(1) Self-directed personal assistance services may be provided up to but not more than 40 hours of attendant service per week per recipient as defined by the plan of care. The department may, within its discretion, authorize additional hours in excess of this limit. Any services exceeding this limit must be prior authorized by the department. Prior authorization for excess hours may be authorized if additional assistance is required for:
(a) a period of time not to exceed three months and as the result of an acute medical episode;
(b) a period of time not to exceed three months and to prevent institutionalization during the absence of the normal caregiver; or
(c) a period of time not to exceed three months and during a post-hospitalization period.
(2) The base reimbursement for self-directed personal assistance services is $3.68 per 15-minute unit of service. Reimbursement above this amount is conditional and negotiated with the department. The rate is for units of attendant and nurse supervision service.
(a) A unit of attendant service is 15 minutes and means an on-site visit specific to a recipient.
(b) A unit of nurse supervision service is 15 minutes and means an on-site recipient visit and related activity specific to that recipient.
(3) A person retained personally by a recipient to deliver self-directed personal assistance services is not a provider of self-directed personal assistance services for the purpose of this rule and therefore may not be reimbursed for self-directed personal assistance services by the department.
(4) Reimbursement is not available for self-directed personal assistance provided by immediate family members.