Section 684.70  Service Planning Limitations

a)         For customers served under a Medicaid Waiver program administered by DHS-DRS, all services listed on the Service Plan must be necessary to meet an unmet care need of the individual or, for respite cases, to provide relief to the caregiver, and must be within the SCM for the DON score attained by the customer as a result of the determination or redetermination of eligibility.

b)         Customers who cannot be served under the HSP waiver programs' SCM and who meet the criteria established by HFS, may be eligible for an exceptional care rate (89 Ill. Adm. Code 140.569(a)(2)).  The monthly cost of these services provided through the Home Services Program shall not exceed the exceptional care rate.

(Source:  Amended at 31 Ill. Reg. 433, effective December 29, 2006)