3616 - Provision of certified home health agency services, long term home health care programs and AIDS home care programs.

§  3616. Provision of certified home health agency services, long term  home health care programs and AIDS home care programs. 1.  A  long  term  home  health  care  program shall be provided only to those patients who  are medically eligible for placement in a hospital or residential health  care facility. An AIDS home care  program  shall  be  provided  only  to  persons  who  are  medically  eligible  for  placement  in a hospital or  residential health  care  facility  and  who  (a)  are  diagnosed  by  a  physician  as  having  acquired  immune  deficiency syndrome, or (b) are  deemed by a physician, within his judgment,  to  be  infected  with  the  etiologic  agent  of  acquired  immune  deficiency  syndrome,  and whose  illness, infirmity or disability can be  reasonably  ascertained  to  be  associated  with  such  infection.  Provision  of  certified home health  agency services, a long term home health care program or  an  AIDS  home  care  program  paid for by government funds shall be based upon, but not  limited to, a comprehensive assessment that shall include,  but  not  be  limited to, an evaluation of the medical, social and environmental needs  of  each  applicant  for such services or program. This assessment shall  also serve as  the  basis  for  the  development  and  provision  of  an  appropriate  plan  of  care  for  the  applicant.  In cases in which the  applicant is  a  patient  in  a  hospital  or  residential  health  care  facility, the assessment shall be completed by persons designated by the  commissioner,  including, but not limited to, the applicant's physician,  the discharge coordinator of the hospital  or  residential  health  care  facility   referring  the  applicant,  a  representative  of  the  local  department of social services, and a representative of the provider of a  long term home health care program,  AIDS  home  care  program,  or  the  certified home health agency that will provide services for the patient.  In  cases  in  which  the  applicant  is  not a patient in a hospital or  residential health care facility, the assessment shall be  completed  by  persons  designated  by  the commissioner including, but not limited to,  the applicant's physician, a representative of the local  department  of  social services and a representative of the provider of a long term home  health care program, AIDS home care program or the certified home health  agency  that will provide services for the patient. The assessment shall  be completed prior to or within  thirty  days  after  the  provision  of  services  begins.  Payment for services provided prior to the completion  of the assessment shall be made only if it  is  determined,  based  upon  such  assessment,  that  the  recipient qualifies for such services. The  commissioner shall prescribe the forms on which the assessment  will  be  made.    2.  Continued  provision of a long term home health care program, AIDS  home care program or certified home health agency services paid  for  by  government  funds  shall be based upon a comprehensive assessment of the  medical,  social  and  environmental  needs  of  the  recipient  of  the  services.  Such assessment shall be performed at least every one hundred  eighty days by the provider of a long term  home  health  care  program,  AIDS  home  care  program  or the certified home health agency providing  services for the patient and the local department  of  social  services,  and  shall be reviewed by a physician charged with the responsibility by  the commissioner. The commissioner shall prescribe the  forms  on  which  the assessment will be made.    3.  Prior to the initial provision of services, and upon the continued  provision of services pursuant to each complete reassessment, the agency  shall present the recipient or the  recipient's  representative  with  a  standardized   written   statement   prepared   by  the  department,  in  consultation  with  providers  of  home  care  services   and   consumer  representatives,  which informs the recipient or representative that the  services to be provided are subject  to  change  in  accordance  with  achange  in  the  recipient's  needs,  a  change in information about the  recipient's  needs  and/or  about  the  formal  and  informal   services  available  to  meet  such  needs. The statement shall further inform the  recipient  or  representative that such notification and acknowledgement  is for purposes of consumer information and education, and to  establish  and  maintain  proper  understanding and expectations about the possible  course of care to be provided by the agency.