Section 29-9711. ADHP PLAN OF CARE

 

9711.1An ADHP plan of care shall:  

 

(a)Be completed within fourteen (14) business days of the participant’s admission to the ADHP; 

 

(b)Be developed in consultation with the participant, or the participant’s representative and the participant’s Support Team;

 

(c)Incorporate the participant’s person-centered service plan and take into account the assessment conducted in accordance with Subsection 9709.3, as well as any other information relevant to a comprehensive understanding of the participant’s clinical and support needs;

 

(d)Specify how the ADHP will provide the services and supports that will assist the participant to achieve his or her identified goals as identified in the person-centered service plan;

 

(e) Reflect the participant’s preferences as to the types and scheduling of ADHP services to be provided as identified in the participant’s person-centered service plan ;

 

(f) Indicate any other supportive services that the participant is receiving away from the ADHP such as homemaker services, other  therapies and services; and

 

(g)Include efforts to coordinate services with other health care providers, to prevent a gap of service delivery in the event of unscheduled absences from the ADHP program.

 

9711.2The ADHP plan of care shall be reviewed by the support team and the participant or the participant’s representative at least once every ninety (90) days, and whenever there has been a significant change in the participant’s conditions, and shall be updated or modified as needed.

 

9711.3The initial ADHP plan of care, as well as any updates or changes made, shall be approved and signed by the participant and/or the participant’s representative, the registered nurse in charge of the participant’s care and all support team members who participate in its development.

 

9711.4For participants receiving a combination of ADHP and personal care aid services, any change requests to a participant’s approved schedule or services must be communicated and coordinated between the ADHP and Home Care Agency providers.  The change requests must be submitted to DHCF on the first (1st) and fifteenth (15th) day of every month in order for the prior authorization to be issued and changes to be in effect on the first (1st) day of the following month. Exceptions will be considerered for emergencies consisting of a sudden or unexpected change in a person’s health care needs that necessitates a change.

9711.5A support team includes the clinical and non-clinical staff who shall be responsible for providing or arranging for services and supports for the participant. At minimum, for purposes of developing an ADHP  plan of care for each participant, the Support Team shall include:

 

(a)  The Registered Nurse;

 

(b) The Social Worker;

 

(c) The Dietician/Nutritionist;

(d) The Activities Coordinator;

 

(e) The direct support professional(s) who worked directly with the  participant; and

 

(f) Any other person chosen by the participant.

 

authority

An Act to enable the District of Columbia to receive federal financial assistance under Title XIX of the Social Security Act for a medical assistance program, and for other purposes, approved December 27, 1967 (81 Stat. 744; D.C. Official Code § 1-307.02 (2014 Repl.)), and Section 6(6) of the Department of Health Care Finance Establishment Act of 2007, effective February 27, 2008 (D.C. Law 17-109; D.C. Official Code § 7-771.05(6) (2012 Repl.)).

source

Final Rulemaking published at 63 DCR 1031 (January 29, 2016).