R501-20-8. Additional Considerations for DSPD Home and Community Based Medicaid Waiver Licensees

(1) This section of rule supersedes any conflicting requirements of Rules R501-1 and R501-20. (2) A licensee serving clients of DSPD shall ensure staff to client ratios are determined by the DSPD worksheet and are individualized based on the person's need. (3) A licensee shall ensure a ratio of one staff to six persons is maintained at all times. (4) A licensee serving Home and Community Based Services (HCBS) Medicaid Waiver clients shall: (a) identify themselves as a Waiver provider on their licensing application and follow all attestation and survey requirements therein; (b) comply with the HCBS Settings rule and Rule R414-519 to include: (i) providing non-segregated bathrooms; (ii) providing individually stalled bathrooms with locking capability with only trained and authorized staff having access to keys for safety; (iii) ensuring the setting is fully accessible and affords access to the community; (iv) ensuring client information is not posted or stored in public spaces; (v) not restricting client access to food unless documented in the person-centered service plan or behavior support plan; (vi) allowing clients individual initiative, autonomy, independence and choices in regard to their daily activities, physical environment and with whom they interact as much as safely possible; and (vii) supervising clients and maintaining supporting documentation according to the person-centered service plan or behavior support plan; and (c) when there is a conflict between a rule under Title R501 and Settings rule, Settings rule shall supersede. (5) A licensee shall identify any community-based supports provided under the day treatment license and ensure that community-based services are provided safely and in consideration of weather, transportation, emergencies and overall client needs for food, medicine and any other assistance necessary for safe participation in the program.