Haw. Code R. § 11-800-27 - Service monitoring

(a) The case management agency shall provide continuing, regular contact with the client, caregiver, and other service providers to ensure that:

(1) Services are being provided in accordance with the service plan and continue to meet the client's needs;

(2) The caregiver and residential care facility environment continue to meet the client's needs;

(3) Sufficient progress is made towards achieving desired goals and outcomes; and

(4) All of the client's rights, as provided in section 11-800-50, are met.

(b) The service monitoring process shall include:

(1) Face-to-face contact with the client at least once a months with more frequent contacts depending on the client's condition and the caregiver's capability. The frequency of this contact shall be specified in the service plan;

(2) Regular RN monitoring of the client who has a medically complex condition, as determined by a physician or RN. The frequency of this monitoring shall be specified in the service plan;

(3) Ongoing evaluation of the client's response to and satisfaction with services provided and follow-up as needed;

(4) Ongoing evaluation of the appropriateness, timeliness, adequacy, and quality of services, caregivers, and home-like environment provided;

(5) Ongoing evaluation of the caregiver's status, behavior, and skills competency; substitute caregiver coverage and skills competency; and other caregiver responsibilities, such as child care or employment, to identify areas that may necessitate case management intervention;

(6) Assessment for, review, and follow-up activities on all reports of unusual occurrences involving the client, such as adverse events and inappropriate or lack of client supervision;

(7) Follow-up activities to assure that substandard care and unsafe practices or conditions have improved, or to arrange for alternative placement, as provided in section 11-800-44;

(8) Assurance that a qualified caregiver is physically available to the client twenty- four hours a day, seven days a week;

(9) Facilitating and documenting conflict resolution of client complaints or grievances about services, service providers, as well as conflicts between contracted personnel and the client;

(10) Monitoring and documenting continued medicaid eligibility for medicaid waiver service recipients; and

(11) Reporting to the department any concerns the case management agency may have about the home in which a client has been placed, including but not limited to:

(A) Changes in the composition of the household; and

(B) Inappropriate activities on the premises.

Notes

Haw. Code R. § 11-800-27

[Eff 11/13/2018] (Auth: HRS §§ 321-481, 321-482, 321-485, 346-14) (Imp: HRS §§ 321-481, 321-482, 321-485, 346-14)