCA, or ARM 24.159.1616 ((8)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)
• 3PAS provided by an immediate family member (spouse, or natural/adoptive/foster parent of a minor child) are not reimbursable ((10)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)
• 4PAS may not be provided in group home settings unless prior authorized by the department ((6)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)
• 5PAS, except for medical escort, shopping, and laundry, must be provided in the member's home ((5)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)
• 6To qualify for PAS a person must be Medicaid eligible and demonstrate a medical and functional need for assistance with activities of daily living ((1)(a)-(b)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)
• 7Medical escort services are authorized only when directly related to the member's medical/functional need en route to or at a Medicaid-reimbursable medical service, and only when a family member or caregiver is unable to accompany the member ((4)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)
• 8PAS must be delivered by a PAS personal care attendant employed by an enrolled Medicaid provider meeting department criteria under ARM 37.40.1126 and 37.40.1127 ((11)).(ARM 37.40.1111 — Agency-Based and Self-Directed Personal Assistance Services: Eligibility, Services Provided, and Limitations)