1. (1) The cost for services to individuals who qualify for home and community-based care under the waiver program will not exceed a cap of $58,000 per client per year with the exception that crisis intervention services are not included in the cap. Further, the waiver program will not exceed on an average per capita basis, the total expenditures that would be incurred for such individuals if home and community-based services were not available.

Author: Riyyah James, Associate Director, Specialized Waiver Unit, LTC Healthcare Reform Development Division

Statutory Authority: Social Security Act §1915(c); 42 C.F.R. −Section 441, Subpart G Home and Community-Based Services: Waiver Requirements.

Editor’s Note: Entire chapter was repealed as per certification filed December 7, 1995; effective January 11, 1996.

History: New Rule: Filed November 21, 2002; effective December 26, 2002. Amended: Filed January 7, 2009; effective February 11, 2009. Amended: Published June 30, 2025; effective August 14, 2025.