Hawaii Administrative Rules
Title 17 - DEPARTMENT OF HUMAN SERVICES
Department of Human Services
Chapter 1738 - TARGETED CASE MANAGEMENT SERVICES
Subchapter 3 - SEVERELY DISABLED MENTALLY ILL
Section 17-1738-16 - Covered services
Universal Citation: HI Admin Rules 17-1738-16
Current through August, 2024
(a) Covered services means services that are reimbursable by medicaid, and are grouped under the following three categories:
(1)
Case assessment;
(2) Case planning;
and
(3) Ongoing monitoring and
service coordination.
(b) The case assessment shall involve a face-to-face contact with the recipient and may involve family members and other interested persons as appropriate. It is a comprehensive assessment developed by the case manager which identifies the recipients' abilities, deficits, and needs, and shall include the following written documentation:
(1) Identifying information;
(2) A record of any physical, mental, or
dental health assessments, and consideration of any potential for
rehabilitation;
(3) A review of the
recipient's performance in carrying out activities of daily living and degree
of assistance required;
(4)
Identification of social relationships and support including informal care
givers such as family, friends, and volunteers, as well as formal service
providers;
(5) If appropriate, the
vocational and educational status, including prognosis for employment,
rehabilitation;
(6) Legal status if
appropriate, including whether there is a guardian, or any other involvement
with the legal system; and
(7)
Accessibility to community resources which the recipient needs or
wants.
(c) Case planning activities follow the case assessment and includes the development of an individual service plan in writing which addresses the needs of the recipient.
(1) The development of the individual service
plan shall be a collaborative process involving the recipient, the family or
other interested persons, and the case manager.
(2) The service shall include:
(A) Problems identified during the case
assessment;
(B) Priority goals to
be achieved;
(C) Identification of
all formal services which are to be arranged for the recipient, and the names
of the service providers;
(D)
Development of a support system, including a description of the recipient's
informal support system;
(E)
Identification of individuals who participated in the development of the
service plan;
(F) Schedules of
initiation and frequency of various services which are to be made available to
the recipient; and
(G)
Documentation of unmet needs and gaps in service.
(d) Ongoing monitoring and service coordination shall include:
(1) Establishment
and maintenance of a supportive relationship with the recipient in order to
assist the individual in problem-solving, and development of necessary skills
to remain in the community;
(2)
Face-to-face or telephone contacts with the recipient for the purpose of
assessing or reassessing needs, or for planning or monitoring
services;
(3) Face-to-face or
telephone contacts with collaterals for the purposes of mobilizing services and
support, advocating on behalf of the recipient, educating collaterals on the
needs of the recipient, and coordinating services specified in the service
plan;
(4) Periodic observation of
service delivery to ensure that quality service is being provided and shall
evaluate whether a particular service is effectively meeting the needs of the
recipient; and
(5) Recordkeeping
necessary for case planning, service implementation, monitoring, and
coordination. This includes preparation of reports, updating service plans,
making notes about case activities in the recipient's record, and preparing and
responding to correspondence with the recipient and collaterals.
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