<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".13" citation="COMAR 10.09.20.13" title_num="10" subtitle_num="09" chapter_num="20" heading="Limitations.">
  <paragraph num="A.">
    <text>The Department shall establish a budget for personal assistance services that may be included in the participant’s plan of service, based on each participant’s assessed need.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The Program does not cover the following services:</text>
    <paragraph num="(1)">
      <text>Service primarily for the purpose of housekeeping unrelated to the participant’s activities of daily living, such as:</text>
      <paragraph num="(a)">
        <text>Cleaning of the floor and furniture in areas not occupied by the participant;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Laundry other than that incidental to the care of the participant; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Shopping for groceries or household items unless in the company of the participant;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Meals delivered to the home;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Services provided by providers not approved for participation by the Department;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Expenses incurred while escorting participants:</text>
      <paragraph num="(a)">
        <text>To obtain medical diagnosis or treatment;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>To or from the participant’s workplace; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>For participation in social or community activities;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>Expenses related to room and board for either the participant or the worker; or</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Personal assistance services provided outside the State for more than 30 days per calendar year.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Payment for supports planning and nurse monitoring services shall be limited to direct services to the participant and may not be made for:</text>
    <paragraph num="(1)">
      <text>Administrative overhead;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Travel;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Internal quality monitoring activities;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Staff supervision, training, or consultation; or</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Services rendered by an individual supports planner or nurse monitor in excess of 7 hours per day unless pre-authorized by the Department in writing.</text>
    </paragraph>
  </paragraph>
</regulation>