DAR File No. 27753

Human Services, Services for People with Disabilities

R539-4

Quality Assurance

NOTICE OF PROPOSED RULE

DAR File No.: 27753
Filed: 03/15/2005, 12:03
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The change is proposed after a comprehensive revision and consolidation of the Division's rules.

Summary of the rule or change:

The changes involve repealing the current rule and replacing it with a new rule. This rule is repealed in its entirety.

State statutory or constitutional authorization for this rule:

Sections 62A-5-102 and 62A-5-103

Anticipated cost or savings to:

the state budget:

None--This revision does not alter the basic operations or functions of the Division. Therefore, there is cost or savings to the state.

local governments:

None--Local government funding is not used. Therefore, there is no cost to local governments.

other persons:

None--This revision does not alter the basic operations or functions of the Division. Therefore, there is no cost or savings to other persons.

Compliance costs for affected persons:

This revision does not alter the basic operations or functions of the Division. Therefore, there is no cost to affected persons.

Comments by the department head on the fiscal impact the rule may have on businesses:

None--This revision does not alter the basic operations or functions of the Division. Therefore, there is no impact on businesses. Lisa-Michele Church, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Direct questions regarding this rule to:

Suzie Totten at the above address, by phone at 801-538-4197, by FAX at 801-538-4279, or by Internet E-mail at stotten@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

05/02/2005

This rule may become effective on:

05/03/2005

Authorized by:

Lisa-Michele Church, Executive Director

RULE TEXT

R539. Human Services, Services for People with Disabilities.

[R539-4. Quality Assurance.

R539-4-1. Quality Assurance Survey.

A. Policy.

The purpose of the Quality Assurance survey is to ensure that recipients of Division of Services for People with Disabilities funded programs are receiving services that support them in participating fully in community life and an enhanced quality of life.

B. Procedures.

1. The Quality Assurance team will survey quality of life outcomes for the identified individual by observation, interviews, and a review of records.

2. Deficiencies identified in the report require a provider to submit a plan of correction within 15 working days from the final survey report date. The Provider must respond to each identified deficiency, including proposed method of correction, task assignments, and supervision.

3. The Quality Assurance team leader will determine if the submitted plan of correction is acceptable and if not, notify the Provider by certified mail within ten working days of receipt. The Provider must submit a revised plan of correction within five working days. If a revised plan of correction is unsatisfactory, the Division and Regional Director may initiate sanctions.

4. A follow-up survey will be scheduled by Division staff within 60-90 days after receipt of the accepted plan of correction. The purpose of the follow-up is to:

a. determine and certify if the deficiencies have been corrected as specified in the plan of correction.

b. if deficiencies have not been corrected as specified, initiate corrective actions which include the following:

(1) provide additional time for the Provider to complete corrections.

(2) request a revised plan of correction to be submitted to the Division within five days, or

(3) recommend the Division and Regional Director initiate formal sanctions.

5. The Division and Regional Director may initiate sanctions by providing written notice of the action to be taken to the Provider in instances when:

a. Revised plan of corrections is unsatisfactory.

b. Imminent danger and health violations exist or other significant deficiencies are present.

c. The Provider has failed to implement an approved plan of correction.

6. A Provider who disagrees with the proposed sanctions may pursue an appeal through the Department of Human Services (R495-100).

R539-4-2. Volunteer Monitoring.

A. Policy.

Volunteer Monitoring is an integral part of the Division's Quality Assurance system. Volunteer monitors are interested individuals not otherwise paid to provide services. The goal of the Volunteer Monitoring Services Committee is to help children and adults with disabilities be assured of an enhanced quality of life. In order to accomplish this goal, the Volunteers conduct facility and program reviews. Corrective activities may be undertaken for problems identified by the Volunteer Monitoring Services Committee.

B. Procedures.

1. A Plan of Correction may be requested if the review indicates that the program is not in compliance with Division policy and procedures.

a. A written response is required within 20 days to correct any deficiencies and respond to concerns (see R539-4-1.B.2).

b. The Plan of Correction will be submitted to the Division and the Executive Committee of the Volunteer Monitoring Services Committee for review and follow-up. In addition, at the Division Director's request, the Division may conduct a Quality Assurance review (in accordance with R539-4-1).

R539-4-3. Residential Site.

A. Policy.

It is the policy of the Division that acquisition of residential sites for the purpose of providing services to people with disabilities should conform to state and local zoning requirements and shall not violate the Federal Fair Housing Law. The Division shall make a formal determination, where an individual history warrants, that the individual being considered for placement does not pose a direct threat to the health and safety of other individuals.

R539-4-4. Informal Quality Assurance Reconsideration Process.

A. Policy.

A Provider with the Division of Services for People with Disabilities is entitled to a review of any individual's quality assurance outcomes survey.

B. Procedures.

1. A provider of services may request informal reconsideration by submitting a written request to the Division Director of Quality Assurance within 15 working days of receipt of the outcomes survey report. The letter should include a description of the standards or items on the survey for which review is requested.

2. The informal reconsideration will be performed within ten working days of receipt of the request. The results of the reconsideration will be submitted in writing to the provider and the Division Director within ten working days of the completion of the informal reconsideration.

3. The provider may exercise any further formal appeals afforded them in contract or state policy.

R539-4-5. Contracts for Services.

A. Policy

The State Office will coordinate on behalf of the Regional Offices the review of contracts, the call for statewide proposals for services, promulgation of rates, and the development of the contract Objectives and Evaluations attachment. The Regions shall arrange for contracts with Providers on behalf of service recipients, shall establish and manage budgets for signed contracts, and shall conduct contract compliance monitoring activities. The State Office and Regional Offices shall collaborate on the resolution of problems occurring around contracting, which will include promoting an environment of fair competition among providers.

B. Procedures

1. A contract may be terminated immediately:

a. If the individuals served are in clear and imminent danger.

b. If a purchase of service provider cannot demonstrate proper licensing/certification.

2. A contract may be terminated without cause upon 30 days prior written notice under the following circumstances:

a. division funding inadequacies;

b. there is no further need for the contract.

3. A contract may be terminated with cause with a 30 day written notice for:

a. continued contractual violations;

b. continued violations of Department or Division policy;

c. mismanagement of personal, state, or federal funds;

d. failure to correct continuing deficiencies identified in quality assurance surveys;

e. and other situations where the Division determines it is in the best interest of the persons served.

4. Contractors may avail themselves of all remedies available for termination with cause under the provisions of the Utah State Procurement Code, Section 63-56-1.

KEY: social services, disabled persons*

1994

Notice of Continuation December 18, 2002

62A-5-103]

ADDITIONAL INFORMATION

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For questions regarding the content or application of this rule, please contact Suzie Totten at the above address, by phone at 801-538-4197, by FAX at 801-538-4279, or by Internet E-mail at stotten@utah.gov

For questions about the rulemaking process, please contact the Division of Administrative Rules (801-538-3764). Please Note: The Division of Administrative Rules is NOT able to answer questions about the content or application of these administrative rules.