The purpose of the proposed rule amendments is to update Rule Chapter 58D-1, F.A.C., to reflect current statutory language, policies, and procedures; to add language regarding confidentiality and disclosure of information; and to delete references ...

DEPARTMENT OF ELDER AFFAIRS
Alzheimer’s Disease Initiative

RULE NO: RULE TITLE
58D-1.001: Purpose
58D-1.002: Definitions
58D-1.003: Eligibility
58D-1.004: Program Components
58D-1.005: Program Administration
58D-1.006: Service Provider Responsibilities
58D-1.007: Program Forms
58D-1.009: Confidentiality and Disclosure of Information
PURPOSE AND EFFECT: The purpose of the proposed rule amendments is to update Rule Chapter 58D-1, F.A.C., to reflect current statutory language, policies, and procedures; to add language regarding confidentiality and disclosure of information; and to delete references to the Department of Elder Affairs Programs and Services Manual, July 1994 and revised November 1994, which is incorporated by reference in this rule chapter.
SUMMARY: The proposed rule amendments include the purpose of the Alzheimer’s Disease Initiative (ADI); definitions used in this rule chapter; eligibility for the ADI program; ADI program components; administration of the ADI program; service provider requirements under the ADI program; program forms; and the addition of language regarding confidentiality, the disclosure of information and record retention procedures.
SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS: No Statement of Estimated Regulatory Cost was prepared.
Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.
SPECIFIC AUTHORITY: 430.08 FS.
LAW IMPLEMENTED: 430.501-.504 FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE,TIME AND PLACE SHOWN BELOW(IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):
DATE AND TIME: June 18, 2008, 9:30 a.m. – 11:00 a.m., EST.
PLACE: Department of Elder Affairs, 4040 Esplanade Way, Conference Room 225F, Tallahassee, FL 32399-7000
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 72 hours before the workshop/meeting by contacting: Jim Crochet, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32399-7000; Telephone number [phone]; E-mail address: [e-mail]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Jim Crochet, Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, FL 32399-7000; Telephone number [phone]; E-mail address: [e-mail]. A copy of the proposed rule amendments is included on the DOEA Web site at http://elderaffairs.state.fl.us/ under the heading DOEA Rulemaking, Administration of the Alzheimer’s Disease Initiative.

THE FULL TEXT OF THE PROPOSED RULE IS:

58D-1.001 Purpose.

The purpose of these rules is to provide a framework by which the Department of Elder Affairs will administer Sections 430.501 410.401 through 430.504 410.403, F.S., the Alzheimer’s Disease Initiative. The Alzheimer’s Disease Initiative (hereinafter ADI) was established by the Legislature in 1985 to provide services and training to address the special needs of individuals suffering from Alzheimer’s disease and related memory disorders and their caregivers. It also provides for research relating to the cause, prevention, management, and treatment of the disease.

Specific Authority 410.401(3), 430.08 FS. Law Implemented 410.401-.403, 430.04(6), 430.501, 430.502, 430.503, 430.504 FS., Ch. 91-115, Laws of Florida, s.10. History–New 3-28-95, Amended ________.

 

58D-1.002 Definitions.

The following terms are defined in this rule:

(1) Alzheimer’s Disease: A progressive brain syndrome with insidious onset which results in impaired memory, language and cognitive dysfunction during an alert state;, behavioral changes;, and a decline in the ability to perform activities of daily living. Alzheimer’s disease can ultimately result in death. The term as used in these rules includes other “related memory disorders”.

(1)(2) Alzheimer’s Disease Advisory Committee: The committee created pursuant to Section 430.502(2), (3) 410.401(2), F.S., to advise the dDepartment in the performance of its duties pursuant to the ADI.

(3) Alzheimer’s Disease Initiative or ADI: The programs and services created and funded under the provisions of Sections 410.401-.403, F.S.

(2)(4) Alzheimer’s Disease Research Brain Bank: The entity designated by the dDepartment to collect post mortem normal control brains and brains of individuals who were clinically diagnosed as having Alzheimer’s disease for the purpose of conducting comparative research aimed at learning about, finding a cause, and developing a treatment or cure for the disease.

(5) Alzheimer’s Disease Registry: The entity designated by the Department to design and operate a data base to support demographic and epidemiological research on Alzheimer’s disease.

(6) Area Agency on Aging (AAA): The agency designated by the Department in a planning and service area (PSA) to develop and administer a plan for a comprehensive and coordinated system of services for older people.

(7) Area Plan: The document developed by each Area Agency on Aging and submitted to the Department which identifies the planning, administrative and coordination activities to be undertaken by the Area Agency on Aging to assure a comprehensive and coordinated system of services for older people in the designated planning and service area.

(8) Case Management: A client-centered series of activities which include planning, arranging and coordinating community-based services for an eligible client and caregiver. Case management is an approved service, even when delivered in the absence of other services. Case management can be offered with services for emergency cases without an assessment for a limited period of time. Case management includes a comprehensive client assessment, development of an individualized care plan with planned client outcomes, and follow-up contacts for the purpose of monitoring the client’s situation to assure timely, effective delivery of services. Case management is a required service for model day care and respite care providers. It shall be provided to clients and caregivers in accordance with standards established by the Department.

(3)(9) Client: For the purposes of these rules, the client is Tthe person with Alzheimer’s disease; however, the client’s caregiver will receive residual benefits through the provision of education, training, respite, and support services, as needed.

(10) Department: The Department of Elder Affairs, the state agency designated to administer the ADI.

(11) District: The term as used in these rules mean planning and service area.

(4)(12) Memory Disorder Clinic: Research oriented programs created pursuant to Sections 430.502(1) and (2) 410.402(1) and (2), F.S., to provide diagnostic and referral services, conduct basic and service-related multidisciplinary research, and develop training materials and educational opportunities for lay and professional caregivers of individuals with Alzheimer’s disease. The memory disorder clinics are located at the University of Florida (Gainesville), University of South Florida (Tampa), University of Miami (Miami), Mount Sinai Medical Center (Miami Beach), North Broward Regional Medical Center (Pompano Beach), and Florida Institute of Technology (Melbourne). Mayo Clinic Jacksonville (Jacksonville) was funded by the 1994 appropriations bill as a memory disorder clinic. Memory disorder clinics shall provide:

(a) A minimum of four (4) hours of in-service training annually to model day care and respite care providers in the designated service area; and

(b) A minimum of one (1) annual contact with each model day care and respite care provider in the designated service area to plan and develop service-related research projects.

(5)(13) Model Day Care Program: Refers to the three specialized day care programs specifically authorized by Section 430.502(4) 410.402(3), F.S. These programs provide a therapeutic setting for the provision of specialized services to clients with Alzheimer’s disease. They also provide training to health care and social service personnel and caregivers, and serve as a natural laboratory for research.

(14) Planning and Service Area: The term as used in these rules means Aa geographic area of Florida that is designated for purposes of planning, development, delivery and overall administration of services under the ADI.

(15) Programs and Services Manual: Department of Elder Affairs Programs and Services Manual dated July 1994 and revised November 1994, available at the Office of the Department Secretary and at each Area Agency on Aging, and incorporated herein by reference.

(6)(16) Related Memory Disorders: Other forms of progressive memory disorders that result in diminished memory, language, and other cognitive functions, and the inability to perform activities of daily living. Related memory disorders are included under the ADI in these rules.

(7)(17) Research: The term as used in these rules refers to Iinvestigations undertaken to learn more about the Alzheimer’s disease process in order to determine the cause, resulting behavioral changes, treatment, cure, and family or societal impact of Alzheimer’s the disease.

(18) Respite Care: A service to provide supervision and companionship for a specified period of time to a person with a diagnosis of Alzheimer’s disease as defined in these rules. The purpose of respite care is to provide temporary relief to the primary caregiver. Service providers may offer personal care services, as defined in Section 400.402(16), F.S., and essential supplies to a client under these rules.

(a) Facility-Based Respite: Respite care provided in a facility such as a licensed nursing home, adult day care center, adult congregate living facility, or other facility operated by a program under contract with funds provided by the department.

(b) In-home Respite: Respite Care provided in the home or principal residence of the client or primary caregiver.

(19) Service Provider: A private or public organization receiving funds from the Department to provide services to individuals with Alzheimer’s disease or to their caregivers.

(8)(20) Training: The term as used in these rules refers to Tthe provision of educational activities and instruction to assist health care professionals, and social service providers, and the client’s caregivers in understanding Alzheimer’s disease and to increase their knowledge and caregiving skills.

Specific Authority 410.401(3), 430.08 FS. Law Implemented 430.501, 430.502 410.401-.402, 430.04(6) FS., Ch. 91-115, Laws of Florida, s. 10. History–New 3-28-95, Amended________.

 

58D-1.003 Eligibility.

(1) To be eligible for to receive model day care services, an individual, regardless of age, must be 18 years of age and have a diagnosis of Alzheimer’s disease or a related memory disorder.

(2) To be eligible to receive all other services funded under the Alzheimer’s Disease Initiative that are included in the provider’s contract with the department or the area agency on aging, an iIndividuals, regardless of age, must be 18 years of age or older and have a diagnosis of Alzheimer’s disease or a related memory disorder, may be diagnosed as having or be suspected of having Alzheimer’s disease or a related memory disorders to be eligible for all other services funded under the Alzheimer’s Disease Initiative.

(3) The caregivers of individuals receiving services funded under the Alzheimer’s Disease Initiative are eligible to receive training and related support services to assist them in caring for the person with Alzheimer’s disease.

Specific Authority 410.401(3), 430.08 FS. Law Implemented 430.501, 430.502 410.402(2)-(4) FS., Ch. 91-115, Laws of Florida, s.10. History–New 3-28-95, Amended_________.

 

58D-1.004 Program Components.

(1) In its role as advisor to the dDepartment, the Alzheimer’s Disease Advisory Committee shall provide feedback have responsibility for each of the following components:

(a) Memory Disorder Clinics;

(b) Registry;

(b)(c) Brain Bank;

(c)(d) Model Day Care; and

(d)(e) Respite Care.

(2) The Alzheimer’s Disease Advisory Committee shall address service, training, research, and coordination among components.

(3) The Alzheimer’s Disease Advisory Committee may enlist services, assistance, and direction from a broad representation of health care professionals, service providers, individuals affiliated with the Alzheimer’s Association, caregivers, and other interested or knowledgeable parties.

Specific Authority 410.401(2), 430.08 FS. Law Implemented 430.501, 430.502 410.401(2) FS., Ch. 91-115, Laws of Florida, s. 10. History–New 3-28-95, Amended ________.

 

58D-1.005 Program Administration.

(1) The Department of Elder Affairs shall plan, develop and coordinate a statewide program to carry out its responsibilities under the Alzheimer’s Disease Initiative. The Department shall:

(a) Develop a multi-year plan.

(b) Allocate funds for respite services based on the number and proportion of persons seventy-five years of age and older within counties in the Planning and Service Areas.

(c) Develop provider application package(s) and contract specifications, including requirements for a research component in each contract, for distribution to the Area Agencies on Aging and service providers.

(d) Establish policies and procedures for service providers.

(e) Provide technical assistance to staff of the Area Agencies on Aging and service providers as requested.

(f) Evaluate Alzheimer’s disease programs.

(g) Monitor services to assess quality of service delivery.

(h) Develop program reports.

(i) Maintain a resource library for staff development. Include training materials pertaining to Alzheimer’s disease and a list of information and referral services throughout Florida.

(j) Provide access to training whenever possible.

(k) Provide staff support to assist the Alzheimer’s Disease Advisory Committee in the performance of its duties.

(1) Establish guidelines and procedures for the award and allocation of funds received pursuant to Section 410.401(3), F.S., Note, into a Department administrative trust fund.

(2) The aArea aAgency on aAging, under contract with the dDepartment, shall be responsible for the planning and administration of respite and model day care services funded under the Alzheimer’s Disease Initiative and, in turn, shall contract with local service providers for the provision of these services. The Department may retain the budget authority to contract directly with service providers for the implementation of special projects when appropriate. Each aArea aAgency on aAging shall:

(a) In conjunction with the Department, establish priorities, policy and procedures for administration and delivery of services, and include objectives for the Alzheimer’s Disease Initiative in the area plan.

(a)(b) Comply with State of Florida procedures regarding solicitation and execution of agreements with providers of services.

(c) Review and critique applications to ensure completeness and accuracy of information, and assess the applicant’s ability to provide required services and manage a subcontract.

(d) Assure that all service provider contracts include a requirement for an Alzheimer’s disease research component and responsibility for coordination with other Alzheimer’s Disease Initiative components.

(e) Assure that all client information and program reports, including reports of research efforts, are complete and accurate.

(f) Provide for staff development and training of provider staff.

(g) Assume contract management responsibilities.

(h) Assess fiscal management capabilities of service providers.

(i) Monitor service providers.

(j) Process payments to service providers.

(k) Provide technical assistance to service providers as requested or required.

(l) Establish procedures for appeals by clients and contract service providers.

(m) Ensure that grievance and appeals procedures are adhered to by service providers.

(b)(n) Maintain coordination with the mMemory dDisorder cClinics, the Alzheimer’s Disease Brain Bank, the Alzheimer’s Disease Registry, and all other components of the Alzheimer’s Disease Initiative in the designated planning and service area as outlined in its contract with the dDepartment of Elder Affairs Programs and Services Manual dated July 1994 and revised November 1994, available in the Office of the Department Secretary and at each Area Agency on Aging, and incorporated herein by reference.

(c)(o) Comply with all terms and conditions of its the contract with the department and guidelines specified in the Department of Elder Affairs Programs and Services Manual, dated July 1994 and revised November 1994, available in the Office of the Department Secretary and at each Area Agency on Aging, and incorporated herein by reference.

(p) Make available reports submitted to the Department by the memory disorder clinics, the registry and the brain bank to other service providers in the designated planning and service area.

Specific Authority 430.08 FS. Law Implemented 430.502, 430.503 FS. History–New 3-28-95, Amended 10-30-05,_________.

 

58D-1.006 Service Provider Responsibilities.

Each service provider must shall:

(1) No change.

(2) Employ competent and qualified staff to provide the services essential to the achievement of the program goals and objectives as specified in its contract with the department or the area agency on aging.

(3) Maintain the minimum staffing requirements established in its contract with the dDepartment or area agency on aging.

(4) Provide case management services as applicable and as specified in its contract with the dDepartment or area agency on aging of Elder Affairs Programs and Services Manual, dated July 1994 and revised November 1994, available in the Office of the Department Secretary and at each Area Agency on Aging, and incorporated herein by reference.

(5) Provide respite or model day care services, and maintain coordination with or the services of the memory disorder clinics, and the registry or brain bank as specified in its contract with the dDepartment or area agency on aging of Elder Affairs Programs and Services Manual, dated July 1994 and revised November 1994, available in the Office of the Department Secretary and at each Area Agency on Aging, and incorporated herein by reference.

(6) Provide pre-service preservice and in-service inservice training for staff and volunteers as specified in its contract with the dDepartment or area agency on aging of Elder Affairs Programs and Services Manual, dated July 1994 and revised November 1994, available in the Office of the Department Secretary and at each Area Agency on Aging, and incorporated herein by reference.

(7) through (8) No change.

(9) Collect co-payments for services pursuant to Section 430.503(2), F.S. Co-payments must be determined using the fee schedule established in Rule 58C-1.007, F.A.C. Request contributions and ensure that contributions are only used to expand program services.

(10) through (12) No change.

(13) Maintain client and program records and provide reports as required by its contract with the dDepartment or area agency on aging of Elder Affairs Programs and Services Manual, dated July 1994 and revised November 1994, available in the Office of the Department Secretary and at each Area Agency on Aging, and incorporated herein by reference.

(14) Establish goals and objectives for the Alzheimer’s Disease Initiative research component and submit reports as specified by the Department on research activities.

Specific Authority 410.401(3), 430.08 FS. Law Implemented 430.502, 430.503 410.402(3)-(5), 410.403, 430.06(2) FS., Ch. 91-115, Laws of Florida, s. 10. History–New 3-28-95, Amended ________.

 

58D-1.007 Program Forms.

The following forms shall be used for programs regulated by this chapter, are hereby incorporated by reference in Rule 58A-1.010, F.A.C. In addition, a care plan must be developed that meets the criteria established in subsection (3) of that rule. and are available in the Office of the Secretary and at each Area Agency on Aging:

(1) For purposes of assessment:

(a) DOEA Form 701A, Prioritization Form, July, 2000.

(b) DOEA Form 701B, Assessment Instrument, July, 2000.

(c) DOEA Form 701C, Congregate Meals Form, July, 2000.

(2) For purposes of completing forms listed in subsection (1): DOEA Form 701D, Assessment Instructions (701A, 701B, 701C), July, 2000.

(3) For purposes of documenting planned services of care: DOEA Forms 203A, Care Plan, and 203B, instructions dated July, 2001.

Specific Authority 430.08, 430.501-.503 FS. Law Implemented 430.502 430.501-.504 FS. History–New 8-20-00, Amended 8-6-01, ________.

 

58D-1.009 Confidentiality, Disclosure of Information, and Retention of Records.

(1) Entities contracting to provide services under the Alzheimerís Disease Initiative shall collect, maintain, and exchange information about applicants applying for services and clients receiving services only to the extent it is necessary to administer the programs covered under this agreement in accordance with the Health Insurance Portability and Accountability Act (HIPPA) of 1996.

(2) Contracting ADI entities shall retain all client records, financial records, supporting documents, statistical records, and any other documents (including electronic storage media) pertinent to each agreement and/or contract for a period of at least five (5) years after termination of the agreement(s).

(a) If an audit has been initiated and audit findings have not been resolved at the end of five (five) years, the records shall be retained at least until resolution of the audit findings.

(b) These records may be subject to additional retention requirements set by law.

(3) Persons duly authorized by the department shall have full access and the right to examine or duplicate any of said records and documents during the stated retention period or as long as records are retained, whichever is later.

Specific Authority 430.08 FS. Law Implemented 430.504 FS. History–New_________.

NAME OF PERSON ORIGINATING PROPOSED RULE: Jim Crochet
NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: E. Douglas Beach, Ph.D., Secretary
DATE PROPOSED RULE APPROVED BY AGENCY HEAD: May 9, 2008
DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: June 24, 2005