Iowa Code r. 481-70.26 - Service plans
(1) A service
plan shall be developed for each participant based on the evaluations conducted
in accordance with subrules 70.22(1) and 70.22(2) and shall be designed to meet
the specific service needs of the individual participant. The service plan
shall subsequently be updated at least annually and whenever changes are
needed.
(2) Prior to the
participant's signing the contractual agreement and participating in the
program, a preliminary service plan shall be developed by a health care
professional or human service professional in consultation with the participant
and, at the participant's request, with other individuals identified by the
participant, and, if applicable, with the participant's legal representative.
All persons who develop the plan and the participant or the participant's legal
representative shall sign the plan.
(3) When a participant needs personal care or
health-related care, the service plan shall be updated within 30 days of the
participant's participation and as needed with significant change, but not less
than annually.
a. If a significant change
triggers the review and update of the service plan, the updated service plan
shall be signed and dated by all parties.
b. If a significant change does not exist,
the program may, after nurse review, add minor discretionary changes to the
service plan without a comprehensive evaluation and without obtaining
signatures on the service plan.
c.
If a significant change relates to a recurring or chronic condition, a previous
evaluation and service plan of the recurring condition may be utilized without
new signatures being obtained. For example, with chronic exacerbation of a
urinary tract infection, nurse review is adequate to institute the previously
written evaluation and service plan.
(4) The service plan shall be individualized
and shall indicate, at a minimum:
a. The
participant's identified needs and preferences for assistance;
b. Any services and care to be provided
pursuant to the contractual agreement;
c. The service provider(s), if other than the
program, including but not limited to providers of hospice care, home health
care, occupational therapy, and physical therapy; and
d. For participants who are unable to plan
their own activities, including participants with dementia, planned and
spontaneous activities based on the participant's abilities and personal
interests.
Notes
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