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7 AAC 125.010. Purpose and scope of personal care services; coverage limitations. (a) The purpose of 7 AAC 125.010 — 7 AAC 125.199 is to establish standards, requirements, and procedures for the personal care services program. (b) The department will authorize and pay for personal care services that are
(1) provided to a recipient that
(A) experiences functional limitations that
(i) are the result of the recipient’s physical condition;
(ii) are confirmed by an assessment of the recipient conducted in accordance with 7 AAC 125.020; and;
(iii) cause the recipient to be unable to perform, independently or with an assistive device, the activities specified in 7 AAC 125.030;
(B) meets the application requirements of 7 AAC 125.012; and
(C) following an assessment under 7 AAC 125.020 is determined, because of the recipient’s functional limitations, to need a level of assistance specified in 7 AAC 125.020(c);
(2) administered in accordance with a service level authorization for personal care services established under 7 AAC 125.024;
(3) administered by a provider, certified in accordance with 7 AAC 125.060, that is chosen by the recipient to provide the recipient’s agency-based or consumer-directed personal care services; and
(4) provided by a personal care assistant that
(A) meets the requirements of 7 AAC 125.090; and
(B) is not the spouse of the recipient, the parent of a minor child who is the recipient, an individual with a duty to support the recipient under state law, the recipient’s representative, or the representative’s designee that was appointed in accordance with 7 AAC 125.100(c), unless an individual named in this subparagraph is a court-appointed guardian to a ward and a court authorizes the guardian under AS 13.26.311(c) to provide personal care services. (c) After review of a complete application submitted in accordance with 7 AAC 125.012, the department will not further process a recipient’s application if the department finds that the recipient
(1) does not describe a physical condition that affects the recipient’s capacity to perform activities covered under 7 AAC 125.030, or does not indicate specific activities for which the recipient needs physical assistance;