For purposes of this section, minimum needs requirements means: (iv) Individuals must meet minimum needs requirements in accordance with state statute to be eligible for personal care services. (iii) Personal care services, including continuous personal care services and live-in 24-hour personal care services, shall not be authorized to the extent that the social services district or Medicaid managed care organization determines that any of the services or supports identified in subclauses (11) through (13) of subdivision (b)(2)(iii)(a) of this section are available and appropriate to meet the individual’s needs and are cost-effective if provided instead of personal care services. The local social services department may be the outside agency. (c) supervision or direction is provided on an interim or part-time basis as part of a plan of care in which the responsibility for making choices about activities of daily living is assumed by an outside agency or other formal organization. (b) supervision or direction is provided on an interim or part-time basis as part of a plan of care in which the responsibility for making choices about activities of daily living is assumed by a self-directing individual not living within the same household or (a) supervision or direction is provided on an interim or part-time basis as part of a plan of care in which the responsibility for making choices about activities of daily living is assumed by a self-directing individual living within the same household or Patients who are nonself-directing, and who require continuous supervision and direction for making choices about activities of daily living shall not receive personal care services, except under the following conditions: (ii) The patient shall be self-directing, which shall mean that he/she is capable of making choices about his/her activities of daily living, understanding the impact of the choice and assuming responsibility for the results of the choice.
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(2) the condition is such that a physically disabled or frail elderly individual does not need professional care but does require assistance in the home to prevent a health or safety crisis from developing.
(c)(1) the condition is such that a physically disabled individual is in need of routine supportive assistance and does not need skilled professional care in the home or (b) the condition does not require frequent medical or nursing judgment to determine changes in the patient's plan of care and (a) the condition is not expected to exhibit sudden deterioration or improvement and (i) The patient's medical condition shall be stable, which shall be defined as follows: (3) Personal care services, as defined in this section, can be provided only if the individual meets applicable minimum needs requirements described in subparagraph (iv) of this paragraph, and the social services district or Medicaid managed care organization reasonably expects that the individual’s health and safety in the home can be maintained by the provision of such services, as determined in accordance with this section. (2) Continuous personal care services means the provision of uninterrupted care, by more than one personal care aide, for more than 16 hours in a calendar day for a patient who, because of the patient’s medical condition, needs assistance during such calendar day with toileting, walking, transferring, turning and positioning, or feeding and needs assistance with such frequency that a live-in 24-hour personal care aide would be unlikely to obtain, on a regular basis, five hours daily of uninterrupted sleep during the aide’s eight hour period of sleep. Such services must be medically necessary for maintaining an individual’s health and safety in his or her own home, as determined by the social services district or Medicaid managed care organization in accordance with this section ordered by a qualified independent practitioner based on an assessment of the individual’s needs and of the appropriateness and cost-effectiveness of services specified in subparagraph (b)(2)(iii) of this section provided by a qualified person in accordance with a plan of care and supervised by a registered professional nurse.
(1) Personal care services means assistance with nutritional and environmental support functions and personal care functions, as specified in clauses (5)(i)(a) and (5)(ii)(a) of this subdivision.
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