Sec. 14.11.01.04. Limitations on Service and Participation in the Program

A. The Program Director shall limit Program participation to the number of participants whom the Program's budget can serve. If sufficient funds are not available, the Department may limit the rate of payment under the sliding reimbursement scale.

B. The Program Director shall limit Program participation to achieve the following demographic:

(1) At least 50 percent of the participants shall be:

(a) Self-employed or competitively employed with compensation;

(b) Actively seeking employment and reasonably be expected to become employed within 6 months of the date of application approval, which the Program Director may extend an additional 6 months; or

(c) Attending an institution of postsecondary, higher education, or apprenticeship training program; and

(2) Not more than 50 percent of the participants shall be:

(a) At risk of placement in a nursing home, as certified by the attending physician, if attendant care services are not received in the community; or

(b) Residents of a nursing facility or similar institution who are seeking to transition into the community and will be capable of living in the community if attendant care services are received.

C. The Program Director shall seek to achieve the demographic in §B absent a limited or situational waiver from the Secretary.

D. Notwithstanding the above, an applicant found ineligible or properly disenrolled from the Program shall be required to observe a waiting period prior to reapplication of not less than:

(1) 1 year for reason of disability or financial eligibility; or

(2) 3 years upon a finding of fraud or misuse of program funds.

E. Applicants to the Program shall be encouraged to complete an application for medical assistance and utilize personal care services under the following programs, if applicable:

(1) Medical Assistance Personal Care Program;

(2) Community First Choice Program; or

(3) a Home and Community Based Waiver.