Current through Register Vol. 48, No. 12, March 22, 2024
a) An adult day service provider shall have
on file and utilize written procedures to manage storage and administration of
medications, including:
1) storing and
locking medications;
2) labeling
medications brought to the adult day service provider's site; and
3) ensuring that:
A) prescribed medication is administered by
an appropriately licensed professional to those adult day service participants
who are determined to be unable to self-administer medications;
B) judgment of a participant's inability to
self-administer medications shall be documented by a physician's order or the
CCU person-centered plan of care and/or the adult day service person-centered
plan of care addendum by the program nurse;
C) administration of all medications
administered by the adult day service provider staff (prescription and
non-prescription) are recorded in the participant's case record; and
D) physician orders for medication are
utilized and filed in the participant's case record.
b) A facility that houses an adult
day service program (including satellite sites) shall meet the following
criteria:
1) A location will have a home and
community-based setting that allows for services to be provided in the most
integrated setting appropriate for each participant without having the effect
of isolating any participant from the broader community. (See 42 CFR
441.301(c)(5)(v) and 42 CFR 441.301(c)(4)(i).)
A)An integrated setting will:
i)ensure a participant's rights of privacy,
dignity and respect and freedom from coercion and restraint;
ii)optimize, but not regiment, participant
initiative, autonomy, and independence in making life choices, including daily
activities, physical environment, and with whom to interact (See 42 CFR
441.301(c)(4)(iv) ); and
iii)facilitate participant choice regarding
services and supports, and who provides them.
B)A location is not presumed to be a home and
community-based setting if set in a publicly or private-owned facility
providing inpatient treatment; on the grounds of, or adjacent to, a public
institution; or with the effect of isolating participants from the broader
community of individuals not receiving Medicaid Waiver services, as determined
by the federal Centers for Medicare and Medicaid Services on a case-by-case
basis.
2) There shall be
a minimum of 40 square feet of activity area per participant. (Multiple-use
areas must be pro-rated on both time and participant basis.) The activity area
in the square feet per participant requirement is exclusive of exit passages
and fire escapes, administrative space, storage areas, bathrooms, kitchen used
for meal preparation, space required for equipment and gymnasiums or other
areas when used exclusively for active sports.
3) All adult day service providers shall
comply with the applicable provisions of the following codes and standards.
A) State of Illinois Codes and Standards
Code or Standard
|
Agency
|
i)
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Ill. Plumbing Code (77 Ill. Adm. Code 890)
|
Department of Public Health or its authorized local
designee
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ii)
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Illinois Accessibility Code (71 Ill. Adm. Code
400)
Environmental Barriers Act [ 410 ILCS 25 ]
|
Capital Development Board offers guidance to design
professionals and building code officials regarding the interpretation and
application of the Illinois Accessibility Code
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iii)
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Fire Prevention and Safety (41 Ill. Adm. Code
100)
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Office of State Fire Marshal
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iv)
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Illinois Vehicle Code [ 625 ILCS 5 ]
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Secretary of State of Illinois
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v)
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Food Service Sanitation (77 Ill. Adm. Code
750)
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Department of Public Health or its authorized local
designee
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B)
Other Codes and References
Code or Standard
|
Agency
|
i)
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National Fire Protection Association, 1 Batterymarch
Park, Quincy MA 02169-7471 (NFPA 101 Life Safety Code: Chapters 16 and 17; 2018
edition; this incorporation includes no later editions or amendments)
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National Fire Protection Association and Office of
State Fire Marshal shall inspect
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ii)
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Americans With Disabilities Act (
42 USC 12101
et seq.)
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C) In
addition to compliance with the standards set forth in this subsection (b)(3),
all applicable local and State building, fire, health and safety codes,
ordinances and regulations that are enforced by city, county or other local
jurisdictions in which the facility is, or will be, located must be observed
and documented through required inspections by appropriate officials.
4) Each facility shall have posted
an emergency plan for evacuation and shall conduct quarterly fire drills in
accordance with subsection (b)(3)(B)(i). Written documentation of the dates of
the quarterly fire drills must be on file at the facility. A diagram of
emergency evacuation routes shall be posted, at a minimum, in all corridors and
common areas. All personnel employed on the premises shall be aware of the
routes.
5) Each facility shall
maintain room temperatures in the facility of not less than 70 degrees
Fahrenheit and not more than 85 degrees Fahrenheit by utilizing heating
system/air conditioning/circulating fans.
6) Each facility shall designate a dining
area (equipped with enough chairs and table space) to accommodate the daily
number of participants.
7) Each
facility shall have and maintain in working order during operating hours at
least 1 bathroom facility that is physically accessible to persons with
disabilities for up to 12 participants and a minimum of 2 bathroom facilities
(1 accessible to persons with disabilities) to serve 13 or more
participants.
8) Each facility
shall have locked space for storage of office equipment, chemicals/cleaning
products and other hazardous supplies.
9) Hot water temperatures shall be controlled
to not exceed 119 degrees, but shall not be less than 100 degrees, Fahrenheit
in all locations where participants have access to dispensing hot water,
including bathroom facilities through appropriate plumbing mechanisms (e.g.,
anti-scald devices, pumps, and/or hot water tank thermostat settings). Hot
water temperatures at all locations within the ADS shall be checked weekly and
a written log shall be securely kept in the main administrative
office.
10) Unsupervised
participants shall not be allowed in the kitchen if water temperatures are not
controlled as required in subsection (b)(9). Participants should not be allowed
in areas where supplies/medications are stored or where a microwave is in use
unless supervised.
11) Each
facility shall have at least 1 quiet place equipped with a reclining chair, cot
or bed where a participant may rest.
12) Exit areas shall be clear of equipment
and debris at all times and shall be equipped with monitoring or signaling
devices to alert staff to participants leaving the facility
unattended.
13) One landline
telephone capable of accessing and being located by a 911 emergency response
system, if available in the area, shall be immediately available within the
activity area for participants. A list of emergency numbers shall be posted by
the telephone.
14) Supplies and
equipment for emergency first aid shall be immediately accessible to activity
areas for participants.
c) An adult day service provider (including
each satellite site) shall meet the following criteria relative to meals
provided to participants (prepared on-site or contractual):
1) The adult day service provider shall
provide to each participant 1 meal at mid-day that meets the Dietary Guidelines
for Americans, 2015-2020, 8thedition, published by
the Secretary of Health and Human Services and the Secretary of Agriculture;
and provide each participant a minimum of 331/2 percent of the Dietary
Reference Intakes (DRI) as established by the Food and Nutrition Board of the
Institute of Medicine of the National Academy of Sciences. Supplementary
nutritious snacks shall also be provided. The adult day service provider shall
provide modified diets as directed by the participant's physician.
2) Adult day service providers (whether meals
are prepared on-site or contractually) shall:
A) Have menus approved and so documented by
the registered dietitian. Menus shall reflect portion sizes as
appropriate.
B) Post menus in
advance in a location visible to the participants within the adult day service
facility.
C) Assure that menus are
planned for a minimum of 4 weeks on a menu form.
D) Develop methods and follow written
procedures to control portion sizes and to meet the one-third daily dietary
reference intakes recommended.
E)
One employee at each adult day service site, either handling/preparing or
supervising the handling/preparing of foods, shall meet DPH Food Service
Sanitation rules (77 Ill. Adm. Code 750).
F) Have on file and follow written procedures
for receiving and storing food that must include:
i) verification of food quantities;
ii) checking and documentation of food
temperatures at time of delivery and serving;
iii) equipment to be utilized;
iv) procedures to follow for foods that
arrive above or below temperature, deteriorated food and food
shortages.
G) Ensure
that catered meals are transported in equipment that maintains temperatures of
hot food at 140 degrees Fahrenheit, or above, and cold foods at 41 degrees
Fahrenheit, or below. Foods shall be maintained and served at the above
temperatures at the adult day service site.
H) Ensure that potentially hazardous foods
(i.e., food that consists in whole or in part of milk, milk products, eggs,
meat, poultry, fish, shellfish or other ingredients, including synthetic
ingredients, in a form capable of supporting rapid and progressive growth of
infectious or toxigenic microorganisms) intended to be served cold shall be
pre-chilled and transported/maintained at a temperature of 41 degrees
Fahrenheit, or below. Potentially hazardous food intended to be served hot
shall be transported/maintained at a temperature of 140 degrees Fahrenheit, or
above.
I) Ensure that potentially
hazardous foods prepared on-site shall be prepared in accordance with required
cooking temperatures as specified by 77 Ill. Adm. Code 750 and maintained until
service at 140 degrees Fahrenheit, or above, for hot foods and 41 degrees
Fahrenheit, or below, for cold foods.
J) If food is prepared by a caterer, the
adult day service provider shall keep a copy of the current caterer's
inspection certificates/letters on file to verify that the operation complies
with all health, safety and sanitation regulations.
d) An adult day service provider
(including each satellite site) shall comply with applicable requirements of
the current Illinois Vehicle Code [ 625 ILCS 5 ] and meet the following
criteria relative to transportation provided to participant's (directly or
contractually):
1) Adult day service provider
vehicles that transport participants shall be equipped with a working 2-way
communications device and written procedures to be followed in the event of an
emergency.
2) An adult day service
provider that uses its own vehicles to transport participants shall have on
file and utilize written procedures to ensure, to the extent possible, that
safe transportation is provided.
3)
An adult day service provider that subcontracts with another entity to
transport participants shall have on file and incorporate written procedures in
the service agreement to ensure, to the extent possible, that safe
transportation is provided.
e) Adult day service providers shall acquire
and have on file an emergency contact and a recent photograph of each
participant for emergency purposes.
f) An adult day service provider shall
provide services to all participants in the CCP referred by the CCU, except:
1) participants who do not meet the adult day
service provider's admission criteria; and
2) participants whose condition warrants
discharge under the adult day service provider's discharge criteria.
g) It is the adult day service
provider's responsibility to advise the primary caregiver, the participant's
care coordinator and/or appropriate professional of any changes in the
participant's health or functional ability.
h) Management staff of the adult day service
provider shall be required to complete adult day service management training.
1) Training shall be completed by the
provider prior to the award of a CCP adult day service contract from the
Department.
2) At a minimum, the
provider Program Administrator, or Program Coordinator/Director if also
functioning as the Program Administrator, shall complete this
training.
It shall be incumbent upon the provider to assure that its
facility meets all applicable requirements as promulgated by the Capital
Development Board.