Sec. 10.09.20.13. Limitations

A. The Department shall establish a budget for personal assistance services that may be included in the participant’s plan of service, based on each participant’s assessed need.

B. The Program does not cover the following services:

(1) Service primarily for the purpose of housekeeping unrelated to the participant’s activities of daily living, such as:

(a) Cleaning of the floor and furniture in areas not occupied by the participant;

(b) Laundry other than that incidental to the care of the participant; and

(c) Shopping for groceries or household items unless in the company of the participant;

(2) Meals delivered to the home;

(3) Services provided by providers not approved for participation by the Department;

(4) Expenses incurred while escorting participants:

(a) To obtain medical diagnosis or treatment;

(b) To or from the participant’s workplace; or

(c) For participation in social or community activities;

(5) Expenses related to room and board for either the participant or the worker; or

(6) Personal assistance services provided outside the State for more than 30 days per calendar year.

C. Payment for supports planning and nurse monitoring services shall be limited to direct services to the participant and may not be made for:

(1) Administrative overhead;

(2) Travel;

(3) Internal quality monitoring activities;

(4) Staff supervision, training, or consultation; or

(5) Services rendered by an individual supports planner or nurse monitor in excess of 7 hours per day unless pre-authorized by the Department in writing.