reglab/housing_qa huggingface dataset:
CA Welf & Inst Code § 14525 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 2 - Eligibility, Participation, and Discharge|Section 14525.

14525.  Any adult eligible for benefits under Chapter 7 (commencing with Section 14000) shall be eligible for adult day health care services if that person meets all of the following criteria:(a) The person is 18 years of age or older and has one or more chronic or postacute medical, cognitive, or mental health conditions, and a physician, nurse practitioner, or other health care provider has, within his or her scope of practice, requested adult day health care services for the person.(b) The person has functional impairments in two or more activities of daily living, instrumental activities of daily living, or one or more of each, and requires assistance or supervision in performing these activities.(c) The person requires ongoing or intermittent protective supervision, skilled observation, assessment, or intervention by a skilled health or mental health professional to improve, stabilize, maintain, or minimize deterioration of the medical, cognitive, or mental health condition.(d) The person requires adult day health care services, as defined in Section 14550, that are individualized and planned, including, when necessary, the coordination of formal and informal services outside of the adult day health care program to support the individual and his or her family or caregiver in the living arrangement of his or her choice and to avoid or delay the use of institutional services, including, but not limited to, hospital emergency department services, inpatient acute care hospital services, inpatient mental health services, or placement in a nursing facility or a nursing or intermediate care facility for the developmentally disabled providing continuous nursing care.(e) Notwithstanding the criteria established in subdivisions (a) to (d), inclusive, of this section, any person who is a resident of an intermediate care facility for the developmentally disabled-habilitative shall be eligible for adult day health care services if that resident has disabilities and a level of functioning that are of such a nature that, without supplemental intervention through adult day health care, placement to a more costly institutional level of care would be likely to occur.(Repealed and added by Stats. 2006, Ch. 691, Sec. 4. Effective January 1, 2007. Note: Section 14525.1, in subd. (g), prescribes conditions for possible inoperation of this section.)
CA Welf & Inst Code § 14526 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 2 - Eligibility, Participation, and Discharge|Section 14526.

14526.  Participation in an adult day health care program shall require prior authorization by the department. The authorization request shall be initiated by the provider and shall include the results of the assessment screening conducted by the provider’s multidisciplinary team and the resulting individualized plan of care. Participation shall begin upon application by the prospective participant or upon referral from community or health agencies, or the physician, hospital, family, or friends of a potential participant.(Amended by Stats. 2004, Ch. 797, Sec. 1. Effective January 1, 2005.)
CA Welf & Inst Code § 14527 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 2 - Eligibility, Participation, and Discharge|Section 14527.

14527.  Participation in an adult day health care program shall be voluntary. The participant may end the participation at any time. However, an adult day health center shall not otherwise terminate the provision of adult day health services to any participant unless approved by the state department.No provider may employ, or contract for, persons specifically for the sole purpose of solicitation of eligible participants. A provider shall not use false advertising or false statements to induce participants. No solicitation of participants shall include the granting or offering of any monetary or other valuable consideration for participation.All informational material for potential participants prepared by the provider shall have the prior approval of the department.(Added by Stats. 1977, Ch. 1066.)
CA Welf & Inst Code § 14528 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 2 - Eligibility, Participation, and Discharge|Section 14528.

14528.  Before acceptance into the program, all adult day health providers shall conduct a multidisciplinary assessment directed towards ascertaining the individual’s pathological diagnosis, physical disability, functional ability, psychological status, and social and physical environment.(Added by Stats. 1977, Ch. 1066.)
CA Welf & Inst Code § 14528.1 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 2 - Eligibility, Participation, and Discharge|Section 14528.1.

14528.1.  (a) The personal health care provider, as defined in Section 14552.3, shall have and retain responsibility for the participant’s medical care.(b) If the participant does not have a personal health care provider during the initial assessment process to determine eligibility for adult day health care, the adult day health care center staff physician may conduct the initial history and physical for the participant.(c) The adult day health care center shall make all reasonable efforts to assist the participant in establishing a relationship with a personal health care provider.(d) If the adult day health care center is unable to locate a personal health care provider for the participant, or if the participant refuses to establish a relationship with a personal health care provider, the adult day health care center shall do both of the following:(1) Document the lack of personal health care provider relationship in the participant’s health record.(2) Continue to document all efforts taken to assist the participant in establishing a relationship with a personal health care provider.(e) (1) A personal physician for one or more of an adult day health care center’s enrolled participants may serve as the adult day health care staff physician.(2) When a personal physician serves as the staff physician, the physician shall have a personal care services arrangement with the adult day health care center that meets the criteria set forth in Section 1395nn(e)(3)(A) of Title 42 of the United States Code.(3) A personal care physician, an adult day health care staff physician, or an immediate family member of the personal care physician or adult day health care staff physician, shall comply with ownership interest restrictions as provided under Section 654.2 of the Business and Professions Code.(Amended by Stats. 2008, Ch. 648, Sec. 9. Effective January 1, 2009.)
CA Welf & Inst Code § 14529 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 2 - Eligibility, Participation, and Discharge|Section 14529.

14529.  (a) The multidisciplinary health team conducting an assessment shall consist of at least the individual’s personal physician or a staff physician, or both, a registered nurse, and a social worker. (b) For the initial assessment, the multidisciplinary health team shall also include a physical therapist and an occupational therapist. In addition, when the need is identified by a physician or nurse, qualified consultants with skills in recreational therapy, speech language pathology, or dietary assessment shall serve as team members. (c) The multidisciplinary team described in subdivision (b) shall conduct an initial assessment. At the time of reassessment, if an individual plan of care has been developed by the physical therapist or the occupational therapist, they shall reassess the participant to determine any ongoing or different needs for physical therapy or occupational therapy services. If it is determined that no further physical therapy or occupational therapy is needed, the physical therapist and the occupational therapist shall not be required to sign the treatment plan. For further reassessments, the nurse or physician shall determine if the physical therapist or occupational therapist is needed. (d) The assessment team shall: (1) Determine the medical, psychosocial, and functional status of each participant. (2) Develop an individualized plan of care, including goals, objectives, and services designed to meet the needs of the person, which shall be signed by each member of the multidisciplinary team, except that the signature of only one physician member of the team shall be required. (3) At least biannually reassess the participant’s individualized plan care and make any necessary adjustments to the plan. (4) If the initial assessment or any subsequent reassessment shows that restorative therapy is needed, acute rehabilitative treatment shall be provided by the appropriate licensed or certified personnel. (5) If the initial assessment or any subsequent reassessment shows that restorative therapy is not needed, the multidisciplinary team shall determine whether the participant requires maintenance program services and if the team finds that the participant requires these services, the multidisciplinary team shall develop an individual maintenance program as part of the plan of care.(Amended by Stats. 1991, Ch. 985, Sec. 5.)
CA Welf & Inst Code § 14530 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 2 - Eligibility, Participation, and Discharge|Section 14530.

14530.  (a) Individual plans of care shall be submitted to the department. Services for each participant shall be provided as specified in the individual plan of care approved pursuant to Section 14526.(b) Individual monthly service reports shall be submitted to the department.(c) Each provider shall supply a written statement to the participant explaining what services will be provided and specifying the scheduled days of attendance. This statement, which shall be known as the participation agreement, shall be signed by the participant and a provider representative and retained in the participant’s file.(Amended by Stats. 2001, Ch. 681, Sec. 14. Effective January 1, 2002.)
CA Welf & Inst Code § 14551 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14551.

14551.  The following additional services may also be provided:(a) Podiatric services provided or arranged for, or under direction of, the supervising physician.(b) Optometric screening and advice for low-vision cases by a licensed ophthalmologist or optometrist.(c) Dental screening for the purpose of apprising the participant of the necessity of regular or emergency dental care.(d) Such other services within the concept and objectives of adult day health care as may be approved by the department.(Amended by Stats. 1978, Ch. 429.)
CA Welf & Inst Code § 14552 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14552.

14552.  In order to obtain certification as a provider of adult day health care under this chapter and Chapter 7 (commencing with Section 14000), the following standards shall be met:(a) The provider shall have met all other requirements of licensure as an adult day health care center pursuant to Chapter 3.3 (commencing with Section 1570) of Division 2 of the Health and Safety Code.(b) The provider shall comply with requirements of this chapter regarding program and scope of services.(c) The provider shall have appropriate licensed personnel.(d) The provider shall employ required personnel for furnishing of required services pursuant to Section 14550 consistent with commonly accepted professional standards.(e) The provider shall afford to each participant all rights, including the right to be free from harm and abuse, identified in the rules and regulations adopted pursuant to Section 1580 of the Health and Safety Code.(f) A provider serving a substantial number of participants of a particular racial or ethnic group, or participants whose primary language is not English, shall employ staff who can meet the cultural and linguistic needs of the participant population.(g) A provider shall have organizational and administrative capacity to provide services under the provisions of this chapter.(Amended by Stats. 2004, Ch. 797, Sec. 2. Effective January 1, 2005.)
CA Welf & Inst Code § 14552.2 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14552.2.

14552.2.  (a) “Program plan” means a written description of the adult day health care center’s philosophy, objectives, and processes for providing required services to the participant populations.(b) The program plan shall include any of the following elements, as requested by the California Department of Aging, and shall be submitted as required in Section 14574.1:(1) The total number of participants the center proposes to serve, or currently serves, daily.(2) A profile of the participant population the center proposes to serve, or currently serves, that includes a description of the specific medical, social, and other needs of each population.(3) A description of the specific program elements and services that addresses the medical, social, and other needs of each participant population that the center proposes to serve, or currently serves, as specified in paragraph (2). “Program elements” means the components of an adult day health care program, as specified in Section 14550.(4) A description of the specialized professional and program staff that will provide, or currently provide, the adult day health care center’s program services, as specified in paragraph (3), and that staff’s responsibilities. The plan shall demonstrate that the adult day health care center is organized and staffed to carry out the requirements as specified in the regulations adopted pursuant to Section 1580 of the Health and Safety Code.(5) An in-service training plan for each center staff member to commence within the first six months of employment. The training plan shall address, at a minimum, the specific medical, social, and other needs of each participant population the center proposes to serve, as specified in paragraph (2).(6) A sample individual plan of care for each specialty population the adult day health care center proposes to serve, or currently serves, and a sample of a one-week schedule of daily program services for each sample individual plan of care. The individual plan of care shall demonstrate the specific medical, social, and other needs of each participant population the adult day health center proposes to serve.(7) A plan for a behavior modification program if such a program will be used as a basic intervention for meeting the needs of a special population, such as persons with developmental disabilities or persons with mental disabilities.(c) This section shall be implemented only to the extent funds are made available for the purposes of this section in the annual Budget Act or another statute.(d) The implementation of the program plan requirements does not require adoption of regulations pursuant to the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code).(Added by Stats. 2004, Ch. 797, Sec. 3. Effective January 1, 2005.)
CA Welf & Inst Code § 14552.5 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14552.5.

14552.5.  Pursuant to Section 14043.46, the department may implement a one-year moratorium on the certification and enrollment into the Medi-Cal program of new adult day health care centers.(Added by Stats. 2004, Ch. 228, Sec. 26.1. Effective August 16, 2004.)
CA Welf & Inst Code § 14553 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14553.

14553.  An adult day health care provider shall establish written policies and procedures, which shall have prior approval of the department, unless otherwise specified in an interagency agreement entered into pursuant to Section 1572 of the Health and Safety Code, for continuously reviewing the quality of care, performance of all personnel, the utilization of services and facilities, and costs. Information derived from the review shall be made available to the department, unless otherwise specified in an interagency agreement entered into pursuant to Section 1572 of the Health and Safety Code.(Amended by Stats. 2001, Ch. 681, Sec. 18. Effective January 1, 2002.)
CA Welf & Inst Code § 14553.1 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14553.1.

14553.1.  The adult day health care center’s policies and procedures shall include provisions for the following:(a) Designating the staff who will serve in the required positions during a short-term absence or short-term vacancy, as defined in subdivision (o) of Section 1570.7 of the Health and Safety Code, of required staff.(b) Providing coverage for required staff in the event of a long-term absence or long-term vacancy, as defined in subdivision (k) of Section 1570.7 of the Health and Safety Code.(c) Ensuring continuity of services for participants during staff absences.(Added by Stats. 2008, Ch. 648, Sec. 12. Effective January 1, 2009.)
CA Welf & Inst Code § 14554 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14554.

14554.  The adult day health care provider shall maintain a complete standard medical record for each participant, including records of treatment rendered by a subcontractor, according to specifications established by the department and as may be further specified by the California Department of Aging.(Amended by Stats. 2001, Ch. 681, Sec. 19. Effective January 1, 2002.)
CA Welf & Inst Code § 14555 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 3 - Services and Standards|Section 14555.

14555.  Each adult day health care provider shall establish a grievance procedure under which participants may submit their grievances. Such procedure shall be approved by the department prior to the approval of the certification. The department shall establish standards for such procedures to insure adequate consideration and rectification of participant grievances. A provider shall make written findings of fact in the case of each grievance processed, a copy of which shall be transmitted to the participant. If the Medi-Cal participant has an unresolved grievance, the fair hearing provided in Chapter 7 (commencing with Section 10950) of Part 2 of this division shall be available to resolve all grievances regarding care and administration by the adult day health care provider. The findings and recommendations of the department, based on the decision of the hearing officer, shall be binding upon the adult day health care provider.(Amended by Stats. 1998, Ch. 151, Sec. 16. Effective January 1, 1999.)
CA Welf & Inst Code § 14570 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 4 - Administration|Section 14570.

14570.  (a) The department shall adopt all necessary rules and regulations providing for quality of care and payment for services rendered under this chapter pursuant to Chapter 7 (commencing with Section 14000). All regulations heretofore adopted by the department pursuant to this chapter, and that are in effect immediately preceding the operative date of the amendment of this section enacted by the Legislature during the 1977–78 Regular Session, shall remain in effect and shall be fully enforceable unless and until readopted, amended, or repealed by the director.(b) The director shall establish a distinct organizational entity within the department that shall have primary responsibility for the Adult Day Health Care Medi-Cal program. This entity shall coordinate and direct all departmental activities required by this chapter.(Amended by Stats. 2001, Ch. 681, Sec. 20. Effective January 1, 2002.)
CA Welf & Inst Code § 14571 (2021)
2021 California Code|Welfare and Institutions Code - WIC|DIVISION 9 - PUBLIC SOCIAL SERVICES|PART 3 - AID AND MEDICAL ASSISTANCE|CHAPTER 8.7 - Adult Day Health Care Programs|ARTICLE 4 - Administration|Section 14571.

14571.  The department, in consultation with the California Association for Adult Day Services, shall develop a rate methodology. The methodology shall take into consideration all allowable costs associated with providing adult day health care services. Once a methodology has been approved by the department, it shall be the basis of future annual rate reviews.Payment shall be for services provided in accordance with an approved individual plan of care. Billing shall be submitted directly to the department. Additionally, the department shall establish a separately billable and reasonable rate of reimbursement for the initial assessment that takes into account the intensity of services and the skill level of the health professionals required to conduct the mandated three-day assessment of new participant needs and living environment. Subsequent assessments, as needed or required, shall be billed at a lesser amount. The department shall establish utilization controls for assessment days to ensure the appropriate use of assessment and reassessment activity.Nothing in this section shall preclude the department from entering into specific prospective budgeting and reimbursement agreements with providers.(Amended by Stats. 2006, Ch. 691, Sec. 8. Effective January 1, 2007.)