Most people can meet their needs with the hours in their service group. Your services coordinator/personal agent will help you plan how to meet your needs and live the life you want with the hours you have in your service group.
Some people will need more hours than are in their service group. If you can’t meet your needs with the hours in your service group:
Your services coordinator/personal agent has 14 days to complete your request after you ask for an exception. You will get a decision within 45 days from when your exception is received.
There are three main reasons you can get an exception.
1. Intermittent needs
You have a need that happens throughout the day. You need a lot of help to meet this need. Support for this need cannot be scheduled. You cannot know when you will need support. You cannot meet your needs with the number of hours in your service group.
If this need is not met when it happens, you would probably get hurt or sick.
If you need a lot of help with one of these things, you might have intermittent needs:
- Using the bathroom or elimination support
- Getting around your home safely
- Getting out of your bed, out of chairs, or on and off the toilet safely
- Seizures that happen frequently or are dangerous
- Using insulin for diabetes on a slideing scale
- Suctioning to help you breath or stay healthy
- Using a ventilator or CPAP/BiPAP
- Have a challenging behavior that would hurt you or others
2. Need takes longer than usual
You have a need that takes longer to support than other people who have similar needs. You cannot get all of your needs met. The extra time to meet that need is more than the number of hours in your service group. If it takes a lot of time to meet these needs, you might have a need that takes longer than usual.
- Using the bathroom or elimination support
- Getting around your home and community
- Getting out of your bed, out of chairs, or on and off the toilet safely
- Getting dressed
- Taking baths or showers
- Completing grooming like shaving, brushing teeth, and styling hair
- Eating meals and snacks
- A health need that takes a lot of time
3. Social isolation
You are not able to go out into the community because your needs use all of the hours. You need help when you go out in the community. You cannot go into the community at least 20 hours a week to do shopping, errands and other activities.
When you ask for an exception: