Home Health Aide

(A) Conditions of Payment. (1) Home health aide services are covered when the participant requires a range of assistance with ADLs and IADLS related to independent living and when the home health aide service enables the participant to function with greater independence within the participant’s home and community. (2) Home health aide services are covered if the home health aide receives supervision by a registered nurse with a current license by the Massachusetts Board of Registration in Nursing, and if services are expected to exceed the amount, duration, or scope of home health aide services provided under the state plan. (B) Nonpayable Services. (1) Homemaker, home health aide, personal care, adult companion, individual support and community habilitation, and supportive home care aide services, in combination are limited to no more than 84 hours per week. The MassHealth agency or its designee may grant exceptions to the limit on a 90-day basis in order to maintain a participant’s tenure in the community, to provide respite to a caregiver who lives with the participant, to facilitate transitions to a community setting, to ensure that a participant at risk for medical facility admission is able to remain in the community, or to otherwise stabilize a participant’s medical condition. Exceptions may also be granted for participants awaiting transition to a residential waiver. Exceptions to the 84 hour per week limit must be included in the participant’s waiver plan of care.