Current through Register Vol. 50, No. 9, March 1, 2024
RELATES TO: KRS 13B.080-13B.160, 211.180, 211.689
NECESSITY, FUNCTION, AND CONFORMITY: KRS 194A.050(1) requires
the secretary of the Cabinet for Health and Family Services to promulgate
administrative regulations necessary to operate the programs and fulfill the
responsibilities vested in the cabinet. KRS 211.690 authorizes the Cabinet for
Health and Family Services to implement a voluntary statewide home visitation
program for the purpose of providing assistance to at-risk parents during the
prenatal period until the child's third birthday. This administrative
regulation establishes the eligibility criteria, services, provider
qualifications, and hearing rights for participants of the Health Access
Nurturing Development Services (HANDS) Program.
Section 1. Definitions.
(1) "Department" means the Department for
Public Health or its designated representative.
(2) "Family support worker" means an employee
or subcontractor of the local implementing agency who visits participants and
performs services.
(3) "Local
implementing agency" means a local health department or a contracted agency
that agrees to participate as a HANDS provider and employ or contract with
staff that meet the qualifications specified in Section 3 of this
administrative regulation.
(4)
"Participant" means the parent and child enrolled in the HANDS program and
receiving HANDS services.
(5)
"Tele-service" means a home visitation service provided through video
communication with the HANDS provider, parent, and child present in real
time.
Section 2.
Eligibility Criteria.
(1) In order to receive
a service established in Section 4 of this administrative regulation, an
individual shall be:
(a) A pregnant individual
who is under twenty (20) years old;
(b) A pregnant individual who is at least
twenty (20) years old and upon assessment is identified as having one or more
risk factors for the pregnancy or the infant;
(c) The child of an individual identified in
paragraph (a) or (b) of this subsection who is less than three (3) years of age
and assessed for eligibility within ninety (90) days post-birth; or
(d) A father or guardian of a child
identified in paragraph (c) of this subsection.
(2) The local implementing agency shall
assess an applicant for eligibility. The assessment shall reflect:
(a) The child and parents unique strengths
and needs; and
(b) The services
appropriate to meet those needs.
(3) All assessments of the child and family
shall be:
(a) Conducted in a nondiscriminatory
manner;
(b) Selected and
administered so as not to be racially or culturally discriminatory;
and
(c) Conducted in the native or
preferred language of the child or parent.
(4) Parental consent shall be provided to the
local implementing agency before an assessment.
(5) The assessment shall:
(a) Be conducted by a family support worker
professional who meets the qualifications listed in Section 3(2) of this
administrative regulation; and
(b)
Result in:
1. Eligibility for HANDS services,
in which the family shall be referred for the development of a home visiting
plan; or
2. Ineligibility for HANDS
services, in which the family shall be provided with community resources,
referral information, and general parenting information.
(6) Participation in the HANDS
Program is voluntary.
(7)
Participation in the HANDS Program shall be discontinued if:
(a) The child dies;
(b) The family elects to withdraw from the
program;
(c) The family moves out
of state;
(d) Contact with the
family is lost; or
(e) The family
repeatedly fails to participate in program activities.
Section 3. Provider
Qualifications.
(1) A family support worker
paraprofessional shall be a:
(a) High school
graduate or holder of a general education development credential who is at
least eighteen (18) years of age;
(b) Has received department training in:
1. Ongoing assessment of family strengths and
needs;
2. Service plan
development;
3. Evidence-based home
visiting model;
4. Coordination of
services; and
5. Evaluation;
and
(c) Is supervised by
a registered nurse or licensed social worker.
(2) A family support worker professional
shall be a:
(a) Licensed nurse who holds a
valid Kentucky Board of Nursing license as a registered nurse or advanced
practice registered nurse;
(b)
Licensed social worker who holds a valid Kentucky Board of Social Work
license;
(c) Graduate with a
master's degree in human services or closely related field who shall be
supervised by a registered nurse or licensed social worker; or
(d) Graduate with a bachelor's degree in
early childhood education, human services, or closely related field who shall
be supervised by a registered nurse or licensed social worker.
(3) A HANDS supervisor shall be a:
(a) Licensed nurse who holds a valid Kentucky
Board of Nursing license as a registered nurse or advanced practice registered
nurse; or
(b) Licensed social
worker who holds a valid Kentucky Board of Social Work license.
(4) A local implementing agency
shall meet the requirements to provide HANDS services if:
(a) It assures that appropriate staff meet
the licensure requirements of the department pursuant to subsection (1) or (2)
of this section;
(b) It assures
supervision by licensed personnel pursuant to subsection (3)(a) or (b) of this
section; and
(c) It reports program
data from Section 4(1) of this administrative regulation into the online HANDS
database no later than the first Sunday of the month following the date of
service.
Section
4. Services.
(1) Home visitation
may take place in the client's home or another community site if justified in
the record. A home visit shall include:
(a)
Monitoring the child and family's progress by:
1. Making referrals to community
resources;
2. Tracking appointments
to ensure they are being kept;
3.
Following up on referrals; and
4.
Performing periodic evaluations of participant's changing needs;
(b) The preparation and
maintenance of case records that document contacts, services needed, reports,
and progress;
(c) Consultations
with the family on positive pregnancy outcomes, optimal child growth and
development, safe and healthy homes, and family decision making and
self-sufficiency; and
(d) Crisis
assistance.
(2)
(a) Service frequency shall be provided in
accordance with the level of need of the parent or family.
(b) The frequency of visitation shall be
lessened as the family meets goals agreed to by the provider and the
participant.
Section
5. Appeal Rights.
(1) A local
implementing agency shall notify an individual who does not meet criteria for
admission or continuation in the program or who has had a service discontinued,
in writing, within ten (10) days of the denial or discontinuance.
(2) An individual wishing to appeal an
adverse action by the local implementing agency shall notify the department in
writing within thirty (30) days of the date of the notice identified in
subsection (1) of this section that a hearing is requested.
(3) Notice of an administrative hearing shall
be provided in accordance with KRS 13B.050.
(4) The administrative hearing process shall
be conducted in accordance with KRS 13B.080 through 13B.160.
Section 6. Tele-service Delivery
Methods.
(1)
(a) HANDS home visitation services that are
otherwise designated as face-to-face in accordance with this administrative
regulation may be provided through tele-service delivery methods with informed
parental consent.
(b) These
services shall include those listed in Sections 2(5) and 4 of this
administrative regulation.
(c)
Verbal and written consent shall be provided for each child in a shared
household. For example, if the family has twins, verbal and written consent
shall be provided for each child.
(2) Tele-service delivery methods shall be
reimbursed at the usual and customary rate.
STATUTORY AUTHORITY: KRS 194A.050(1),
211.690