A. For purposes of this Article the following
terms are defined:
"Competent member" means a person who is oriented, exhibits
evidence of logical thought, and can provide directions.
"Fiscal and Employer Agent" or "FEA" is a company specified
by the program contractor or the Administration in contract to serve as an
employment/payroll processing center for attendant care workers employed by the
member to provide SDAC services.
"Medically stable" means the member's skilled-care medical
needs are routine and not subject to frequent change because of health
issues.
"Personal care" means activities of daily life such as
dressing, bathing, eating and mobility.
B. In lieu of receiving other attendant care
services a competent member who meets the requirements of A.R.S. §
36-2951
or the member's legal guardian may choose to employ through the FEA a person to
provide Self-directed Attendant Care (SDAC) services. A paid caregiver
described under R9-28-506 and a parent of a minor child shall not receive
reimbursement for SDAC services.
C.
The attendant care worker chosen to provide SDAC services does not need to be a
registered provider. The attendant care worker shall have, at a minimum,
hands-on training in First Aid, CPR, Universal Precautions, and state and
federal laws regarding privacy of health information or training of similar
efficacy as approved by the Administration.
D. The Administration or Program Contractor
shall cover SDAC services only if the member resides in the member's home, and
shall not cover SDAC services if the member is institutionalized or residing in
an alternative residential setting. If the member has a legal guardian, the
legal guardian shall be present when SDAC services are provided.
E. A member who chooses to receive SDAC
services is not precluded from receiving medically necessary, cost-effective
home health services from other agencies or providers if the services provided
are not duplicative of the specific attendant care or skilled service already
received through the program contractor.
F. A competent member or legal guardian may
employ an SDAC attendant care worker to provide personal care, homemaker and
general supervision services.
G. A
competent member, who is medically stable, or the member's legal guardian may
employ an attendant care worker to also provide the following skilled services:
1. Bowel care, including suppositories,
enemas, manual evacuation, and digital stimulation;
2. Bladder catheterizations (non-indwelling)
that do not require a sterile procedure;
3. Wound care (non-sterile);
4. Glucose monitoring;
5. Glucagon as directed by the health care
provider;
6. Insulin by
subcutaneous injection only if the member is not able to self-inject;
7. Permanent gastrostomy tube feeding;
and
8. Additional services
requested in writing with the approval of the Director and the Arizona State
Board of Nursing.
H. The
Administration or program contractor shall not cover services under subsection
(G) unless:
1. For each SDAC attendant care
worker employed by a member or legal guardian, a registered nurse licensed
under A.R.S. Title 32, Chapter 15 visits the member and SDAC attendant care
worker before a skilled service is provided. The registered nurse will assess,
educate, and train the member and SDAC attendant care worker regarding the
specific skilled service that the member requires; and
2. The registered nurse determines in writing
that the attendant care worker understands how and demonstrates the skill to
perform the processes or procedures required to provide the specific skilled
service.
Notes
Ariz. Admin. Code §
R9-28-508
Adopted effective
October 1, 1988, filed September 1, 1988 (Supp. 88-3). Amended effective April
25, 1990 (Supp. 90-2). Amended effective December 8, 1997 (Supp. 97-4). Section
repealed by final rulemaking at 6 A.A.R. 896, effective February 8, 2000 (Supp.
00-1). New Section made by final rulemaking at 16 A.A.R. 2386, effective
January 16, 2011 (Supp. 10-4). Amended by final rulemaking at 18 A.A.R. 2344,
effective November 11, 2012 (Supp. 12-3).
