Application process

(a) The application process consists of: (1) a financial eligibility determination by the Department in accordance with the eligibility standards for participation in the Department's Title XIX medical assistance program that are contained in the Uniform Policy Manual; (2) a preliminary determination by central office administrative staff as to the consumer's needs and financial eligibility based on a review of the information provided on the \"Personal Care Assistance Request\" form; and (3) a referral to the appropriate regional office when an assessment for services is indicated to determine if a cost effective plan of services can be developed to provide services to the person in the community. (b) A determination as to whether the consumer needs services without which the consumer would otherwise require institutionalization shall be made by non-medical Department staff based upon an assessment conducted in collaboration with the consumer. (c) A determination of the personal care assistance services required by the consumer shall consist of: (1) completion of an assessment by the department; and (2) development of a personal care services plan by the department in consultation with the consumer. The plan shall be reviewed annually or more often when a change in the consumer's condition has occurred or when other circumstances may warrant; and (3) a determination documented on a cost of care plan of whether the personal care assistance services combined with all other state administered services are cost effective; and (4) authorization for personal care assistance services in the community if appropriate and cost effective. (d) Eligibility shall be redetermined annually for each recipient.