<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.09.84.04" title_num="10" subtitle_num="09" chapter_num="84" heading="Participant Eligibility.">
  <paragraph num="A.">
    <text>To participate in the Program, a participant shall:</text>
    <paragraph num="(1)">
      <text>Be determined by the Department to need the level of care provided in a hospital, nursing facility, an intermediate care facility for individuals with intellectual disabilities, an institution providing psychiatric services for individuals younger than 21 years old, or an institution for mental diseases for individuals 65 years old or older;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Be eligible for Medicaid under an eligibility group defined in COMAR 10.09.24, except for Regulations .03C, .03-1—.03-3, and .05-2; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Reside at home.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>To be eligible for participation, a participant shall have an active plan of service. The plan of service shall:</text>
    <paragraph num="(1)">
      <text>Be based on:</text>
      <paragraph num="(a)">
        <text>The evaluation and recommended plan of care; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Consultation with the applicant or participant;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>Address the applicant’s or participant’s health and safety needs;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Specify the items and services needed to safely support the participant in the community, including:</text>
      <paragraph num="(a)">
        <text>A plan for receiving personal assistance services in case of an emergency; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Specific requests for items or services that substitute for human assistance;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Specify the provider agency providing personal assistance services; and</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Include the signature of the:</text>
      <paragraph num="(a)">
        <text>Participant or, when applicable, the individual’s representative;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Supports planner; and</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Personal assistance provider agency listed within the plan of service.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A participant’s eligibility for services shall be re-evaluated by the Department every 12 months, or more frequently if needed due to a significant change in the participant’s condition or needs.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Participant eligibility shall be terminated if the participant:</text>
    <paragraph num="(1)">
      <text>No longer meets the required level of care;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>No longer resides at home;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Is without services for 30 consecutive calendar days;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Voluntarily chooses, or the participant’s legal representative chooses on the participant’s behalf, to disenroll from the Program;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Moves to another state;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Is an inpatient for 30 consecutive days or more in an institutional setting, including but not limited to a chronic hospital or nursing facility; or</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Dies.</text>
    </paragraph>
  </paragraph>
</regulation>