LAC 50:XV.12905. Eligibility Criteria

A. Personal care services shall be available to recipients who are 65 years of age or older, or 21 years of age or older and have a disability. Persons with a disability must meet the disability criteria established by the Social Security Administration. B. Recipients must meet the eligibility criteria established by OAAS or its designee. Personal care services are medically necessary if the recipient: 1. meets the medical standards for admission to a nursing facility and requires limited assistance with at least one or more activities of daily living; 2. is able, either independently or through a responsible representative, to participate in his/her care and direct the services provided by the personal care services worker. A responsible representative is defined as the person designated by the recipient to act on his/her behalf in the process of accessing and/or maintaining personal care services; and 3. faces a substantial possibility of deterioration in mental or physical condition or functioning if either home and community-based services or nursing facility services are not provided in less than 120 days. This criterion is considered met if: a. the recipient is in a nursing facility and could be discharged if community-based services were available; b. is likely to require nursing facility admission within the next 120 days; or c. has a primary caregiver who has a disability or is over the age of 70. C. Persons designated as the responsible representative of an individual receiving services under LT-PCS may not be the paid direct service worker of the individual they are representing.