(b) These services must include:

1. (1) Participation as appropriate in the development, review, and update of an individual program plan as part of the interdisciplinary team process; and
2. (2) The development, with a physician, of a medical care plan of treatment for a client when the physician has determined that an individual client requires such a plan.

(c) For those clients certified as not needing a medical care plan, a review of their health status must:

1. (1) Be by a direct physical examination;
2. (2) Be by a registered nurse;
3. (3) Be on a quarterly or more frequent basis depending on client need;
4. (4) Be recorded in the client's record; and
5. (5) Result in any necessary action, including referral to a physician to address client health problems.

(e) Implementing, with other members of the interdisciplinary team, appropriate protective and preventive health measures that include, but are not limited to:

1. (1) Training clients and staff as needed in appropriate health and hygiene methods;
2. (2) Control of communicable diseases and infections, including the instruction of other personnel in methods of infection control; and
3. (3) Training direct care staff in detecting signs and symptoms of illness or dysfunction, first aid for accidents or illness, and basic skills required to meet the health needs of the clients.