HAR §11-800-43. Client care and services

(a) The home shall care for not more than two adults at any one time, who are unrelated to the foster family, or if certified by the department for three beds, shall care for not more than three adults, pursuant to the requirements under section 321-481, HRS. (b) One bed in each home shall be reserved for medicaid recipients, or if certified by the department for three beds, two beds shall be reserved for medicaid recipients, unless the requirements for two private pay individuals under section 321-481, HRS, are met. (c) Care and services provided to the client shall: (1) Be appropriate to the age and condition of the client and provided in a home-like environment; (2) Be based on care directions from the client to the maximum extent possible, with monitoring by the case management agency when the client is not capable of providing care directions; (3) Be based on the caregiver following a service plan for addressing the client's needs. The RN case manager 800-48 B325 11-800-43 may delegate client care and services as provided in chapter 16-89-100; (4) Include the provision of personal care, homemaker, and respite services as appropriate; (5) Include the caregiver observing the following provisions of care: (A) Appropriate, safe techniques, and infection control procedures; and (B) Encouragement of client independence as much as possible; and (6) Include recreation and social activities, which shall: (A) Be arranged and provided, in accordance with the service plan, in or outside the home according to the client's interests, needs, and capabilities; and (B) Include access by the client to radio, television, telephone, internet. [E&N]V 13 2014Auth: HRS §§321-481, 321-483, 321- 485, 346-14) (Imp: HRS §§321- 481, 321-483, 321-485, 346-14) # §11-800-44 Client transfer and discharge. (a) The transfer and discharge of the client may occur when: (1) The home is unable to meet the needs of the client; (2) The primary caregiver and the client notify the case management agency of intended transfers or discharges; (3) A minimum of three weeks advance notice is given prior to any transfer or discharge to: (A) The home and the case manager, when the transfer or discharge is initiated by the client or the client's legal representative; or (B) The client and the client's legal representative, when the transfer or discharge is 800-49 B325 11-800-44 initiated by the case management agency or the home; (4) Three weeks advance notice shall not be required: (A) For emergency transfers or discharges; (B) When the transfer or discharge is mutually agreed upon by the client or the client's legal representative, the home, and the case manager; and (C) When a transfer is required because a home's certificate has been revoked. (b) All transfers and discharges will be coordinated with the client, the client's legal representative, if applicable, the case management agency, and the home. (c) The home caregivers shall cooperate with the case management agency and the department when immediate removal of the client is necessary. (d) The immediate removal of the client shall be ordered when the case management agency or the department determines there is imminent danger to the life, health, safety, or welfare of the client. (e) When the client is relocated, the home caregivers shall not obstruct the relocation process and shall cooperate with the appropriate case management agencies in the relocation process. Such cooperation shall include but not be limited to: (1) Identifying and preparing for removal of the medications, insurance documents, clothing, safeguarded personal funds, valuables, and all other belongings of the client; and (2) Providing access to the client's file during relocation and return of the file to the case management agency upon relocation. (f) A home that will voluntarily close must notify the department in writing ninety days prior to the voluntary closure. [Eff NOV 13 2018 ] (Auth: HRS §§321-481, 321-483, 800-50 B325 11-800-44 321-485, 346-14) (Imp: HRS §§321-481, 321-483, 321-485, 346-14)