Developmental Disabilities Waiver Services

 

AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid

RULE NO: RULE TITLE
59G-13.083: Developmental Disabilities Waiver Services

NOTICE OF CHANGE

Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 34, No. 6, February 8, 2008 issue of the Florida Administrative Weekly.

These changes are in response to comments received from the and during the public hearing process.

Rule 59G-13.083, F.A.C., incorporates by reference the Florida Medicaid Developmental Disabilities Waiver Services Coverage and Limitations Handbook, July 2007. The following revisions were made to the handbook.

Page 1-5, General Definitions, Medicaid Waiver Services Agreement. We added two sentences, which read, “Modifications or additions may be made by APD to the sample agreement provided on a case-by-case basis as necessary to address specific facts or other concerns relevant to an individual provider. An example of the Medicaid Waiver Services Agreement is included as Appendix D.”

Page 1-16, Adult Day Training Provider Requirements, Provider Qualifications, last bulleted item. We have revised to read, “Direct service staff must be at least 18 years of age and possess at least a high school diploma or equivalent. When determining the equivalency of high school degrees, providers may accept official transcripts, affidavits from educational institutions, and other formal or legal documents that can be reasonably used to determine educational background. Employees who have been hired using the best judgment of the hiring agency, prior to this amendment, will not be affected by this change.”

Page 1-16, Adult Day Training Provider Requirements, Training Requirements, first paragraph. We have revised to read, “Proof of training in the areas of Cardiopulmonary Resuscitation (CPR), HIV/AIDS and infection control is required for all staff within 90 days of initially providing adult day training services. Proof of annual or required updated training shall be maintained on file for review. At all times when recipients are present, a minimum of a least one staff member or 50 percent of all staff at the facility (whichever is greater), must be trained in CPR, infection control techniques, zero tolerance (of sexual abuse), core competencies, and the use of approved restraints and seclusion approved by the Agencies.”

Page 1-30, Residential Habilitation Provider Requirements, Training Requirements, first paragraph. We have revised the first sentence and added the last sentence to read, “Proof of training in the areas of Cardiopulmonary Resuscitation (CPR), HIV/AIDS and infection control is required within 90 days of initially providing residential habilitation services. Proof of annual or required updated training shall be maintained on file for review. At all times when recipients are present, a minimum of a least one staff member or 50 percent of all staff at the facility (whichever is greater), must be trained in CPR, infection control techniques, zero tolerance (of sexual abuse), core competencies, and the use of approved restraints and seclusion approved by the Agencies.”

Page 2-5, Requirements to Receive Services, Medical Necessity Determinations, second paragraph, last sentence. We have revised to read, “A request for hearing shall be made to the agency, in writing, within 30 days of the recipient’s receipt of the notice.”

Page 2-65, Residential Habilitation Services, Minimum Staffing Requirements for Standard and Behavior Focus Residential Habilitation Services Provided in a Licensed Facility, first paragraph. We have deleted the introductory language so that the paragraph begins, “Providers of standard and behavior focus residential habilitation services shall provide a minimum level of staffing consistent with the minimum Direct Care Staff Hours per Person per 24 Hour Day identified in the table below.”

Page 2-65, Residential Habilitation Services, Minimum Staffing Requirements for Standard and Behavior Focus Residential Habilitation Services Provided in a Licensed Facility, table of hours. We have revised the table of hours, to read,

“Direct Care Staff Hours per Person per 24 Hour Day:

Level of DisabilityLevel of Direct Care Staffing

Hours per 24 hour DayHours per Week

Basic Level214

Minimal428

Moderate Level6.545.5

Extensive 1 Level8.559.5

Extensive 2 Level1177

Hours counted must be provided by direct care staff or by other staff, who are providing direct care or direct time spent on client training, intervention or supervision.”

Page 2-67 through 2-70, Residential Habilitation Services, Level of Supports, entire section. We have deleted this section.

Page D-1 through D-4, Appendix D, Medicaid Waiver Service Agreement, entire appendix.

We have withdrawn the previously noticed deletion of this appendix and re-numbered it as Appendix D.