42583 - 10A Ncac 06 Report With Comments
G.S. 150B-21.3A Report for 10A NCAC 06, AGING: PROGRAM OPERATIONS
Agency - DHHS/Division of Aging
Comment Period - Filled in by Agency
Date Submitted to APO - Filled in by RRC staff
| Subchapter | Rule Section | Rule Citation | Rule Name | Date and Last Agency Action on the Rule | Agency Determination [150B-21.3A(c)(1)a] | Implements or Conforms to Federal Regulation [150B-21.3A(e)] | Federal Regulation Citation | Public Comment Received [150B-21.3A(c)(1)] | Agency Determination Following Public Comment [150B-21.3A(c)(1)] |
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| SUBCHAPTER 06A – AGING: IN-HOME AIDE SERVICES FOR OLDER ADULTS | SECTION .0100 - SCOPE OF SERVICE | 10A NCAC 06A .0101 | SCOPE OF IN-HOME AIDE SERVICES | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| 10A NCAC 06A .0102 | DEFINITIONS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0103 | DESCRIPTION OF IN-HOME AIDE SERVICE LEVELS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0104 | TARGET POPULATION | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SECTION .0200 - CLIENT ELIGIBILITY | 10A NCAC 06A .0201 | ELIGIBILITY FOR IN-HOME AIDE SERVICES | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| SECTION .0300 - SERVICE PROVISION | 10A NCAC 06A .0301 | SERVICE DELIVERY | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06A .0302 | ASSESSMENT AND REASSESSMENT OF CLIENT | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0303 | IN-HOME AIDE SERVICE PLAN | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0304 | COMPETENCY REQUIREMENTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0305 | IN-HOME AIDE TASKS AND REQUIRED COMPETENCIES | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0306 | TIME FRAMES FOR COMPLETING COMPETENCY REQUIREMENTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0307 | AIDE SUPERVISION | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
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| 10A NCAC 06A .0308 | SELECTION OF AIDES | Amended Eff. May 1, 1995 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0309 | CLIENT RECORDS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06A .0310 | QUALITY ASSURANCE REQUIREMENTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06B - INSTITUTIONAL RESPITE CARE SERVICE | SECTION .0100 - SCOPE OF INSTITUTIONAL RESPITE CARE | 10A NCAC 06B .0101 | SCOPE OF INSTITUTIONAL RESPITE CARE SERVICE | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| SECTION .0200 - SERVICE PROVISION | 10A NCAC 06B .0201 | SCREENING OF CLIENT | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06B .0202 | HOME VISIT | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06B .0203 | SERVICE PLANS | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06B .0204 | DOCUMENTATION/RECORDS FOR PERSON REQUIRING CONSTANT CARE OR SUPERVISION | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06C – INFORMATION AND ASSISTANCE | SECTION .0100 - SCOPE OF INFORMATION AND ASSISTANCE | 10A NCAC 06C .0101 | DEFINITIONS AND SCOPE OF INFORMATION AND ASSISTANCE | Amended Eff. July 18, 2002 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| 10A NCAC 06C .0102 | SERVICE PROVISION | Eff. July 18, 2002 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SECTION .0200 – SERVICE PROVISION | 10A NCAC 06C .0201 | ELIGIBILITY FOR INFORMATION AND ASSISTANCE | Amended Eff. July 18, 2002 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
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| 10A NCAC 06C .0202 | RESOURCE FILE | Amended Eff. July 18, 2002 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06C .0203 | STAFF COMPETENCE | Amended Eff. July 18, 2002 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06C .0204 | DOCUMENTATION | Amended Eff. July 18, 2002 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06D - CARE MANAGEMENT | SECTION .0100 - SCOPE OF SERVICE | 10A NCAC 06D .0101 | SCOPE OF CARE MANAGEMENT | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| 10A NCAC 06D .0102 | DEFINITIONS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06D .0103 | TARGET POPULATION | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SECTION .0200 - SERVICE PROVISION | 10A NCAC 06D .0201 | CLIENT ELIGIBILITY | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06D .0202 | SCREENING | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06D .0203 | ASSESSMENT AND REASSESSMENT | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06D .0204 | CARE PLANNING | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06D .0205 | MONITORING | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06D .0206 | DOCUMENTATION | Eff. November 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06E - HOUSING AND HOME IMPROVEMENT SERVICE | SECTION .0300 - GENERAL | 10A NCAC 06E .0301 | PURPOSE | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest |
| 10A NCAC 06E .0302 | DEFINITIONS | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | ||
| 10A NCAC 06E .0303 | SERVICE POPULATIONS | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | ||
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| 10A NCAC 06E .0304 | APPLICATION FOR SERVICES | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | ||
| SECTION .0400 - SERVICE PROVISION | 10A NCAC 06E .0401 | SERVICE PROVIDER RESPONSIBILITIES | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | |
| 10A NCAC 06E .0402 | PROHIBITED SERVICE ACTIVITIES | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | ||
| 10A NCAC 06E .0403 | REQUEST FOR WAIVER | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06F - HEALTH SCREENING SERVICES | SECTION .0100 - SCOPE OF SERVICE | 10A NCAC 06F .0101 | SCOPE OF HEALTH SCREENING SERVICES | Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest |
| SECTION .0200 - SERVICE PROVISION | 10A NCAC 06F .0201 | PROVISION OF HEALTH SCREENING SERVICES | Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | |
| 10A NCAC 06F .0202 | ELIGIBILITY FOR HEALTH SCREENING SERVICES | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | ||
| 10A NCAC 06F .0203 | PERSONNEL REQUIREMENTS | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 3030 (a)(4) | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06G - SENIOR COMPANION | SECTION .0100 - SCOPE OF SERVICE | 10A NCAC 06G .0101 | SCOPE OF SENIOR COMPANION | Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| 10A NCAC 06G .0102 | DEFINITION OF VOLUNTEER STATION | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SECTION .0200 – SENIOR COMPANION ELIGIBILITY | 10A NCAC 06G .0201 | SENIOR COMPANION ELIGIBILITY | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06G .0202 | LETTER OF AGREEMENT | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06G .0203 | HOURS | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06G .0204 | TRAINING AND COMPETENCY | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06G .0205 | TERMINATION | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
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| SUBCHAPTER 06H - VOLUNTEER PROGRAM DEVELOPMENT | SECTION .0100 - SCOPE OF SERVICE | 10A NCAC 06H .0101 | SCOPE OF VOLUNTEER PROGRAM DEVELOPMENT SERVICE | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| SECTION .0200 - SERVICE PROVISION | 10A NCAC 06H .0201 | NEEDS ASSESSMENT | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06H .0202 | ADEQUACY OF INSURANCE | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06H .0203 | DOCUMENTATION | Eff. February 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06I - HOME HEALTH SERVICES | SECTION .0100 - SCOPE OF SERVICES | 10A NCAC 06I .0101 | SCOPE OF HOME CARE SERVICES | Eff. April 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| 10A NCAC 06I .0102 | DESCRIPTION OF HOME CARE SERVICES | Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SECTION .0200 - SERVICE PROVISION | 10A NCAC 06I .0201 | ELIGIBILITY FOR HOME CARE SERVICES | Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06I .0202 | SERVICE DELIVERY | Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06I .0203 | QUALITY ASSURANCE | Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06J – MULTIPURPOSE SENIOR CENTERS | SECTION .0100 – GENERAL PROVISIONS | 10A NCAC 06J .0101 | MULTIPURPOSE SENIOR CENTER OPERATING REQUIREMENTS | Eff. October 1, 1980 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321.53 © | No | Necessary without substantive public interest |
| SUBCHAPTER 06K – NUTRITION SERVICES | SECTION .0100 – SCOPE OF SERVICE | 10A NCAC 06K .0101 | DEFINITION OF CONGREGATE AND HOME-DELIVERED MEALS | Amended Eff. November 1, 1993 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest |
| SECTION .0200 – SERVICE PROVISION | 10A NCAC 06K .0201 | STAFFING | Amended Eff. July 1, 2003 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06K .0202 | FOOD PREPARATION AND SAFETY REQUIREMENTS | Amended Eff. July 1, 2003 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06K .0203 | MENU PLANNING REQUIREMENTS | Amended Eff. July 1, 2003 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06K .0204 | ELIGIBILITY FOR SERVICE | Amended Eff. July 1, 2003 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
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| 10A NCAC 06K .0205 | ADMINISTRATION REQUIREMENTS | Amended Eff. July 1, 2003 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06K .0206 | PROHIBITED ACTIVITIES | Amended Eff. July 1, 2003 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 & 42 U.S.C.3027 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06P – ADMINISTRATION OF ADULT DAY CARE SERVICES | SECTION .0100 – SERVICE DESCRIPTION: DEFINITION OF TERMS | 10A NCAC 06P .0101 | DEFINITION OF TERMS | Amended Eff. January 1, 1986 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 & 42 U.S.C.1397 | No | Necessary without substantive public interest |
| SECTION .0200 - CLIENT ELIGIBILITY: FEES AND CHARGES | 10A NCAC 06P .0201 | LIMITATIONS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 & 42 U.S.C.1397 | No | Necessary without substantive public interest | |
| SECTION .0300 - PAYMENT METHODS FOR DAY CARE CENTERS/HOMES | 10A NCAC 06P .0301 | GENERAL POLICY | Amended Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 & 42 U.S.C.1397 | No | Necessary without substantive public interest | |
| SECTION .0400 - ROLE RESPONSIBILITIES IN PROGRAM CERTIFICATIONS | 10A NCAC 06P .0401 | STATE DIVISION OF AGING AND ADULT SERVICES RESPONSIBILITIES | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 & 42 U.S.C.1397 | No | Necessary without substantive public interest | |
| 10A NCAC 06P .0402 | COUNTY DEPARTMENT OF SOCIAL SERVICES RESPONSIBILITY | Amended Eff. July 1, 1984 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 & 42 U.S.C.1397 | No | Necessary without substantive public interest | ||
| SECTION .0500 – PROGRAM CERTIFICATION | 10A NCAC 06P .0501 | DAY CARE PROGRAMS SERVING MORE THAN ONE COUNTY | Amended Eff. July 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 & 42 U.S.C.1397 | No | Necessary without substantive public interest | |
| 10A NCAC 06P .0502 | THE DSS-OPERATED ADULT DAY CARE CENTER | Amended Eff. July 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 & 42 U.S.C.1397 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06Q - ADULT DAY CARE | SECTION .0100 - SCOPE OF ADULT DAY CARE | 10A NCAC 06Q .0101 | ADULT DAY CARE STANDARDS | Eff. July 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | Yes | Necessary with substantive public interest |
| SECTION .0200 - REQUIREMENTS | 10A NCAC 06Q .0201 | MAXIMUM REIMBURSEMENT RATES | Eff. July 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | |
| SUBCHAPTER 06R - ADULT DAY CARE STANDARDS FOR CERTIFICATION | SECTION .0100 - INTRODUCTION | 10A NCAC 06R .0101 | CERTIFICATION REQUIREMENT | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest |
| 10A NCAC 06R .0102 | CORRECTIVE ACTION | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| SECTION .0200 - DEFINITION OF TERMS | 10A NCAC 06R .0201 | DEFINITIONS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | |
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| SECTION .0300 - ADMINISTRATION | 10A NCAC 06R .0301 | GOVERNING BODY | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06R .0302 | PROGRAM GOALS | Amended Eff. July 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0303 | AGREEMENTS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0304 | INSURANCE | Eff. July 1, 1978 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0305 | PERSONNEL: CENTERS: HOMES WITH OPERATOR AND STAFF | Amended Eff. September 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0306 | PERSONNEL: DAY CARE HOMES: ONLY STAFF PERSON IS OPERATOR | Amended Eff. September 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0307 | PERSONNEL: VOLUNTEERS | Eff. July 1, 1978 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| SECTION .0400 - THE FACILITY | 10A NCAC 06R .0401 | GENERAL REQUIREMENTS | Amended Eff. September 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | |
| 10A NCAC 06R .0402 | BUILDING CONSTRUCTION | Amended Eff. September 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0403 | EQUIPMENT AND FURNISHINGS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| SECTION .0500 - PROGRAM OPERATION | 10A NCAC 06R .0501 | PLANNING PROGRAM ACTIVITIES | Amended Eff. February 1, 2008 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | |
| 10A NCAC 06R .0502 | NUTRITION | Amended Eff. February 1, 2008 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0503 | TRANSPORTATION | Amended Eff. February 1, 2008 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0504 | EMERGENCIES AND FIRST AID | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0505 | MEDICATIONS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
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| 10A NCAC 06R .0506 | HOURS AND DAYS OF OPERATION | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0507 | AVAILABILITY AND ACCESSIBILITY OF PROGRAM POLICIES | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0508 | RECORDS | Amended Eff. February 1, 2008 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0509 | PROGRAM EVALUATION | Amended Eff. January 1, 1981 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0510 | DAY CARE PROGRAMS IN MULTI-USE FACILITIES | Amended Eff. July 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| SECTION .0600 – CERTIFICATION PROCEDURE | 10A NCAC 06R .0601 | PROCEDURE | Amended Eff. September 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | |
| 10A NCAC 06R .0602 | CHANGES IN PERSONNEL | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| SECTION .0700 - CONSTRUCTION REQUIREMENTS FOR DAY CARE HOME | 10A NCAC 06R .0701 | RESIDENTIAL BUILDING CODE REQUIREMENTS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06R .0702 | FIRE AND SAFETY REQUIREMENTS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0703 | OTHER | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| SECTION .0800 - CERTIFICATION INFORMATION | 10A NCAC 06R .0801 | THE CERTIFICATE | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | |
| 10A NCAC 06R .0802 | PROVISIONAL CERTIFICATE | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0803 | TERMINATION OF CERTIFICATION | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0804 | DENIAL OR REVOCATION OF CERTIFICATE | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0805 | PENALTY | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
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| 10A NCAC 06R .0806 | PROCEDURE FOR APPEAL | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| SECTION .0900 - SPECIAL CARE FOR PERSONS WITH ALZHEIMER’S DISEASE OR OTHER DEMENTIAS, MENTAL HEALTH DISABILITIES OR OTHER SPECIAL NEEDS DISEASES OR CONDITIONS IN ADULT DAY CARE CENTERS | 10A NCAC 06R .0901 | DISCLOSURE | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06R .0902 | POLICIES AND PROCEDURES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0903 | THE FACILITY – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0904 | ENROLLMENT – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06R .0905 | INDIVIDUAL SERVICE PLANS – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0906 | PROGRAM PLAN – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0907 | STAFF ORIENTATION AND TRAINING – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06R .0908 | REQUIREMENTS FOR SPECIAL CARE SERVICES UNIT | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 45 C.F.R.1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06S – ADULT DAY HEALTH STANDARDS FOR CERTIFICATION | SECTION .0100 - INTRODUCTION AND DEFINITIONS | 10A NCAC 06S .0101 | INTRODUCTORY STATEMENT | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest |
| 10A NCAC 06S .0102 | DEFINITIONS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| SECTION .0200 - ADMINISTRATION | 10A NCAC 06S .0201 | ADMINISTRATION | Eff. September 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
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| 10A NCAC 06S .0202 | PROGRAM GOALS | Eff. September 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0203 | STAFFING PATTERN | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06S .0204 | STAFF REQUIREMENTS | Amended Eff. September 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| SECTION .0300 - FACILITY REQUIREMENTS FOR CENTERS AND HOMES | 10A NCAC 06S .0301 | REQUIREMENTS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | |
| 10A NCAC 06S .0302 | CONSTRUCTION REQUIREMENTS FOR DAY HEALTH HOMES | Eff. September 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| SECTION .0400 - PROGRAM OPERATION | 10A NCAC 06S .0401 | PROGRAM OPERATION REQUIREMENTS | Eff. September 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06S .0402 | ADDITIONAL ENROLLMENT AND PARTICIPATION REQUIREMENTS | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06S .0403 | HEALTH AND PERSONAL CARE SERVICES | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06S .0404 | TRANSPORTATION | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06S .0405 | EMERGENCIES AND FIRST AID | Amended Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| SECTION .0500 - CERTIFICATION INFORMATION | 10A NCAC 06S .0501 | PROCEDURE | Amended Eff. July 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | |
| 10A NCAC 06S .0502 | CHANGES IN PERSONNEL | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0503 | THE CERTIFICATE | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0504 | PROVISIONAL CERTIFICATE | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0505 | TERMINATION OF CERTIFICATION | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
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| 10A NCAC 06S .0506 | DENIAL OR REVOCATION OF CERTIFICATE | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0507 | PENALTY | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0508 | PROCEDURE FOR APPEAL | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | Yes | Necessary with substantive public interest | ||
| 10A NCAC 06S .0509 | CORRECTIVE ACTION | Eff. March 1, 1992 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SECTION .0600 - SPECIAL CARE FOR PERSONS WITH ALZHEIMER'S DISEASE OR RELATED DISORDERS, MENTAL HEALTH DISABILITIES, OR OTHER SPECIAL NEEDS DISEASES OR CONDITIONS IN ADULT DAY CARE CENTERS | 10A NCAC 06S .0601 | DISCLOSURE | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | |
| 10A NCAC 06S .0602 | THE FACILITY – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0603 | ENROLLMENT – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0604 | INDIVIDUAL SERVICE PLANS – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0605 | PROGRAM PLAN – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0606 | STAFF ORIENTATION AND TRAINING – SPECIAL CARE SERVICES | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| 10A NCAC 06S .0607 | REQUIREMENTS FOR SPECIAL CARE SERVICES UNIT | Eff. July 17, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C. 1397 & 45 C.F.R. 1321 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06T – STATE ADULT DAY CARE FUNDING | SECTION .0200 - STATE ADULT DAY CARE FUND | 10A NCAC 06T .0201 | NATURE AND PURPOSE OF STATE ADULT DAY CARE FUND | Amended Eff. March 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | Yes | Necessary with substantive public interest |
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| 10A NCAC 06T .0202 | DEFINITION OF SERVICE | Amended Eff. July 1, 1983 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06T .0203 | ELIGIBILITY | Amended Eff. July 1, 1983 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06T .0204 | COST-SHARING | Amended Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06T .0205 | PROGRAM POLICIES AND STANDARDS | Amended Eff. November 1, 1984 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06T .0206 | ALLOCATION | Eff. January 1, 1982 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06U – STATE IN-HOME SERVICES FUND | SECTION .0100 – STATE IN-HOME SERVICES FUND | 10A NCAC 06U .0101 | NATURE AND PURPOSE OF STATE IN-HOME SERVICES FUND | Amended Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest |
| 10A NCAC 06U .0102 | DEFINITIONS OF SERVICES | Amended Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06U .0103 | ELIGIBILITY | Amended Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06U .0104 | COST-SHARING | Amended Eff. March 1, 1994 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06U .0105 | PROGRAM POLICIES AND STANDARDS | Amended Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06U .0106 | ALLOCATION | Amended Eff. October 1, 2000 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06V – STATE IN-HOME SERVICES FUND: PREPARATION and DELIVERY OF MEALS | SECTION .0100 – SERVICE DESCRIPTION | 10A NCAC 06V .0101 | REIMBURSABLE COST ITEMS | Amended Eff. July 1, 1984 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest |
| SECTION .0200 - DEFINITIONS | 10A NCAC 06V .0201 | DEFINITIONS | Amended Eff. July 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | |
| SECTION .0300 - METHODS OF SERVICE PROVISION | 10A NCAC 06V .0301 | GENERAL POLICY | Amended Eff. July 1, 1984 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | |
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| SECTION .0400 - MAXIMUM PURCHASE AND DELIVERY RATES: FEES: AND VOLUNTARY CONTRIBUTIONS | 10A NCAC 06V .0401 | MAXIMUM PURCHASE AND DELIVERY RATES | Amended Eff. July 1, 1984 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | |
| SECTION .0500 - ADDITIONAL REQUIREMENTS | 10A NCAC 06V .0501 | HEALTH AND SAFETY REQUIREMENTS | Readopted Eff. October 31, 1977 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | |
| 10A NCAC 06V .0502 | PROFESSIONAL CONSULTATION REQUIRED | Amended Eff. July 1, 1990 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06W – STATE IN-HOME SERVICES FUND: HOUSING AND HOME IMPROVEMENT SERVICES | SECTION .0100 – PROGRAM REQUIREMENTS | 10A NCAC 06W .0104 | NATURE AND PURPOSE | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest |
| 10A NCAC 06W .0105 | DEFINITIONS | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06W .0106 | SERVICE POPULATIONS | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06W .0107 | APPLICATION FOR SERVICES | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06W .0108 | SERVICE PROVIDER RESPONSIBILITIES | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06W .0109 | PROHIBITED ACTIVITIES | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06W .0110 | REQUEST FOR WAIVER | Eff. July 1, 2007 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| SUBCHAPTER 06X – STATE IN-HOME SERVICES FUND: IN-HOME AIDE SERVICES | SECTION .0100 - COORDINATION | 10A NCAC 06X .0101 | IN-HOME AIDE SERVICES FOR OLDER ADULTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest |
| SECTION .0200 - PROGRAM REQUIREMENTS | 10A NCAC 06X .0201 | IN-HOME AIDE SERVICES: ADULTS, CHILDREN AND THEIR FAMILIES | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | |
| 10A NCAC 06X .0202 | DEFINITIONS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
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| 10A NCAC 06X .0203 | DESCRIPTION OF IN-HOME AIDE SERVICE LEVELS FOR ADULTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0204 | DESCRIPTION OF IN-HOME AIDE LEVELS FOR CHILDREN/FAMILIES | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0205 | SERVICE DELIVERY | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0206 | ASSESSMENT AND REASSESSMENTS | Amended Eff. September 1, 1993 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0207 | IN-HOME AIDE SERVICE PLAN | Amended Eff. September 1, 1993 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0208 | COMPETENCY REQUIREMENTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0209 | TIME FRAMES FOR COMPLETING COMPETENCY REQUIREMENTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0210 | AIDE SUPERVISION | Amended Eff. September 1, 1993 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0211 | SELECTION OF AIDES | Amended Eff. December 1, 1995 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0212 | CLIENT RECORDS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0213 | QUALITY ASSURANCE REQUIREMENTS | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest | ||
| 10A NCAC 06X .0214 | METHODS OF SERVICE PROVISION | Eff. December 1, 1991 | Necessary without substantive public interest | Yes If yes, include the citation to the federal law | 42 U.S.C.1397 & 45 C.F.R.Part 96 | No | Necessary without substantive public interest |
| Row | RuleTitle | RuleCitation | Timestamp | FirstName | LastName | Company | Comment | DAAS Response | RRC Recommendation | |
|---|---|---|---|---|---|---|---|---|---|---|
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| 1 | ||||||||||
| 2 | SCOPE OF IN-HOME AIDE SERVICES | 10A NCAC 06A .0101 | 20-Apr-16 | Erin | Glendening | DHSR | erin.glendening@dhhs.nc.gov | This is a test of the system. | N/A | |
| 3 | ADULT DAY CARE STANDARDS | 10A NCAC 06Q .0101 | 20-Jun-16 | Carrie | Cameron | ccameron113@gmail.com | The reimbursement rates are not sustainable and should be Increased! Please! | DAAS is working with the NC Adult Day Services Association (NCADSA) to | ||
| 4 | ADULT DAY CARE STANDARDS | 10A NCAC 06Q .0101 | 24-Jun-16 | Marianne | Ratcliffe | Piedmont Health SeniorCare | ratclifm@piedmonthhealth.org | recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows on my comments in pertinent rules. | PACE is a a Medicaid Program. under the authority of the Division of Medical Assistance (DMA). When the NC PACE program was developed in 2014 it was | |
| 5 | MAXIMUM REIMBURSEMENT RATES | 10A NCAC 06Q .0201 | 16-Jun-16 | The Wright's Center, Inc. | wrightsboard@gmail.com | The financial stability of many adult day service centers is in jeopardy because we are restricted to a HCCBG reimbursement rate that does not adequately cover the actual cost of the services provided. When completing the 2016-17 Service Cost Computation Worksheet (SCCW) for next year, it is quite evident that my expenses are more than the revenue I anticipate receiving. Therefore, as a non-profit we are required to raise funds as best we can to balance our budget. According to the SCCW, the average cost of one day of adult day health service is $135.24; however, the center only receives $40 from either County served (Nash and Edgecombe). The SCCW rate for day care is $111.47, yet we only receive $33.01 from HCCBG reimbursement for either county. We serve a population that is indigent, on fixed incomes and without the expensive transportation we provide to them at a minimal cost of $6 (in town) or $7 (out of town), round trip per day, many would not be able to attend the program. Our transportation cost is over $10,000 per month, yet we only collect about $500 per month to cover this cost from participants. We definitely need a rate increase to be able to continue to operate in our community. Thank you for the opportunity to share my comments. | ||||
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| 6 | MAXIMUM REIMBURSEMENT RATES | 10A NCAC 06Q .0201 | 16-Jun-16 | Nate | Huggins | Blessed Assurance Adult Day and Health Care Svcs, Inc. | Nate@blessedadultcare.org | 1. Current Adult Day Health Care service reimbursement rate is $40 per day with a $3 per day transportation reimbursement. 2. The $40 per day service reimbursement needs to be changed to at least $60 to compete with the minimum daily cost of doing business. Currently, the Veteran's Administration's service reimbursement rate begins at $60 per day and goes beyond $100 per day in some states. 3. The $3 per day transportation reimbursement is not enough to purchase 1 gallon of premium fuel and certainly doesn't cover the fuel and other overhead related cost of transporting a mentally and physically challenged adult 40 miles round trip from their home to the Adult Day Care Center and back. This reimbursement should be increased to a minimum of $20 per day. Currently, the Veteran's Administration's reimbursement rate begins at $30 per day and goes beyond $50 per day in some states. Nate Huggins, CEO Blessed Assurance Adult Day and Health Care Svcs, Inc. 13001 Idlewild Road Matthews, NC 28105 | DAAS is working with the NCADSA to address this issue | |
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| 7 | MAXIMUM REIMBURSEMENT RATES | 10A NCAC 06Q .0201 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | Of all the services eligible for HCCBG funding, adult day care and adult day health are the only services for which maximum rates of payment are not market-based and are set by a regulatory entity. Remove the maximum reimbursement rates for HCCBG and State Adult Day Care Fund adult day care and adult day health so adult day centers can operate more effectively while allowing for differences such as in service levels, hours of operation, regional economies. - Adult day centers share the same focus as other HCCBG services. - Removing the maximum rates will not require an increase in funding; it will simply allow the rates to be set at the local level just like all of the other HCCBG funded services. - The current system makes it extremely difficult to increase reimbursement rates. The last rate increase for adult day centers for HCCBG and SADCF was in 2006. This established a maximum reimbursement rate of $33.07 per unit/day of adult day care and $40 per unit/day of adult day health. - The low reimbursement rates place significant challenges on the sustainability of existing adult day centers and severely limit growth of this service sector in NC. - Lack of adult day centers limits affordable care options for frail and impaired adults and their | DAAS is working with the NCADSA to address this issue | |
| 8 | MAXIMUM REIMBURSEMENT RATES | 10A NCAC 06Q .0201 | 24-Jun-16 | Marianne | Ratcliffe | Piedmont Health SeniorCare | ratclifm@piedmonthhealth.org | Not applicable to PACE. PACE receives no reimbursement for the provision of adult day services. PACE is a distinct and separate program which receives capitated payments from Medicare and Medicaid. | N/A this issue is not related to the provision of PACE | |
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| 9 | MAXIMUM REIMBURSEMENT RATES | 10A NCAC 06Q .0201 | 24-Jun-16 | Michael | Boles | Resources for Seniors, Inc. | michaelb@rfsnc.org | Please remove the maximum reimbursement rates through HCCBG and SADCF for adult day care and adult day health. Locally developed calculated rates will allow adult day centers to operate more effectively while allowing for differences such as in service levels, hours of operation, and regional economies. Of all the services eligible for Home and Community Care Block Grant funding, adult day care and adult day health care are the only services for which maximum rates of payment are not market-based and are set by a regulatory entity. The current reimbursement rates of $33.07/day for social ADS and $40.00/day for health ADS place significant challenges on the sustainability of existing adult day centers and severely limit growth of this service sector in NC. Continued low reimbursement rates may lead to a lack of adult day centers, limiting affordable care options for frail and impaired adults and their caregivers, potentially leading to premature institutionalization of adults that will drive up costs for taxpayers. In March of 2015, the North Carolina Adult Day Services Association (NCADSA) extended an invitation to all adult day service providers in our state to participate in a Cost Analysis Project by completing a basic cost analysis spreadsheet based on their most recently completed fiscal year. Follow up calls and | DAAS is working with the NCADSA to address this issue | |
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| 10 | CERTIFICATION REQUIREMENT | 10A NCAC 06R .0101 | 22-Jun-16 | Linda | Shaw | NC PACE Asssociation | linda.shaw@ncpace.org | Requirement is unnecessary and duplicative for PACE. Page ii of the DHHS Adult Day Care and Adult Day Health Standards for Certification states that 'The standards which follow for adult day care and adult day health are not intended as standards for day hospitals, partial hospital programs or other medically oriented day services.' PACE is a Medicare (and Medicaid) program delivering comprehensive medical care. PACE is the full-risk insurer and provider of all medical care to its patients. Most of the services are delivered at the PACE facility, which includes a 'day center' as just one component of the all-inclusive health care provided by PACE. PACE clearly fits into the referenced medical exclusion. Additionally, all aspects of PACE are regulated and monitored by both the federal government (CMS) and by the NC Division of Medical Assistance, so additional regulation as an ADHC is duplicative and unnecessary. | Page ii of the North Carolina Adult Day Care/Day Health Services Standards for Certification is the preface to the Standards and is not a rule. Please refer to the September 15, 2014 PACE Strategic Plan Report and to the Federal Registry 42 CFR 460. DAAS defers to DMA on this item. | |
| 11 | CERTIFICATION REQUIREMENT | 10A NCAC 06R .0101 | 24-Jun-16 | Requirement is unnecessary and duplicative for PACE. Page ii of the DHHS Adult Day Care and Adult Day Health Standards for Certification states that 'The standards which follow for adult day care and adult day health are not intended as standards for day hospitals, partial hospital programs or other medically oriented day services.' PACE is a Medicare (and Medicaid) program delivering comprehensive medical care. PACE is the full-risk insurer and provider of all medical care to its patients. Most of the services are delivered at the PACE facility, which includes a 'day center' as just one component of the all-inclusive health care provided by PACE. PACE clearly fits into the referenced medical exclusion. Additionally, all aspects of PACE are regulated and monitored by both the federal government (CMS) and by the NC Division of Medical Assistance, so additional regulation as an ADHC is duplicative and unnecessary. | This is a duplicate of the above item. | |||||
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| 12 | CORRECTIVE ACTION | 10A NCAC 06R .0102 | 22-Jun-16 | Duplicative of existing DMA and CMS monitoring. Recommend elimination for PACE. Alternatively, create PACE Adult Day Center set of standards for monitoring. | Please refer to the September 15, 2014 PACE Strategic Plan Report for PACE programs. | |||||
| 13 | CORRECTIVE ACTION | 10A NCAC 06R .0102 | 24-Jun-16 | Duplicative of existing DMA and CMS monitoring. Recommend elimination for PACE. Alternatively, create PACE Adult Day Center set of standards for monitoring. | Duplication of above comment. | |||||
| 14 | DEFINITIONS | 10A NCAC 06R .0201 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | 25. Owner: Not-for-profit centers do not have owners; rather, they have a board of directors. Suggest: person responsible for management of a for profit day care home or day health home. | DAAS unsure of what is meant by this comment as the rule already states the suggested language. | |
| 15 | DEFINITIONS | 10A NCAC 06R .0201 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | 30. Program Director: Although the duties are comparable, the title is not consistent with PACE programs which are also monitored by DAAS. In PACE the Program Director could be titled Executive Director and or CEO; however, ADH regulations require use of the title Program Director. This label also causes confusion and problems in adult day programs where there is a parent company that often has other titles. Consideration should be given to being flexible on 'the title' and more focused on 'the duties.' Add Health Care Coordinator definition. Add PACE definition. | 1). For the comments related to PACE programs, please refer to the September 15, 2014 PACE Strategic Plan Report. 2). For the ADC/ADH programs, the current rule allows for flexibility, and focuses on the required duties, functions and qualifications of the Program Director position. 3). The current rules outline the requirements and duties of the Health Care Coordinator. 4). DAAS defers to DMA on this item. | |
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| 16 | DEFINITIONS | 10A NCAC 06R .0201 | 22-Jun-16 | As indicated throughout these comments, PACE is a distinct program already heavily monitored by CMS and DMA, rendering state certification as an ADHC unneccessary and duplicative. If certification continues, however, a definition should be added for the 'PACE adult day center' and rules and requirements throughout should be amended or deleted to reflect the important distinction. Existing definitions would also need to change to be relevant to PACE. The capacity definition based on square footage does not apply because all PACE participants do not attend the adult day health center. The definition of Special Care services also does not apply to PACE programs. | Please refer to the September 15, 2014 PACE Strategic Plan Report for PACE programs and DAAS defers to DMA as DMA is the administering agency for PACE. | |||||
| 17 | DEFINITIONS | 10A NCAC 06R .0201 | 24-Jun-16 | As indicated throughout these comments, PACE is a distinct program already heavily monitored by CMS and DMA, rendering state certification as an ADHC unneccessary and duplicative. If certification continues, however, a definition should be added for the 'PACE adult day center' and rules and requirements throughout should be amended or deleted to reflect the important distinction. Existing definitions would also need to change to be relevant to PACE. The capacity definition based on square footage does not apply because all PACE participants do not attend the adult day health center. The definition of Special Care services also does not apply to PACE programs. | This is a duplicate of the above item. | |||||
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| 18 | DEFINITIONS | 10A NCAC 06R .0201 | 24-Jun-16 | As indicated throughout these comments, PACE is a distinct program already heavily monitored by CMS and DMA, rendering state certification as an ADHC unneccessary and duplicative. If certification continues, however, a definition should be added for the 'PACE adult day center' and rules and requirements throughout should be amended or deleted to reflect the important distinction. Existing definitions would also need to change to be relevant to PACE. The capacity definition based on square footage does not apply because all PACE participants do not attend the adult day health center. The definition of Special Care services also does not apply to PACE programs. | This is a duplicate of the above item. | |||||
| 19 | DEFINITIONS | 10A NCAC 06R .0201 | 24-Jun-16 | Repeat of comments on 10A NCAC 06R .0201: As indicated throughout these comments, PACE is a distinct program already heavily monitored by CMS and DMA, rendering state certification as an ADHC unneccessary and duplicative. If certification continues, however, a definition should be added for the 'PACE adult day center' and rules and requirements throughout should be amended or deleted to reflect the important distinction. Existing definitions would also need to change to be relevant to PACE. The capacity definition based on square footage does not apply because all PACE participants do not attend the adult day health center. The definition of Special Care services also does not apply to PACE programs. | Duplication of above comment. | |||||
| 20 | PROGRAM GOALS | 10A NCAC 06R .0302 | 22-Jun-16 | Goals for PACE should be consistent with the mission, vision and values of PACE, which is a considerably more comprehensive medical and social model of care. | The current rule allows flexibility regarding the program's goals. Please refer to the September 15, 2014 PACE Strategic Plan Report for PACE programs. | |||||
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| 21 | PROGRAM GOALS | 10A NCAC 06R .0302 | 24-Jun-16 | Goals for PACE should be consistent with the mission, vision and values of PACE, which is a considerably more comprehensive medical and social model of care. | This is a duplicate of the above item. | |||||
| 22 | INSURANCE | 10A NCAC 06R .0304 | 22-Jun-16 | Adequate liability insurance coverage should also include professional staff | DAAS is not sure what is meant by "professional staff." Is this a reference to licensed or non-licensed or both? However, defers to DMA as the Current ADC/ADH rules only require one licensed professional. | |||||
| 23 | INSURANCE | 10A NCAC 06R .0304 | 24-Jun-16 | Adequate liability insurance coverage should also include professional staff | Duplication of above comment. | |||||
| 24 | PERSONNEL: CENTERS: HOMES WITH OPERATOR AND STAFF | 10A NCAC 06R .0305 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (4) There shall be a written job description for each position, full-time or part-time. The job description shall specify qualifications of education and experience; to whom employee is responsible; duties and responsibilities; and salary range. Requirement to include salary range should be eliminated. Job descriptions should not be required to have salary ranges. There is inconsistency in how this rule is being applied by monitors. The numbers are often meaningless. | Although DAAS has scheduled routine meetings with NCADSA, this concern was not yet expressed by the association. DAAS will research this and review that rule. | |
| 25 | PERSONNEL: CENTERS: HOMES WITH OPERATOR AND STAFF | 10A NCAC 06R .0305 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (5) References, including former employers, shall be required in recruitment of staff. This rule is problematic because most employers will only provide employment verification rather than a reference. Change to include employment verification. | During routine meetings with NCADSA, this comment was not yet expressed by the association to DAAS staff as a concern. DAAS will research this comment and review that rule. | |
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| 26 | PERSONNEL: CENTERS: HOMES WITH OPERATOR AND STAFF | 10A NCAC 06R .0305 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | The program director shall have the authority and responsibility for the management of activities and direction of staff to ensure that activities and services are provided in accordance with established program policies. Allow flexibility in the title to use Program Director as the title. In PACE the Program Director could be titled Executive Director and or CEO; however, ADH regulations require use of the title Program Director. Focus should be given on ensuring that the duties are addressed rather than a rigid title. Adult day centers that are part of larger organizations may be locked in to titles other than 'Program Director.' | Duplication of previous comment | |
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| 27 | PERSONNEL: CENTERS: HOMES WITH OPERATOR AND STAFF | 10A NCAC 06R .0305 | 22-Jun-16 | Owners to reside in the home should be eliminated. PACE employees do not live in the PACE centers. Eliminate section (d) requirement for job descriptions to include salary ranges. Eliminate reference requirement due to employment laws which only allow for limited reference information such as dates of employment and title. It is optional for previous employers to give rehire eligibility Ratios are applicable for Adult Day Health and Day Health only. PACE programs staff also include members of the IDT and drivers who are considered direct care staff. Program Director requirement-eliminate requirement to use Program Director as the title. In PACE the Program Director could be titled Executive Director and or CEO; however, ADH regulations require use of the title Program Director.This is purely semantics and has no bearing on the delivery of care to the individuals. Health Care Coordinator requirement-PACE programs have multiple nurses caring for the participant. Eliminate requiring one nurse identified as health care coordinator. Maintain all nursing requirements except completing preadmission health assessment for initial acceptance into program, including problem-identification and care planning. Potential PACE participants receive medical assessments by licensed physician prior to enrollment. These medical assessments include a recommendation from the Physician regarding PACE | Many statements in this comment are duplications of other comments. DAAS response is limited to only the new items expressed in this comment: 1). PACE programs do not have owners, they have non-profit board of directors, therefore, this comment about homes is not applicable to PACE programs, but is applicable to ADC/ADH homes. 2). although the NC PACE Association has participated in meetings with DAAS and NCADSA several times this concern related to staffing ratios had not yet been raised. This rule relates to the ADH setting, not the additional services provided by PACE. 3). DAAS will need to consult with DMA regarding the designated Health Care Coordinator position and the nursing pre-admission assessment requirements. | |||||
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| 28 | PERSONNEL: CENTERS: HOMES WITH OPERATOR AND STAFF | 10A NCAC 06R .0305 | 24-Jun-16 | PACE employees do not live in the PACE centers. Eliminate section (d) requirement for job descriptions to include salary ranges. Eliminate reference requirement due to employment laws which only allow for limited reference information such as dates of employment and title. It is optional for previous employers to give rehire eligibility Ratios are applicable for Adult Day Health and Day Health only. PACE programs staff also include members of the IDT and drivers who are considered direct care staff. Program Director requirement-eliminate requirement to use Program Director as the title. In PACE the Program Director could be titled Executive Director and or CEO; however, ADH regulations require use of the title Program Director.This is purely semantics and has no bearing on the delivery of care to the individuals. Health Care Coordinator requirement-PACE programs have multiple nurses caring for the participant. Eliminate requiring one nurse identified as health care coordinator. Maintain all nursing requirements except completing preadmission health assessment for initial acceptance into program, including problem-identification and care planning. Potential PACE participants receive medical assessments by licensed physician prior to enrollment. These medical assessments include a recommendation from the Physician regarding PACE | This is a duplicate of the above item. | |||||
| 29 | GENERAL REQUIREMENTS | 10A NCAC 06R .0401 | 21-Jun-16 | g. Address whether or not urinals can be counted as toilets. Clarify which staff are being counted..is it all staff (which is not feasible in a large center) or just the # of staff to meet the direct care ratio? For certification purposes, what is used? Allowances should be made if there are bathrooms available for staff use that are outside of the certified space, but in a shared area (with other departments or services). In other words, if that is the case and that is what the staff use then they should be able to be counted OR remove staff from the count. | DAAS will confer with Department of Insurance, State Fire Marshal's office regarding this comment as it also pertains to accesibility of bathrooms. | |||||
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| 30 | GENERAL REQUIREMENTS | 10A NCAC 06R .0401 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (i) A telephone shall be available for participants to make and receive calls. The following is obsolete and should be deleted: [A pay station telephone is not acceptable for local calls.] | DAAS agrees with removing "A pay station telephone is not acceptable for local calls." | |
| 31 | EQUIPMENT AND FURNISHINGS | 10A NCAC 06R .0403 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (2) table space adequate for all participants to be served a meal at a table at the same time and for program activities; 'At the same time' is in conflict with person-centered care. It is more reasonable in larger facilities that some people may be eating simultaneously while others are engaged in program activities. Delete 'at the same time.' | DAAS is not opposed to this suggestion, will consult with Person Centered Experts. | |
| 32 | EQUIPMENT AND FURNISHINGS | 10A NCAC 06R .0403 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (3) chairs or sofas that allow for position changes, are upholstered or of soft material, and water and stain resistant, so that at least half of the participants can relax and rest at the same time. If all participants take a daily rest period at the same time, the facility shall have enough of such seating for all participants; This does not address people who are in wheelchairs who are best served by staying in their wheelchairs for position changes. Suggest adding an exception for people in wheelchairs that allow for position changes. | DAAS is not opposed to this suggestion, will review. | |
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| 33 | EQUIPMENT AND FURNISHINGS | 10A NCAC 06R .0403 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (4) a quiet space with a minimum of one bed or cot so that participants can lie down as needed separate from other program activities. This is interpreted inconsistently by monitors and needs clarification. Currently, some interpret that this can be the bed in the treatment room and some say that it has to be a separate room. This needs to be clarified and the question needs to be asked...why can't it be the bed in the treatment room. Several centers either have a room deemed 'quiet room' that meets the standard but it never used because it is used more for storage and is not appealing to the participants or that there is a folding cot stored away that can be brought out if needed and meets the standard. , such as it has to be an exclusive room which is rarely used in many centers. The clinic in a PACE center should be allowed as quiet space. | Using the bed in the treatment room is not acceptable because another participant may be receiving treatment on said bed in treatment room, therefore, defeating the purpose of the quiet space. Additionally, the quiet space should not be used for storage. A folding cot that can be placed in the quiet space is fine. The current rule allows for provider flexibility. As for the clinic area in the PACE center, this is not always a quiet place, therefore, defeats the purpose of the rule. | |
| 34 | EQUIPMENT AND FURNISHINGS | 10A NCAC 06R .0403 | 22-Jun-16 | PACE is a full service clinic and comprehensive care provider, with additional space and equipment specifically suited to the frail elderly population served, rendering these ADHC regulations unneccessary. Recommend elimination for PACE, or creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: For PACE, the quiet space for lying down can include a space in the clinic where beds are available for clinical care as well as resting, and a separate area for quieter activities or programs. The PACE program will provide sufficient furnishings and equipment that meet the needs of all participants. | Duplication of above See above | |||||
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| 35 | EQUIPMENT AND FURNISHINGS | 10A NCAC 06R .0403 | 24-Jun-16 | Recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: For PACE, the quiet space for lying down can include a space in the clinic where beds are available for clinical care as well as resting, and a separate area for quieter activities or programs. | Duplication of above See above | |||||
| 36 | PLANNING PROGRAM ACTIVITIES | 10A NCAC 06R .0501 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | 1. Enrollment Procedures a. For PACE, Enrollment Agreement will suffice for ADH enrollment procedures provided they cover CMS/DMA Enrollment Process (460.162) & Participant Rights (460.116). Standard NC PACE Intake Enrollment Agreement & Process to be accepted provided enrollment agreement includes a statement that document was received and an agreement to abide by the ADH policies. 2. Planning Services for individual participants a. PACE will comply with participant assessment requirements set forth in 460.104. b. For PACE, the service plan will be signed in accordance with PACE regulation 460.106. c. For PACE, the written service plan will be developed according to PACE regulation 460.106. | Please refer to the September 15, 2014 PACE Strategic Plan report and crosswalk | |
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| 37 | PLANNING PROGRAM ACTIVITIES | 10A NCAC 06R .0501 | 22-Jun-16 | Requirements for PACE are extensively covered by CMS and/or DMA regulations. Recommend eliminating PACE from NC Adult Day standards. Alternatively, recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: 1. Enrollment Procedures a. For PACE, in lieu of this requirement, Enrollment Agreement will suffice for ADH enrollment procedures provided they cover CMS/DMA Enrollment Process (460.162) & Participant Rights (460.116). Standard NC PACE Intake Enrollment Agreement & Process to be accepted provided enrollment agreement includes a statement that document was received and an agreement to abide by the ADH policies. b. For PACE, in lieu of this requirement, the enrollment process will be conducted in accordance with PACE regulation 460.162 c. For PACE, in lieu of this requirement, CMS/DMA voluntary disenrollment regulation 460.164 will be followed d. For PACE, in lieu of this requirement, CMS/DMA involuntary disenrollment regulation 460.164 will be followed. 2. Planning Services for individual participants | Please refer to the September 15, 2014 PACE Strategic Plan report and crosswalk | |||||
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| 38 | PLANNING PROGRAM ACTIVITIES | 10A NCAC 06R .0501 | 24-Jun-16 | recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: 1. Enrollment Procedures a. For PACE, in lieu of this requirement, Enrollment Agreement will suffice for ADH enrollment procedures provided they cover CMS/DMA Enrollment Process (460.162) & Participant Rights (460.116). Standard NC PACE Intake Enrollment Agreement & Process to be accepted provided enrollment agreement includes a statement that document was received and an agreement to abide by the ADH policies. b. For PACE, in lieu of this requirement, the enrollment process will be conducted in accordance with PACE regulation 460.162 c. For PACE, in lieu of this requirement, CMS/DMA voluntary disenrollment regulation 460.164 will be followed d. For PACE, in lieu of this requirement, CMS/DMA involuntary disenrollment regulation 460.164 will be followed. 2. Planning Services for individual participants a. For PACE, in lieu of this requirement, the participant assessments will conducted in accordance with CMS/DMA regulation 460.104. b. For PACE, in lieu of this requirement, the service | Please refer to the September 15, 2014 PACE Strategic Plan report and crosswalk | |||||
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| 39 | NUTRITION | 10A NCAC 06R .0502 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (d) A licensed dietician/nutritionist shall give consultation to the staff on basic and special nutritional needs and proper food handling techniques and the prevention of foodborne illness. This rule is interpreted inconsistently--some monitors accept ServSafe Certification, while others require consultation by a licensed dietician which is very costly. Update the rule to be comparable to nutrition site language (10A NCAC 06K .0202) or allow for ServSafe Certfication. Suggested update: A licensed dietician/nutritionist shall give consultation to the staff on basic and special nutritional needs. All staff working in the preparation of food shall insure the application of hygienic techniques and practices in food handling, preparation and service. This staff consult with the a licensed dietician/nutritionist for advice and consultation as necessary. PACE programs are regulated by PACE regulation 460.78 | DAAS will review and provide interpretation as needed of this rule. | |
| 40 | NUTRITION | 10A NCAC 06R .0502 | 22-Jun-16 | RECOMMENDATION FOR CHANGE TO STANDARD: ADD somewhere in this section: For PACE programs, dietary services will be regulated by PACE regulation 460.78 3. Snacks shall be planned to keep sugar, salt and total fat intake to a minimum. | Refer to September 15, 2014 PACE Strategic Plan report and crosswalk | |||||
| 41 | NUTRITION | 10A NCAC 06R .0502 | 24-Jun-16 | RECOMMENDATION FOR CHANGE TO STANDARD: Nutrition - ADD somewhere in this section: For PACE programs, dietary services will be regulated by PACE regulation 460.78 3. Snacks shall be planned to keep sugar, salt and cholesterol total fat intake to a minimum. | Duplication of above | |||||
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| 42 | TRANSPORTATION | 10A NCAC 06R .0503 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | For PACE programs, transportation services will be regulated by PACE regulation 460.76. (4) Vehicles shall be equipped with a first aid kit, consisting of the items listed in 10A NCAC 06S .0301(a), and a fire extinguisher. The first aid supplies should not be listed because some are never used and others that are not listed are used frequently. This list is outdated, impractical and not in keeping with the daily operational needs of most Adult Day centers. Modify to state that first aid supplies should consistent with those recommended by American Red Cross. | Refer to September 15, 2014 PACE Strategic Plan report and crosswalk. DAAS will review the first aid supplies comment. | |
| 43 | TRANSPORTATION | 10A NCAC 06R .0503 | 22-Jun-16 | Requirements for PACE are extensively covered by CMS and/or DMA regulations. Recommend eliminating PACE from NC Adult Day standards. Alternatively,recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: In lieu of this requirement, for PACE programs, transportation services will be regulated by PACE regulation 460.76. The first aid kit contents should be changed to reflect the suggested changes in 10A NCAC 06R .0504 | Duplication of above. | |||||
| 44 | TRANSPORTATION | 10A NCAC 06R .0503 | 24-Jun-16 | recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: In lieu of this requirement, for PACE programs, transportation services will be regulated by PACE regulation 460.76. Note that the first aid kit contents will be changed to reflect the suggested changes in section 111 B5. ' | Duplication of above. | |||||
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| 45 | EMERGENCIES AND FIRST AID | 10A NCAC 06R .0504 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (f) The program shall have a portable basic emergency information file available on each client that includes... Add 'portable includes electronic access' since PACE programs and a growing number of adult day centers store information electronically. | DAAS will review it. | |
| 46 | EMERGENCIES AND FIRST AID | 10A NCAC 06R .0504 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (d) All physically able staff who have direct contact with participants shall complete certified training in standard first aid and cardio-pulmonary resuscitation (CPR). This first aid rule seems irrelevant for the certified or licensed medical personnel such as the doctors, pharmacists in PACE or nurses. Suggest revising so that only non-certified or non-licensed medical personnel with direct contact with participants shall be required to complete first aid training. | DAAS will review and seek consultation from various licensing boards. | |
| 47 | EMERGENCIES AND FIRST AID | 10A NCAC 06R .0504 | 22-Jun-16 | recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: In lieu of this requirement, for PACE programs, emergency services will be regulated by PACE regulation on Emergency Care, 460.100 and pertinent elements of CMS/DMA regulation 460.102 (staffing, Training & Interdisciplinary Team). 4. Revise first sentence here to state: All physically able staff who have direct contact with participants shall complete certified training in cardio-pulmonary resuscitation (CPR). Only non-certified or non-licensed medical personnel with direct contact with participants shall be required to complete first aid training. a. taught by a certified instructor. Delete the wording 'certified through the American Hearth Association, American red cross, national safety council, American safety and health institute, or EMS.' 6. ADD: 'Portable' includes electronic access. | ||||||
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| 48 | EMERGENCIES AND FIRST AID | 10A NCAC 06R .0504 | 24-Jun-16 | recommend creation of PACE Adult Day Centers standards that reflect the realities of PACE as follows: RECOMMENDATION FOR CHANGE TO STANDARD: In lieu of this requirement, for PACE programs, emergency services will be regulated by PACE regulation on Emergency Care, 460.100 and pertinent elements of CMS/DMA regulation 460.102 (staffing, Training & Interdisciplinary Team). 4. Revise first sentence here to state: All physically able staff who have direct contact with participants shall complete certified training in cardio-pulmonary resuscitation (CPR). Only non-certified or non-licensed medical personnel with direct contact with participants shall be required to complete first aid training. a. taught by a certified instructor. Delete the wording ''certified through the American Hearth Association, American red cross, national safety council, American safety and health institute, or EMS.'' 6. ADD: 'Portable' includes electronic access. ' | First portion is a duplicate. DAAS will review comments related to instructor certification. Last item tiled 4 is a duplicate. | |||||
| 49 | HOURS AND DAYS OF OPERATION | 10A NCAC 06R .0506 | 22-Jun-16 | Do not require that PACE director receive agreement from county DSS for scheduled closure days | DAAS will review. | |||||
| 50 | HOURS AND DAYS OF OPERATION | 10A NCAC 06R .0506 | 24-Jun-16 | Do not require that PACE director receive agreement from county DSS for scheduled closure days. | Duplication of above | |||||
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| 51 | RECORDS | 10A NCAC 06R .0508 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (D) time of day participant will arrive and time of day participant will leave the program; Caregivers are often unsure, when enrolling the participant, what kinds of issues they will run into when getting a family member ready and it changes based upon which family member is providing transportation that day. If the participant is using contracted transportation, then the caregiver doesn't know upon enrollment what those times will be. I think the intent was to allow the program to plan...but we learn and adjust to participant's schedules regularly (not based upon what they wrote on enrollment paperwork). Therefore, it is often arbitrary times that are added in order to meet the standard (no value). It would be much more meaningful to capture the expected days participants plan to attend. | This rule is to ensure participant safety and adequate staff to participant ratios are maintained. DAAS will review. | |
| 52 | RECORDS | 10A NCAC 06R .0508 | 22-Jun-16 | As noted throughout, PACE is also regulated by CMS and DMA, and these regulations are more appropriate for PACE. This requirement is duplicative of the CMS regulation. In lieu of eliminating duplicative regulations, PACE Association recommends the following language for standards specific to PACE: PACE will comply with 42 CFR § 460.210 as it pertains to individual participant records in lieu of ADHC regulations b.1-7. For PACE, maintenance of records will comply with 42 CFR § 460.200, as opposed to ADHC regulations. 8A-H For personnel records (9-11), PACE programs will comply with CMS/DMA Reg. Requirements for Staffing, Training & Interdisciplinary Team (460.102) vs. DAAS ADHC requirements. For program records: For PACE, policies will be accepted as PACE policies, and not a separate creation of ADHC policies. | Refer to September 15, 2014 PACE Strategic Plan report and crosswalk | |||||
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| 53 | RECORDS | 10A NCAC 06R .0508 | 24-Jun-16 | As noted throughout, PACE is also regulated by CMS and DMA, and these regulations are more appropriate for PACE. This requirement is duplicative of the CMS reg. PACE RECOMMENDATION FOR CHANGE TO STANDARD: In lieu of this requirement, PACE will comply with 42 CFR § 460.210 as it pertains to individual participant records in lieu of ADHC regulations b.1-7. For PACE, maintenance of records will comply with 42 CFR § 460.200, as opposed to ADHC regulations. 8A-H For personnel records (9-11), PACE programs will comply with CMS/DMA Reg. Requirements for Staffing, Training & Interdisciplinary Team (460.102) vs. DAAS ADHC requirements. For program records: For PACE, policies will be accepted as PACE policies, and not a separate creation of ADHC policies. ' | Refer to September 15, 2014 PACE Strategic Plan report and crosswalk | |||||
| 54 | PROGRAM EVALUATION | 10A NCAC 06R .0509 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | ADD somewhere in this section: For PACE programs, program evaluation will be regulated by PACE regulation on Quality Improvement and Performance Improvement, 460.136. | Refer to September 15, 2014 PACE Strategic Plan report and crosswalk | |
| 55 | PROGRAM EVALUATION | 10A NCAC 06R .0509 | 24-Jun-16 | This rule is unneccessary for PACE, which is already regulated by federal CMS PACE regulation 460.136 on Quality Improvement and Performance Improvement. PACE RECOMMENDATION FOR CHANGE TO STANDARD: For PACE programs, in lieu of this requirement, program evaluation will be regulated by PACE regulation on Quality Improvement and Performance Improvement, 460.136. | Duplication of the above | |||||
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| 56 | PROCEDURE | 10A NCAC 06R .0601 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (d) No more than 60 days prior to the end of the current period of certification, the county department of social services shall submit to the Division of Aging and Adult Services the following forms and materials which make up a certification package for the renewal of a certification. The following should be changed to reflect current practices by DAAS at NCADSA's request for changing 60 days to 90 days. Potentially add language for Division of Aging and Adult Services to respond to the county department of social services and the provider within 30 days prior to the end of the current period of certification with questions on submitted materials or need for additional information. 4. Renewal Certification Package [10A NCAC 06R .0601] Suggested change... If there are any findings which may affect the renewal of certification, the Division of Aging and Adult Services will provide to the county department of social services and the provider such information within 30 days prior to the end of current period of certification. Define 'timely fashion'--This statement is actually related to submission of the packet by the county department of social services to DAAS and could | DAAS will review. DAAS has revised the certification reminder process per the NCADSA's request as discussed during the regularly scheduled meetings DAAS has with NCADSA and the NC PACE Association. | |
| 57 | PROCEDURE | 10A NCAC 06R .0601 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (13) verification of standard first aid and cardio-pulmonary resuscitation certification (CPR) for each proposed staff member who is physically able and who will have direct contact with participants. Same comment on relevance of First Aid Training for professionals. Suggest that only non-certified or non-licensed medical personnel with direct contact with participants shall be required to complete first aid training. | Duplication. | |
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| 58 | THE CERTIFICATE | 10A NCAC 06R .0801 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | The certificate will be issued by the Division of Aging when, in the division's judgment, minimum requirements for certification have been met under the rules of this Subchapter. 'In the division's judgment' is very subjective and should be removed. | DAAS will review | |
| 59 | THE CERTIFICATE | 10A NCAC 06R .0801 | 22-Jun-16 | As indicated in comments to 10A NCAC 06R .0101, PACE is distinct from ADHC, offering a full complement of medical care for which it assumes all risk. A Medicare/Medicaid fully capitated program, it is heavily regulated and monitored by CMS and DMA. The process of securing state certification as an ADHC is duplicative, unneccessary and costly to both the program and the taxpayers. Recommend that the words 'in the division's judgment' be eliminated. | Duplication | |||||
| 60 | THE CERTIFICATE | 10A NCAC 06R .0801 | 24-Jun-16 | As indicated in comments to 10A NCAC 06R .0101, PACE is distinct from ADHC, offering a full complement of medical care for which it assumes all risk. A Medicare/Medicaid fully capitated program, it is heavily regulated and monitored by CMS and DMA. The process of securing state certification as an ADHC is duplicative, unneccessary and costly to both the program and the taxpayers. Recommend that the words 'in the division's judgment' be eliminated. | Duplication | |||||
| 61 | PROVISIONAL CERTIFICATE | 10A NCAC 06R .0802 | 22-Jun-16 | Should be unnecessary for PACE, per comments on 10A NCAC 06R .0101 and 10A NCAC 06R .0801. If continued, however, DAAS should advise programs of any needed corrections at least 30 days prior to expiration of current certificate and renewal process should start at least 90 days in advance of expiration to significantly reduce the need for provisional certificates. | Duplication | |||||
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| 62 | PROVISIONAL CERTIFICATE | 10A NCAC 06R .0802 | 24-Jun-16 | Should be unneccessary for PACE, per comments on 10A NCAC 06R .0101 and 10A NCAC 06R .0801. If continued, however, DAAS should advise programs of any needed corrections at least 30 days prior to expiration of current certificate. | Duplication | |||||
| 63 | PROCEDURE FOR APPEAL | 10A NCAC 06R .0806 | 22-Jun-16 | L | PACE is already covered by a more extensive CMS/DMA appeals process (CFR 460.122), making this unnecessary for PACE | This comment is not pertinent to this rule citation | ||||
| 64 | PROCEDURE FOR APPEAL | 10A NCAC 06R .0806 | 24-Jun-16 | PACE is already covered by a more extensive CMS/DMA appeals process (CFR 460.122), making this unneccesary for PACE | Duplication of the above | |||||
| 65 | POLICIES AND PROCEDURES | 10A NCAC 06R .0902 | 22-Jun-16 | Linda | SHAW | NC PACE Asssociation | This does not apply to PACE programs, which do not separate individuals by diagnoses and do not have special needs section of facility | This rule is optional, this is not a requirement for certification. | ||
| 66 | POLICIES AND PROCEDURES | 10A NCAC 06R .0902 | 24-Jun-16 | This does not apply to PACE programs, which do not separate individuals by diagnoses and do not have special needs section of facility | Duplication of the above | |||||
| 67 | ENROLLMENT – SPECIAL CARE SERVICES | 10A NCAC 06R .0904 | 22-Jun-16 | Shaw | NC PACE Association | PACE does not distinguish participants or the care provided as 'special care', although many PACE participants have dementia or Alzheimers. All potential PACE participants receive the same thorough enrollment procedure and information covered by CMS regulations noted throughout these comments. | Duplication of the above | |||
| 68 | ENROLLMENT – SPECIAL CARE SERVICES | 10A NCAC 06R .0904 | 24-Jun-16 | PACE does not distinguish participants or the care provided as 'special care', although many PACE participants have dementia or Alzheimers. All potential PACE participants receive the same thorough enrollment procedure and information covered by CMS regulations noted throughout these comments. | Duplication of the above | |||||
| 69 | INTRODUCTORY STATEMENT | 10A NCAC 06S .0101 | 22-Jun-16 | Linda | Shaw | NC PACE Association | PACE supports the goals and intent of Adult Day Services certification. However, as indicated in our comments to 10A NCAC 06R .0101, these services are but one aspect of a comprehensive medical/social delivery system that is PACE, and separate certification for PACE is unnecessary and duplicative of other intensive state and federal regulation. | Duplication of previous comments | ||
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| 70 | INTRODUCTORY STATEMENT | 10A NCAC 06S .0101 | 24-Jun-16 | PACE supports the goals and intent of Adult Day Services licensure. However, as indicated in our comments to 10A NCAC 06R .0101, these services are but one aspect of a comprehensive medical/social delivery system that is PACE, and separate certification for PACE is unneccessary and duplicative of other intensive state and federal regulation. | Duplication of previous comments | |||||
| 71 | DEFINITIONS | 10A NCAC 06S .0102 | 22-Jun-16 | NC PACE Association | Repeat of comments on 10A NCAC 06R .0201: As indicated throughout these comments, PACE is a distinct program already heavily monitored by CMS and DMA, rendering state certification as an ADHC unneccessary and duplicative. If certification continues, however, a definition should be added for the 'PACE adult day center' and rules and requirements throughout should be amended or deleted to reflect the important distinction. Existing definitions would also need to change to be relevant to PACE. The capacity definition based on square footage does not apply because all PACE participants do not attend the adult day health center. The definition of Special Care services also does not apply to PACE programs. | Duplication of previous comments | ||||
| 72 | DEFINITIONS | 10A NCAC 06S .0102 | 24-Jun-16 | Repeat of comments on 10A NCAC 06R .0201: As indicated throughout these comments, PACE is a distinct program already heavily monitored by CMS and DMA, rendering state certification as an ADHC unneccessary and duplicative. If certification continues, however, a definition should be added for the 'PACE adult day center' and rules and requirements throughout should be amended or deleted to reflect the important distinction. Existing definitions would also need to change to be relevant to PACE. The capacity definition based on square footage does not apply because all PACE participants do not attend the adult day health center. The definition of Special Care services also does not apply to PACE programs. | Duplication of previous comments | |||||
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| 73 | DEFINITIONS | 10A NCAC 06S .0102 | 24-Jun-16 | Repeat of comments on 10A NCAC 06R .0201: As indicated throughout these comments, PACE is a distinct program already heavily monitored by CMS and DMA, rendering state certification as an ADHC unneccessary and duplicative. If certification continues, however, a definition should be added for the 'PACE adult day center' and rules and requirements throughout should be amended or deleted to reflect the important distinction. Existing definitions would also need to change to be relevant to PACE. The capacity definition based on square footage does not apply because all PACE participants do not attend the adult day health center. The definition of Special Care services also does not apply to PACE programs. | Duplication of previous comments | |||||
| 74 | STAFFING PATTERN | 10A NCAC 06S .0203 | 22-Jun-16 | NC PACE Association | Request clarification regarding 'direct participant care' staff as PACE employs positions not typically found within an ADHC that do provide direct participant care but are not PCAs (e.g. PT, OT, Clinic staff, etc).Create a PACE Adult Day Center set of standards that distinguish the realities of PACE from ADHCs | Duplication | ||||
| 75 | STAFFING PATTERN | 10A NCAC 06S .0203 | 22-Jun-16 | NC PACE Association | Request clarification regarding 'direct participant care' staff as PACE employs positions not typically found within an ADHC that do provide direct participant care but are not PCAs (e.g. PT, OT, Clinic staff, etc). Another example of the need to remove PACE from these regulations or create a PACE Adult Day Center set of standards that distinguish the realities of PACE from ADHCs. | Duplication | ||||
| 76 | STAFFING PATTERN | 10A NCAC 06S .0203 | 24-Jun-16 | Request clarification regarding 'direct participant care' staff as PACE employs positions not typically found within an ADHC that do provide direct participant care but are not PCAs (e.g. PT, OT, Clinic staff, etc).Create a PACE Adult Day Center set of standards that distinguish the realities of PACE from ADHCs | Duplication | |||||
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| 77 | STAFF REQUIREMENTS | 10A NCAC 06S .0204 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | Rigid titles are problematic. PACE programs have multiple nurses caring for the participant. Eliminate requiring the title of health care coordinator; however, maintain all nursing requirements except completing preadmission health assessment for initial acceptance into program, including problem-identification and care planning. Potential PACE participants receive medical assessments by licensed physician prior to enrollment. These medical assessments include a recommendation from the Physician regarding PACE appropriateness. Program Director may have a different title in a PACE program (e.g. Executive Director, CEO) or in a center part of a larger organization. | Duplication | |
| 78 | STAFF REQUIREMENTS | 10A NCAC 06S .0204 | 22-Jun-16 | NC PACE Association | Based on PACE protocol for providing these services, the Center Manager and the PACE clinic nurses should be sufficient to meet these requirements without requiring a designated 'Health Care Coordinator'. Create a PACE Adult Day Center set of standards that distinguish the realities of PACE from ADHCs or remove PACE programs from these regulations that duplicate existing federal and state regulations. | Duplication | ||||
| 79 | STAFF REQUIREMENTS | 10A NCAC 06S .0204 | 24-Jun-16 | Based on PACE protocol for providing these services, the Center Manager and the PACE clinic nurses should be sufficient to meet these requirements without requiring a designated 'Health Care Coordinator'. Create a PACE Adult Day Center set of standards that distinguish the realities of PACE from ADHCs. | Duplication | |||||
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| 80 | REQUIREMENTS | 10A NCAC 06S .0301 | 21-Jun-16 | Teresa | Johnson | NC Adult Day Services Association | ncadultdayservices@gmail.com | (6) The treatment room shall have the following medical supplies and equipment: (A) first aid supplies consisting of absorbent compress, adhesive bandages, adhesive tape, antiseptic, burn treatment, medical exam gloves, sterile pads and triangular bandage; (B) fever thermometer; (C) blood pressure cuff; (D) stethoscope; (E) medical scales, or scales that can be calibrated; (F) emesis basin; (G) bed pan; (H) urinal; and (I) wash basin. The first aid supplies should not be listed because some are never used and others that are not listed are used frequently. Triangular bandages are not even sold in many places anymore. Refer to current first aid supplies recommended by the American Red Cross if a reference needs to be made. The emesis basin, bed pan and wash basin are rarely if ever used. The urinal belongs in the bathroom area, not in the treatment room. This list is outdated, impractical and not in keeping with the daily operational needs of most Adult Day centers. | DAAS will review | |
| 81 | REQUIREMENTS | 10A NCAC 06S .0301 | 22-Jun-16 | NC PACE Association | As a full service clinic, PACE already has all of these items (Items 4, 5 and 6 A-I) on site with multiple treatment areas. It is burdensome to store and monitor these specific supplies in each 'treatment' room versus using our clinical central supply. For example, we have medical weight scales in the clinic on-site but we also have to have 'medical scales' in each treatment room. These requirements are clearly intended for centers that do not have a clinic on-site. PACE should be distinguished from other ADHCs either by creating a PACE Adult Day Center set of standards or by removing PACE from ADHC certification requirements. | DAAS will review | ||||
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| 82 | REQUIREMENTS | 10A NCAC 06S .0301 | 24-Jun-16 | As a full service clinic, PACE already has all of these items (Items 4, 5 and 6 A-I) on site with multiple treatment areas. It is burdensome to store and monitor these specific supplies in each 'treatment' room versus using our clinical central supply. For example, we have medical weight scales in the clinic on-site but we also have to have 'medical scales' in each treatment room. These requirements are clearly intended for centers that do not have a clinic on-site. Create a PACE Adult Day Center set of standards that distinguish the realities of PACE from ADHCs | Duplicaton | |||||
| 83 | ADDITIONAL ENROLLMENT AND PARTICIPATION REQUIREMENTS | 10A NCAC 06S .0402 | 22-Jun-16 | SHAW | NC PACE Association | Section (b) is not applicable to PACE. PACE is established to serve frail older adults who must be eligible for nursing home level of care but are able to live at home with the support of PACE. PACE is not allowed to turn away anyone simply because of a health condition, nor can it disenroll someone for a worsening health situation. Once enrolled, the PACE program is responsible for ALL aspects of that individual's care, no matter how complicated or costly, whether it is provided directly or through contractual arrangements with other providers. This is antithetical to (b) and further demonstrates that PACE is very different from ADHCs and should not be regulated as an ADHC. | DAAS will review and defer to DMA | |||
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| 84 | ADDITIONAL ENROLLMENT AND PARTICIPATION REQUIREMENTS | 10A NCAC 06S .0402 | 24-Jun-16 | Section (b) is not applicable to PACE. PACE is established to serve frail older adults who must be eligible for nursing home level of care but are able to live at home with the support of PACE. PACE is not allowed to turn away anyone simply because of a health condition, nor can it disenroll someone for a worsening health situation. Once enrolled, the PACE program is responsible for ALL aspects of that individual's care, no matter how complicated or costly, whether it is provided directly or through contractual arrangements with other providers. This is antithetical to (b) and further demonstrates that PACE is very different from ADHCs and should not be regulated as an ADHC. | Duplication | |||||
| 85 | HEALTH AND PERSONAL CARE SERVICES | 10A NCAC 06S .0403 | 22-Jun-16 | NC PACE Association | Recommend creation of a PACE Adult Day Center set of standards for this standard. It should mirror ADH language except the following: b. rather than the adult day care program staff alerting family to changes it should be designated PACE staff. d. Health education programs to be coordinated by activities director. 2. Need for specialized services to be determined by the PACE interdisciplinary team. | comment re: Health Education programs coordinated by Activities Director, DAAS will review. | ||||
| 86 | HEALTH AND PERSONAL CARE SERVICES | 10A NCAC 06S .0403 | 24-Jun-16 | Recommend creation of a PACE Adult Day Center set of standards for this standard. It should mirror ADH language except the following: b. rather than the adult day care program staff alerting family to changes it should be designated PACE staff. d. Health education programs to be coordinated by activites director. 2. Need for specialized services to be determined by the PACE interdisciplinary team. ' | Duplication | |||||
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| 87 | TRANSPORTATION | 10A NCAC 06S .0404 | 22-Jun-16 | Shaw | NC PACE Association | For this, as well as 10A NCAC 06R .0503, PACE should be distinguished from ADHCs and allowed to follow currently existing CMS/DMA Transportation Services regulations. Create a PACE Adult Day Center set of standards if necessary to allow this. More streamlined, cost-effective and efficient to eliminate PACE from ADHC regulations altogether. | Duplication | |||
| 88 | TRANSPORTATION | 10A NCAC 06S .0404 | 24-Jun-16 | Create a PACE Adult Day Center set of standards.Follow currently existing CMS/DMA Transportation Services regulations in the new ADH PACE requirements | Duplication | |||||
| 89 | EMERGENCIES AND FIRST AID | 10A NCAC 06S .0405 | 22-Jun-16 | For this, as well as 10A NCAC 06R .0504, PACE should be distinguished from ADHCs and allowed to follow currently existing CMS/DMA regulations. Create a PACE Adult Day Center set of standards if necessary to allow this. It should reflect the comments submitted for 10A NCAC 06R .0504 as well as the following: Fire safety standards should mirror existing CMS/DMA PACE regulation to avoid redundancy or inconsistencies. Due to the unique structure of a PACE program with a staffed medical clinic during all hours of operations the PACE Adult Day Center standards for CPR and first aid should be waived. PACE Adult Day Center Incident Reporting to follow CMS/DMA PACE Occurrence Reporting requirements Follow CMS/DMA PACE Emergency Care, Natural Disaster Responses & Adult Day Health Emergency Evacuation. | Duplication. Refer to September 15, 2014 PACE Strategic Plan Report & Crosswalk | |||||
| 90 | EMERGENCIES AND FIRST AID | 10A NCAC 06S .0405 | 24-Jun-16 | Create a PACE Adult Day Center set of standards. Fire safety standards should mirror existing CMS/DMA PACE regulation to avoid redundancy or inconsistencies. Due to the unique structure of a PACE program with a staffed medical clinic during all hours of operations the PACE Adult Day Center standards for CPR and first aid should be waved. PACE Adult Day Center Incident Reporting to follow CMS/DMA PACE Occurrence Reporting requirements Follow CMS/DMA PACE Emergency Care, Natural Disaster Responses & Adult Day Health Emergency Evac.' | Dupluication | |||||
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| 91 | PROCEDURE | 10A NCAC 06S .0501 | 22-Jun-16 | NC PACE Association | As noted in comments to 10A NCAC 06R .0101, certification as an ADC/ADHC is unnecessary and duplicative for PACE which is already heavily regulated by CMS and DMA, with regulations that reflect the unique nature of PACE. Page ii of the DHHS Adult Day Care and Adult Day Health Standards for Certification states that 'The standards which follow for adult day care and adult day health are not intended as standards for day hospitals, partial hospital programs or other medically oriented day services.' PACE is a Medicare (and Medicaid) program delivering comprehensive medical care. PACE is the full-risk insurer and provider of all medical care to its patients. Most of the services are delivered at the PACE facility, which includes a 'day center' as just one component of the all-inclusive health care provided by PACE. PACE clearly fits into the referenced medical exclusion. Additionally, all aspects of PACE are regulated and monitored by both the federal government (CMS) and by the NC Division of Medical Assistance, so additional regulation as an ADHC is duplicative and unnecessary. If certification as an ADC is to continue, a 'PACE Adult Day Center' set of standards should be created. In reference to 10A NCAC 06S .0501, the procedure should mirror the ADH initial certification and recertification except: | DAAS defers to DMA | ||||
| 92 | PROCEDURE | 10A NCAC 06S .0501 | 24-Jun-16 | PACE Adult Day Center standards to mirror ADH initial certificaion and recertification except: Verification of first aid and CPR requirement due to the staffed medical clinic during all hours of operations the PACE Adult Day Center standards for CPR and first aid should be waved. Elimination of form 732A-ADS due to the CMS fiscal soundness reporting requirements and the capitated payment model for PACE programs.' | Duplication. Refer to September 15, 2014 PACE Strategic Plan Report & Crosswalk | |||||
| 93 | PROCEDURE FOR APPEAL | 10A NCAC 06S .0508 | 22-Jun-16 | Shaw | NC PACE Association | This rule is duplicative for PACE, which already has extensive appeals process through CMS and DMA. PACE RECOMMENDATION FOR CHANGE TO STANDARD: For PACE programs, in lieu of this requirement, PACE will follow the CMS and DMA process for appeal in 42 CFR § 460.122. | Duplication | |||
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| 94 | PROCEDURE FOR APPEAL | 10A NCAC 06S .0508 | 24-Jun-16 | This rule is duplicative for PACE, which already has extensive appeals process through CMS and DMA. PACE RECOMMENDATION FOR CHANGE TO STANDARD: For PACE programs, in lieu of this requirement, PACE will follow the CMS and DMA process for appeal in 42 CFR § 460.122. | Duplication | |||||
| 95 | NATURE AND PURPOSE OF STATE ADULT DAY CARE FUND | 10A NCAC 06T .0201 | 18-Jun-16 | The reimbursement rates of $33.07 for adult day care, $40 for adult day health, and $1.50 per trip are absolutely NOT sustainable! These rates are appallingly low. They do not cover half of the costs of providing these services. For the sake of adult day centers and the people who need and rely on adult day services please revise/increase these rates! | Duplication | |||||
| 96 | NATURE AND PURPOSE OF STATE ADULT DAY CARE FUND | 10A NCAC 06T .0201 | 20-Jun-16 | Pam | Hayworth | Reimbursement rates are not sustainable & should be increased. In most cases they are less than have of the daily expenses. | Duplication |
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