Hawaii Administrative Rules › Title 17 - DEPARTMENT OF HUMAN SERVICES › Department of Human Services › Chapter 1737 - SCOPE AND CONTENTS OF THE FEE FOR SERVICE MEDICAL ASSISTANCE PROGRAM › Subchapter 4 - LONG TERM INSTITUTIONAL SERVICES › Section 17-1737-30 - Content of ICF-MR services

Current through June, 2024
(a) Long-term
				  institutional services shall be provided by freestanding or distinct part
				  ICF-MR facilities that shall meet the eligibility requirements specified in
				  chapters 17-1736 and 17-1739.
(b)
				  ICF-MR facilities shall provide inpatient or authorized community-based
				  services designed primarily for the treatment and rehabilitation of the
				  mentally retarded or persons with related conditions.
(c) ICF-MR services shall include but not be
				  limited to:
(1) Twenty-four hour supervision
				  of mentally retarded individuals or persons with related conditions in a
				  protected residential setting;
(2)
				  A continuous active treatment program which includes aggressive, consistent
				  implementation of a program of specialized and generic training, treatment
				  health services and related services described in this subsection, that is
				  directed towards:
(A) The acquisition of the
				  behaviors necessary for the client to function with as much self-determination
				  and independence as possible; and
(B) The prevention or deceleration of
				  regression or loss of current optimal functional status.
Active treatment does not include services to maintain
					 generally independent clients who are able to function with little supervision
					 or in the absence of a continuous active treatment program;
(3) Interventions to manage
				  inappropriate client behavior that are employed with sufficient safeguards and
				  supervision to ensure that the safety, welfare and civil and human rights of
				  clients are adequately protected;
(4) Sufficient direct care staff to manage
				  and supervise clients in accordance with their individual program plans, to
				  respond to injuries and symptom of illness and to handle emergencies in each
				  defined residential living unit;
(5) Preventive and general medical care as
				  well as annual physical exams of each client that include:
(A) Evaluation of vision and
				  hearing;
(B) Immunizations, using
				  as a guide the recommendations of the Public Health Service Advisory Committee
				  on Immunization Practices or of the Committee on the Control of Infectious
				  Diseases of the American Academy of Pediatrics;
(C) Routine screening lab exams and special
				  studies; and
(D) TB control,
				  appropriate to the facility's population, and in accordance with the
				  recommendations of the American College of Chest Physicians or the section of
				  diseases of the American Academy of Pediatrics, or both;
(6) Licensed nursing services sufficient to
				  care for clients health needs, including those clients with medical care
				  plans;
(7) Provision of or
				  arrangements for comprehensive dental diagnostic services and comprehensive
				  dental treatment services that include:
(A)
				  The availability of emergency dental treatment on a twenty-four hours a day
				  basis by a licensed dentist; and
(B) Dental care needed for relief of pain and
				  infections, restoration of teeth, and maintenance of dental health;
(8) Provision of or arrangements
				  for routine and emergency drugs and biologicals that are administered in
				  compliance with physician's orders;
(9) At least three meals a day that comprise
				  a nourishing, well-balanced diet including modified and specially prescribed
				  diets;
(10) Physician services
				  available twenty-four hours a day to:
(A)
				  Develop and maintain, in coordination with licensed nursing personnel, a
				  medical care plan of treatment for a client if the physician determines that an
				  individual client requires twenty-four hours licensed nursing care;
				  and
(B) Participate in establishing
				  an initial individual program plan for a newly admitted client; and
(11) Provision of necessary
				  services, including emergency and other health care through contractual
				  agreements which shall:
(A) Stipulate the
				  responsibilities, functions, objectives, service fee, and other terms agreed to
				  by the ICF-MR and the provider; and
(B) Provide that the ICF-MR is responsible
				  for assuring that the outside services meet the standards for quality of
				  services.