(a)

1. (1) No service provider shall accept a client unless there is a reasonable expectation that the client's needs can be adequately met and services begun within the timeframe established below.

2. (2)

   1. (A) If the client is not accepted, the client and/or referring agent shall be notified within three (3) days.
   2. (B) Notification must include explanation of the reason or reasons for denial and other options available.

(b)

1. (1) Emergency services will be provided when an unforeseen combination of circumstances and the resulting conditions require immediate action.

2. (2)

   1. (A) When immediate services are necessary due to an emergency, the case manager shall notify the direct service provider by telephone on the day of the referral.
   2. (B) This must be followed by written notification within three (3) working days.

3. (3)

   1. (A) The provider shall not wait for the written notification before starting services.
   2. (B) Services should be provided as soon as possible.

(e) Service implementation.

1. (1) The case manager shall complete a Client Intake Form and a service plan for each client (see Appendix for Service Plan Form).

2. (2)

   1. (A) If the direct service provider agency is not the case management agency, the case manager shall notify the direct service provider agency by telephone the same day the approved service plan is completed.
   2. (B) Follow-up written notification shall be submitted within three (3) working days.

3. (3)

   1. (A) The direct service provider agency shall develop and implement a schedule of services within three (3) days of the telephoned referral.
   2. (B) A copy of this schedule of services shall be forwarded to the case manager within three (3) days.

4. (4)

   1. (A) The standardized Service Plan Form shall be used by all agencies.
   2. (B) The form shall be completed as appropriate for the service or services to be provided.
   3. (C) No physician's signature is required for services other than personal care.
5. (5) Service plans shall include a range (minimum and maximum) of service hours approved to minimize problems of complying with the approved service plan, e.g., when staff shortages preclude providing the maximum number of hours approved.
6. (6) The service plan shall be signed by the client and the case manager.

7. (7)

   1. (A) Care shall follow the written plan.
   2. (B) The plan shall be reviewed during in-home visits at least every sixty (60) days.

8. (8)

   1. (A) Personal care provided under the Nursing Home Alternatives Program shall comply with the service delivery requirements of the Medicaid Personal Care Program.
   2. (B) Personal care services under this program and the Medicaid Personal Care Program are the same, the only difference is the funding source.

9. (9)

   1. (A) Direct service providers shall ensure that in-home service workers deliver all services prescribed for the client on the service plan or document the reason the service was not delivered.
   2. (B) If an exception to the service plan is expected to be in effect for more than two (2) weeks, a new service plan shall be prepared.
10. (10) When a client's condition changes substantially, the case manager shall be notified in writing.

(f) Client direct service files shall contain the following documentation:

1. (1) Intake/referral;
2. (2) Verification of income;
3. (3) Assessment/reassessment, for personal care clients;
4. (4) Statement of level of care needed, for personal care clients;
5. (5) Client identification number;
6. (6) Service plan;
7. (7) Change of client status, if applicable;
8. (8) In-home service worker introduction form, if applicable;
9. (9) In-home service workers' worksheets which include their daily notes, if applicable;
10. (10) Supervisory home visit report and client's evaluation of care;
11. (11) Notice of termination/transfer/suspension of services; and
12. (12) Notation of reason for discharge, i.e., hospitalization, nursing home placement, living with caregiver, moved from service area, improved, no longer needs service, died, other.