77 Ill. Adm. Code 245.210
Services – Home Services Agencies
Section 245.210 Services – Home
Services Agencies
a)Â Â Â Â Â Â Â Â Agencies licensed as
home services agencies shall provide non-medical services, which may be
provided directly by agency staff or through a contractual purchase of
services, that are intended to assist clients with activities of daily living.Â
Services may include, but are not limited to, activity of daily living support,
personal care, medication reminding, housekeeping services, personal laundry,
cooking, shopping, assistance in getting to and from appointments, maintenance
of household records, and companionship. Each agency shall maintain a listing
of the types of services offered by the agency, and the scope of the work to be
provided under each area, which the agency shall distribute to clients before
contracting with the client, with the signed contract, and when changes occur.
b)Â Â Â Â Â Â Â Â If the agency provides
services under contractual arrangements with a third party, it shall have a
written agreement that includes, but is not limited to, the following:
1)Â Â Â Â Â Â Â Â A
detailed description of the services to be provided;
2)Â Â Â Â Â Â Â Â Provisions for adherence
to all applicable agency policies and personnel requirements, including
requirements for initial health evaluations and employee health policies, and
criminal background checks if applicable;
3)Â Â Â Â Â Â Â Â Designation of full
responsibility for agency control over contracted services;
4)Â Â Â Â Â Â Â Â Procedures
for submitting clinical and progress notes;
5)Â Â Â Â Â Â Â Â Charges
for contracted services;
6)Â Â Â Â Â Â Â Â A statement of responsibility
of liability and insurance coverage (employment, workers' compensation) and
taxes, including employment and Social Security taxes;
7)Â Â Â Â Â Â Â Â The
period of time the written agreement is in effect;
8)Â Â Â Â Â Â Â Â Date
and signatures of appropriate authorities; and
9)Â Â Â Â Â Â Â Â Provisions
for termination of services.
c)Â Â Â Â Â Â Â Â When services are
provided to clients by a home services agency, there shall be a written
contractual agreement between the client and the agency that includes, but is
not limited to:
1)Â Â Â Â Â Â Â Â Indication and assurance
of compliance by the agency with the requirements of the Act, including the
Health Care Worker Background Check Act;
2)Â Â Â Â Â Â Â Â Identification of
parties responsible for payment of employment taxes, Social Security taxes, and
workers' compensation;
3)Â Â Â Â Â Â Â Â Information on the
parties responsible for supervising workers, as well as hiring, firing and
discipline of in-home services workers;
4)Â Â Â Â Â Â Â Â Identification of the
charges to be paid, payment schedule, and to whom the client, or person acting
on behalf of the client, is to make payments for services under the contract;
5)Â Â Â Â Â Â Â Â Time period for the contractual
arrangement and conditions for termination of the contract; and
6)Â Â Â Â Â Â Â Â Contact information for
the client to use in case of concerns, complaints, or questions on care to be
provided.
d)Â Â Â Â Â Â Â Â Acceptance of Clients.Â
Home services agencies shall develop and follow policies on acceptance and
discharge of clients, which shall include, but not be limited to, the
following:
1)Â Â Â Â Â Â Â Â Persons shall be
accepted for service on the basis of their desire or need for assistance with household
or personal support or companionship services. A home services agency shall
not provide medical services that would be performed by an agency licensed as a
home health agency or home nursing agency.
2)Â Â Â Â Â Â Â Â The agency may accept a
client who requires complete repositioning and where the client is unable to
assist either verbally, non-verbally (including non-verbal indications and
cues), or through others (i.e., a bed-ridden client who requires complete
assistance to reposition in bed every two hours with no ability to provide any
verbal or non-verbal indications and cues that repositioning may be needed)
only when the following conditions are met:
A)Â Â Â Â Â Â Â The home services worker
shall have been trained in the indications of and the procedures for
positioning and repositioning a client in the above situation;
B)Â Â Â Â Â Â Â The client's
representative shall be able to assist with the positioning or repositioning,
either directly or by providing ongoing feedback, including indications of
potential harm or discomfort, to the home services workers through either
verbal or non-verbal indications and cues if the client representative is
present when the position needs to be changed; and
C)Â Â Â Â Â Â Â The agency shall have
conducted a competency evaluation of the worker that confirms competency with
the indications of and the procedures for positioning and repositioning a
client in the above situation.
3)Â Â Â Â Â Â Â Â No person shall be
refused services based on
actual or perceived race, color, religion,
national origin, ancestry, age, sex, marital status, order of protection
status, disability, military status, sexual orientation, pregnancy, or
unfavorable discharge from military service
[775 ILCS 5/1-103(Q)].
4)Â Â Â Â Â Â Â Â When services are
terminated by the agency, the client is to be notified at least seven working
days in advance of the date of termination, with a stated reason for the
termination. This information shall be maintained in the client record. The seven-day
notice requirement is not applicable in cases in which the worker's safety is
at risk. In these cases, the agency may notify the client of termination of
services and the reason for termination. Documentation of the risk to the
provider shall be maintained in the client record.
5)Â Â Â Â Â Â Â Â The acceptance of the
client for non-medical services shall be based on the following documented
information, in consultation with the client and the client's appropriate
family members or representative:
A)Â Â Â Â Â Â Â Any functional
limitations of the client and the relevance of the limitation to the services
requested; and
B)Â Â Â Â Â Â Â Any circumstances that
may have an impact on activity or involvement by the client, such as basic
information on medications being taken, treatments received, client's physical
activity, diet and mental status in relation to the services requested.
e)        Service Plan. The
agency shall establish a plan for each client, in consultation with agency
staff, the client, or the client's representative or Power of Attorney (if
applicable), or members of the client's family (at the request of the client,
client's representative, or client's Power of Attorney), that outlines the
services to be provided to the client. The plan shall address and include, but
not be limited to:
1)Â Â Â Â Â Â Â Â Client care regimen
including:
A)Â Â Â Â Â Â Â Assistance with ADLs and
in-home support services (see Section 245.20), which may include staff
responsibilities outlined in Section 245.40(c)(4)(A) through (P);
B)Â Â Â Â Â Â Â Medication reminders
(frequency and time of day);
C)Â Â Â Â Â Â Â Information on treatments
being received;
D)Â Â Â Â Â Â Â Activity;
E)Â Â Â Â Â Â Â Diet;
F)Â Â Â Â Â Â Â Â Functional limitations
and specific procedures considered essential for the health and safety of the
client;
G)Â Â Â Â Â Â Â Mental health status; and
H)Â Â Â Â Â Â Â Frequency of the home
service worker visits.
2)Â Â Â Â Â Â Â Â Equipment required
3)Â Â Â Â Â Â Â Â Client limitations
4)Â Â Â Â Â Â Â Â The service plan shall
not include services outside the scope of work for a home services worker as
provided in Section 245.40(c)(4)(A) through (P).
f)Â Â Â Â Â Â Â Â Physician signature is
not required for the plan of service developed under this Section.
g)Â Â Â Â Â Â Â Â The service plan shall
be reviewed and revised as necessary, but not less than once annually.
h)        Client Records. A
client record shall be maintained for each client receiving in-home services.Â
The record shall contain:
1)Â Â Â Â Â Â Â Â Appropriate identifying
information for the client, including the client's name, address and telephone
numbers;
2)Â Â Â Â Â Â Â Â The name, telephone
numbers and address of the client's representative, if applicable;
3)Â Â Â Â Â Â Â Â The name, telephone
numbers and address of an individual or relative to be contacted in an
emergency;
4)Â Â Â Â Â Â Â Â The plan of services
agreed to by the client and agency;
5)Â Â Â Â Â Â Â Â A copy of the client
home care services agreement or contract; and
6)Â Â Â Â Â Â Â Â Documentation by the
home services worker of each of the services provided at each visit.
i)Â Â Â Â Â Â Â Â Â Each agency shall have
a written policy on records procedures and shall retain records for a minimum
of two years beyond the last date of service provided. The agency may utilize
hard copies or an electronic format. Each agency shall have written policies
and procedures for records maintenance and shall retain records for a minimum
of two years beyond the last date of service provided. The procedures may
include that the agency will use and maintain faxed copies of records, rather
than original records, provided that faxed copies shall be maintained on
non-thermal paper and that the original records will be maintained for a period
of two years by the originating entity.
j)Â Â Â Â Â Â Â Â Â Each agency shall have
a written policy for protecting the confidentiality of patient records that
explains the use of records, removal of records, and release of information.