(a) This section establishes the requirements for adult
day services, a service provided under the Older Americans Act and
funded, in whole or in part, by DADS.
(b) Eligibility. A AAA must ensure that a program participant
who receives adult day services:
(1) is:
(A) 60 years of age or older; and
(B) at least moderately impaired in the ability to
perform instrumental or ordinary activities of daily living; or
(2) is qualified to receive services under Title III,
Part E, of the Older Americans Act.
(c) Requirement for licensed vendor to provide services.
A AAA must enter into a vendor agreement for the provision of adult
day services with an adult day care facility licensed in accordance
with §98.11 of this title (relating to Criteria for Licensing).
(d) Service authorization. Before adult day services
are provided by a vendor to a program participant, a AAA must ensure
that the vendor obtains authorization for the services from the AAA
in accordance with §83.3(o)(2)(B) of this title (relating to
System of Access and Assistance).
(e) Description of adult day services. Adult day services
consist of nursing services, physical rehabilitative services, nutrition
services, socialization activities, and transportation services.
(1) Nursing services. Nursing services must include:
(A) assessing, observing, evaluating, and documenting
a program participant's health condition, and instituting appropriate
nursing interventions to stabilize or improve a program participant's
condition or prevent complications;
(B) assisting a program participant with self-administered
medications including, but not limited to, ordering, maintaining,
or administering the medications as directed by a physician or other
health care practitioner acting within the scope of the practitioner's
authority and license;
(C) assisting a program participant with medical treatments,
as directed by a physician or other health care practitioner acting
within the scope of the practitioner's authority and license;
(D) counseling a program participant on the program
participant's health needs and involving family members and caregivers
in the discussions regarding immediate and long-term health goals;
and
(E) providing or supervising personal day services
to enable a program participant to restore, maintain, or improve the
ability to perform activities of daily living and instrumental activities
of daily living as defined in DADS Program Instruction AAA-PI-310 Activities of Daily Living/Instrumental Activities
of Daily Living NAPIS Mapping Requirements.
(2) Physical rehabilitative services. Physical rehabilitative
services must include:
(A) restorative nursing; and
(B) group and individual exercises, including range
of motion exercises.
(3) Nutrition services. Nutrition services must include:
(A) one hot meal served between the hours of 10:30
a.m. and 1:30 p.m. that:
(i) is suitable in quantity and adequacy to attain
and maintain nutritional requirements, including those of a special
needs program participant; and
(ii) consists of at least two ounces of meat, one-half
cup of fruit or vegetables, one cup of milk, and two servings of bread;
(B) special diets as required by a program participant's
plan of care;
(C) a supplementary mid-morning and mid-afternoon snack;
(D) dietary counseling and nutrition education for
a program participant and family member; and
(E) assisting with meals, if necessary, for program
participants with hand deformities, paralysis, hand tremors, or trouble
chewing, including:
(i) grinding meats and mashing vegetables; and
(ii) spoon feeding, bread buttering, and opening containers
such as milk or juice.
(4) Socialization activities. Socialization activities
are community interaction, cultural enrichment, educational, recreational,
or other social activities held in the vendor's facility or in the
community in a planned program to meet the social needs and interests
of a program participant. A AAA must ensure that a service provider:
(A) provides at least three social activities each
day; and
(B) posts a monthly activity calendar in a visible
location at least one week in advance of the activities listed.
(5) Transportation services.
(A) Transportation services must include:
(i) round trip transportation to a vendor's facility
from a program participant's residence; and
(ii) round trip transportation from a vendor's facility
to medical appointments ordered by a physician or other health care
practitioner acting within the scope of the practitioner's authority
and license if it is necessary for a program participant to attend
such therapies or appointments while at the facility.
(B) If a vendor does not provide transportation directly,
it must arrange for transportation from another person or organization.
(C) A vehicle used for transportation services must
be properly operated and maintained and have proper heating and cooling
systems to maintain reasonable temperature levels inside the vehicle.
(f) Staff qualifications. A AAA must ensure that staff
persons of a service provider meet the qualifications described in §98.62(a)
of this title (relating to Program Requirements).
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Source Note: The provisions of this §213.211 adopted to be effective September 1, 2008, 33 TexReg 7293; transferred effective November 15, 2020, as published in the Texas Register October 30, 2020, 45 TexReg 7721 |