TABLE OF CONTENTS

 

CHAPTER He-E 500  SOCIAL SERVICES

          PART He-E 501  THE SOCIAL SERVICES BLOCK GRANT (TITLE XX)

                  Section He-E 501.01  Purpose and Goals

                  Section He-E 501.02  Definitions

                  Section He-E 501.03  Confidentiality

                  Section He-E 501.04  Title XX Services

                  Section He-E 501.05  Eligibility Requirements for Services

                  Section He-E 501.06  Application Requirements and Process

                  Section He-E 501.07  Determination, Notice of Eligibility, and Eligibility Period

                  Section He-E 501.08  Individual’s Responsibility to Report Changes

                  Section He-E 501.09  Redetermination of Service Eligibility

                  Section He-E 501.10  Termination of Services

                  Section He-E 501.11  Administrative Hearing and Provisions of Services During the Administrative Appeal Process

                  Section He-E 501.12  Contract Agency Requirements

                  Section He-E 501.13  Fees for Title XX Services

                  Section He-E 501.14  Wait Lists

                  Section He-E 501.15  Service Authorization

                  Section He-E 501.16  Service Records

                  Section He-E 501.17  Title XX Services Added During the Eligibility Period

                  Section He-E 501.18  Relocation and Title XX Services

                  Section He-E 501.19  Cessation of Title XX Services by a Contract Agency

                  Section He-E 501.20  Vendor Requirements

                  Section He-E 501.21  Person-Centered Plan

                  Section He-E 501.22  Adult Day Program Services

                  Section He-E 501.23  Adult Day Non-Medical Day Program Services

                  Section He-E 501.24  Adult In-Home Care

                  Section He-E 501.25  Home-Delivered Meals

                  Section He-E 501.26  Homemaker Services

                  Section He-E 501.27  Essential Services

 

          PART He-E 502  OLDER AMERICANS ACT SERVICES:  TITLE IIIB – SUPPORTIVE SERVICES, TITLE IIIC1 AND C2 – NUTRITION PROGRAM POLICIES, AND TITLE IIID – DISEASE PREVENTION AND HEALTH PROMOTION SERVICES

                  Section He-E 502.01  Purpose and Goals

                  Section He-E 502.02  Definitions

                  Section He-E 502.03  Confidentiality

                  Section He-E 502.04  Title III Services

                  Section He-E 502.05  Eligibility Requirements for Services

                  Section He-E 502.06  Service Requests and Process

                  Section He-E 502.07  Determination, Notice of Eligibility, and Eligibility Period

                  Section He-E 502.08  Redetermination of Service Eligibility

                  Section He-E 502.09  Termination of Services

                  Section He-E 502.10  Informal Resolution

                  Section He-E 502.11  Contract Agency Requirements

                  Section He-E 502.12  Voluntary Donations

                  Section He-E 502.13  Wait Lists

                  Section He-E 502.14  Service Authorization

                  Section He-E 502.15  Service Records

                  Section He-E 502.16  Cessation of Title III Services by a Contract Agency

                  Section He-E 502.17  Person-Centered Plan

                  Section He-E 502.18  Adult Day Program Services

                  Section He-E 502.19  Adult In-Home Care Services

                  Section He-E 502.20  Adult Non-Medical Day Program Services

                  Section He-E 502.21  Alcohol and Substance Abuse Prevention Services

                  Section He-E 502.22  Dental Services

                  Section He-E 502.23  Elder Abuse Counseling

                  Section He-E 502.24  Home Health Aide Services

                  Section He-E 502.25  Homemaker Services

                  Section He-E 502.26  Legal Services

                  Section He-E 502.27  Low Vision Services

                  Section He-E 502.28  Nursing Services

                  Section He-E 502.29  Nutrition Services: Congregate Meals

                  Section He-E 502.30  Nutrition Services: Home-Delivered Meals

                  Section He-E 502.31  Prevention Services

                  Section He-E 502.32  Transportation

 

          PART He-E 503  ALZHEIMER'S RESPITE CARE SERVICE

                  Section He-E 503.01  Purpose

                  Section He-E 503.02  Definitions

                  Section He-E 503.03  Eligibility

                  Section He-E 503.04  Person-Centered Respite Care Plan

                  Section He-E 503.05  ADRD Respite Care Services

                  Section He-E 503.06  Responsibilities of the Contract Agency

                  Section He-E 503.07  Responsibilities of Respite Care Providers

                  Section He-E 503.08  Wait List

 

          PART He-E 504 METHOD OF SERVICE PROVISION - EXPIRED

 

          PART He-E 505 PAYMENT FOR SERVICES - EXPIRED

 

          PART He-E 506 APPLICATION PROCESS - EXPIRED

 

          PART He-E 507 SERVICE AGREEMENT - EXPIRED

 

          PART He-E 508 PLAN OF CARE - EXPIRED

 

          PART He-E 509 SERVICE RECORD - EXPIRED

 

          PART He-E 510 MODES OF SERVICE - EXPIRED

 

          PART He-E 511 EVALUATION AND MONITORING OF SERVICE PROVISION - EXPIRED

 

          PART He-E 512 REDETERMINATION OF ELIGIBILITY FOR ADRD RESPITE CARE SERVICE - EXPIRED

 

          PART He-E 513 TRAINING - EXPIRED

 

CHAPTER He-E 600  DEAS SOCIAL SERVICES

 

          PARTS He-E 601 through He-E 604 - RESERVED

 

          PART He-E 605  STANDARD DISCLOSURE SUMMARY

                  Section He-E 605.01  Purpose

                  Section He-E 605.02  Scope

                  Section He-E 605.03  Definitions

                  Section He-E 605.04  Completion of the Standard Disclosure Summary

 

          PART He-E 606  ADULT IN-HOME CARE SERVICE - EXPIRED

                  Section He-E 606.01  Purpose

                  Section He-E 606.02  Definitions

                  Section He-E 606.03  Service Unit

                  Section He-E 606.04  Application

                  Section He-E 606.05  Eligibility Requirements

                  Section He-E 606.06  Eligibility Determination Process

                  Section He-E 606.07  Notification of Applicant

                  Section He-E 606.08  Maximum Number of Service Hours

                  Section He-E 606.09  Redetermination of Eligibility

                  Section He-E 606.10  Suspension of Service Provision

                  Section He-E 606.11  Termination of Service Provision

                  Section He-E 606.12  Provider Qualifications

                  Section He-E 606.13  Administrative Responsibilities of Contract Agencies

                  Section He-E 606.14  Service Activities

                  Section He-E 606.15  Payment For Adult In-Home Care

 

PARTS He-E 607 through He-E 610 – RESERVED

 

          PART He-E 611  CONGREGATE HOUSING SERVICES PROGRAM - EXPIRED

                  Section He-E 611.01  Purpose of Rules

                  Section He-E 611.02  Purpose of CHSP Services

                  Section He-E 611.03  Definitions

                  Section He-E 611.04  Administrative Responsibilities of DEAS

                  Section He-E 611.05  Administrative Responsibilities of the Contract Agency

                  Section He-E 611.06  Summary of CHSP Services

                  Section He-E 611.07  The CHSP Contracting Process

                  Section He-E 611.08  Renewal of Contract

                  Section He-E 611.09  Application for CHSP Services

                  Section He-E 611.10  Eligibility for CHSP Services

                  Section He-E 611.11  Service Plan

                  Section He-E 611.12  Fees

                  Section He-E 611.13  Service Record

                  Section He-E 611.14  Monitoring of Service Plan

                  Section He-E 611.15  Redetermination of Eligibility

                  Section He-E 611.16  Termination of CHSP Services

                  Section He-E 611.17  Adult Group Day Care

                  Section He-E 611.18  Case Management

                  Section He-E 611.19  Health Maintenance

                  Section He-E 611.20  Homemaker Assistance

                  Section He-E 611.21  Meals

                  Section He-E 611.22  Personal Assistance

                  Section He-E 611.23  Personal Emergency Response System

                  Section He-E 611.24  Transportation

 

CHAPTER He-E 700  ADULT PROTECTION SERVICES PROGRAM

          PART He-E 701  OVERVIEW

                  Section He-E 701.01  Purpose

                  Section He-E 701.02  Definitions

                  Section He-E 701.03  Protective Reports

                  Section He-E 701.04  Protective Investigation Requirements

                  Section He-E 701.05  Dispositions

                  Section He-E 701.06  Interviews

                  Section He-E 701.07  Investigation Responsibilities and the Determination

                  Section He-E 701.08  Purpose of a Review

                  Section He-E 701.09  Registry Eligible Alleged Perpetrator Review Prior to Completion of the Investigation

                  Section He-E 701.10  Notification Following a Review of a Registry Eligible Alleged Perpetrator

                  Section He-E 701.11  Retention of Protective Investigation Material

                  Section He-E 701.12  Notification Following Investigation

                  Section He-E 701.13  Purpose of Reconsideration

                  Section He-E 701.14  Request for Non-Registry Eligible Reconsideration

                  Section He-E 701.15  Notification Following a Non-Registry Eligible Reconsideration

                  Section He-E 701.16  Appeal Rights

                  Section He-E 701.17  Opening a Protective Services Program Case

                  Section He-E 701.18  Protective Services

                  Section He-E 701.19  Role of the BEAS in the Guardianship Process

                  Section He-E 701.20  Guardianship Hearing

                  Section He-E 701.21  Releasing Information

                  Section He-E 701.22  Who May Receive Information

                  Section He-E 701.23  The BEAS State Registry

 

          PART He-E 720  BUREAU OF ELDERLY AND ADULT SERVICES STATE REGISTRY

                  Section He-E 720.01  Purpose

                  Section He-E 720.02  Scope

                  Section He-E 720.03  Definitions

                  Section He-E 720.04  State Registry

                  Section He-E 720.05  Waiver for Employment

                  Section He-E 720.06  Confidentiality and Release of Information

 

CHAPTER He-E 800  MEDICAL ASSISTANCE

          PART He-E 801  CHOICES FOR INDEPENDENCE PROGRAM

                  Section He-E 801.01  Purpose

                  Section He-E 801.02  Definitions

                  Section He-E 801.03  Eligibility

                  Section He-E 801.04  Eligibility Determination

                  Section He-E 801.05  Development of the Comprehensive Care Plan

                  Section He-E 801.06  Service Authorization

                  Section He-E 801.07  Redetermination of Eligibility and Service Authorization

                  Section He-E 801.08  Request for Clinical Redetermination After Clinical Denial

                  Section He-E 801.09  Cost Control Methodology

                  Section He-E 801.10  Commissioner Prior Approval Process

                  Section He-E 801.11  Post-Eligibility Computation of Cost of Care for CFI Services

                  Section He-E 801.12  Covered Services and Requirements of Service Provision

                  Section He-E 801.13  Non-Covered Services

                  Section He-E 801.14  Adult Family Care

                  Section He-E 801.15  Adult In-Home Care Services

                  Section He-E 801.16  Adult Medical Day Services

                  Section He-E 801.17  Environmental Accessibility Adaptations

                  Section He-E 801.18  Home-Delivered Meals Services

                  Section He-E 801.19  Home Health Aide Services

                  Section He-E 801.20  Homemaker Services

                  Section He-E 801.21  Non-Medical Transportation Services

                  Section He-E 801.22  Personal Care Services

                  Section He-E 801.23  Personal Emergency Response Systems Services

                  Section He-E 801.24  Residential Care Services

                  Section He-E 801.25  Respite Care Services

                  Section He-E 801.26  Skilled Nursing Services

                  Section He-E 801.27  Specialized Medical Equipment Services

                  Section He-E 801.28  Supportive Housing Services

                  Section He-E 801.29  Provider Participation

                  Section He-E 801.30  Required Documentation

                  Section He-E 801.31  Payment for Services

                  Section He-E 801.32  Utilization Review and Control

                  Section He-E 801.33  Third Party Liability

                  Section He-E 801.34  Waivers

 

          PART He-E 802  NURSING FACILITY SERVICES

                  Section He-E 802.01  Definitions

                  Section He-E 802.02  Provider Participation

                  Section He-E 802.03  Eligibility

                  Section He-E 802.04  Eligibility Criteria for Atypical Services

                  Section He-E 802.05  Clinical Eligibility Determination for NF Services

                  Section He-E 802.06  Request for Clinical Redetermination After Clinical Denial

                  Section He-E 802.07  Utilization Review

                  Section He-E 802.08  Covered Services

                  Section He-E 802.09  Covered Atypical Services

                  Section He-E 802.10  Non-Covered Services

                  Section He-E 802.11  Residents’ Rights

                  Section He-E 802.12  Plan of Care

                  Section He-E 802.13  Room Changes Within the Facility

                  Section He-E 802.14  Personal Accounts Belonging to Residents

                  Section He-E 802.15  Temporary Absence from the Nursing Facility

                  Section He-E 802.16  Transfer or Discharge of Residents

                  Section He-E 802.17  Appealing Transfers or Discharges

                  Section He-E 802.18  Required Forms

 

          PART He-E 803  ADULT MEDICAL DAY CARE SERVICES

                  Section He-E 803.01  Purpose

                  Section He-E 803.02  Definitions

                  Section He-E 803.03  Adult Medical Day Program Requirements

                  Section He-E 803.04  Eligibility Requirements to Receive Adult Medical Day Services

                  Section He-E 803.05  Notice to the Participant

                  Section He-E 803.06  Adult Medical Day Services

                  Section He-E 803.07  Required Documentation

                  Section He-E 803.08  Payment for Services

                  Section He-E 803.09  Third Party Liability

                  Section He-E 803.10  Utilization Review

 

          PART He-E 804  NURSING ASSISTANT TRAINING REIMBURSEMENT

                  Section He-E 804.01  Definitions

                  Section He-E 804.02  Requirements, Conditions and Limitations

                  Section He-E 804.03  Application Requirements

                  Section He-H 804.04  Payment

 

          PART He-E 805  TARGETED CASE MANAGEMENT SERVICES

                  Section He-E 805.01  Purpose

                  Section He-E 805.02  Definitions

                  Section He-E 805.03  Eligibility

                  Section He-E 805.04  Provider Agency Requirements

                  Section He-E 805.05  Required Case Management Services

                  Section He-E 805.06  Qualification Requirements for Case Managers

                  Section He-E 805.07  Participant Selection of Case Management Agency

                  Section He-E 805.08  Payment for Services

                  Section He-E 805.09  Third Party Liability

                  Section He-E 805.10  Quality Management

 

          PART He-E 806  NURSING FACILITY REIMBURSEMENT

                  Section He-E 806.01  Definitions

                  Section He-E 806.02  Annual Cost Reports

                  Section He-E 806.03  Record Keeping Requirements

                  Section He-E 806.04  Accounting Principles for Annual Cost Reports

                  Section He-E 806.05  Reimbursement Based on Actual Allowable Costs

                  Section He-E 806.06  Routine Services

                  Section He-E 806.07  Physician Services, Psychologist Services and Pharmacist Consultant Services

                  Section He-E 806.08  Ancillary Services

                  Section He-E 806.09  Drugs and Institutional Pharmacy Costs

                  Section He-E 806.10  Barber and Beauty Services

                  Section He-E 806.11  Motor Vehicle Expense

                  Section He-E 806.12  Depreciation of Equipment and Property

                  Section He-E 806.13  Leased Facility and Equipment

                  Section He-E 806.14  Administrator Salaries

                  Section He-E 806.15  Assistant Administrator Salaries

                  Section He-E 806.16  Social Workers

                  Section He-E 806.17  Owners, Operators, or Their Relatives

                  Section He-E 806.18  Non-Paid Workers

                  Section He-E 806.19  Administrative Expenses and Administrator Duties

                  Section He-E 806.20  General County Government Costs

                  Section He-E 806.21  Approved Educational Activities

                  Section He-E 806.22  Research Costs

                  Section He-E 806.23  Advertising Expense

                  Section He-E 806.24  Home Office Costs

                  Section He-E 806.25  Services to Individuals Other Than Residents

                  Section He-E 806.26  Other Non-Allowable Costs

                  Section He-E 806.27  Interest Expenses

                  Section He-E 806.28  Discounts, Trade Discounts and Refunds of Expenses

                  Section He-E 806.29  Bad Debts, Charity and Courtesy Allowances

                  Section He-E 806.30  Audit Procedures

                  Section He-E 806.31  Methodology for Determining the Per Diem Rate

                  Section He-E 806.32  Methodology for Determining the Per Diem Rate for New NF Providers, When Reconstruction Occurs, and When a Change in Ownership Occurs

                  Section He-E 806.33  Per Diem Rates and Payment for Nursing Care

                  Section He-E 806.34  Medicare Provider Reimbursement Manual

                  Section He-E 806.35  Rate Setting and Payment Limitations For General Nursing Facility Care

                  Section He-E 806.36  Rate Setting and Payment Limitations for Atypical Nursing Care

                  Section He-E 806.37  Reimbursement for Out-of-State Nursing Care

                  Section He-E 806.38  Bed Days

                  Section He-E 806.39  Maintenance of Resident Funds

                  Section He-E 806.40  Reconsiderations for Cost Report Adjustments

                  Section He-E 806.41  Administrative Appeals

                  Section He-E 806.42  Incorrect Payments

 

          PART He-E 807  NURSING FACILITY ENFORCEMENT REMEDIES - EXPIRED