DHS 105.14(7)(b)3. 3. All caregivers who provide participant care and supervision shall have continual access to the participant’s service plan.

DHS 105.14(7)(c) (c) Caregiver staffing requirements.

DHS 105.14(7)(c)1. 1. In this paragraph, “severely impaired” means any impairment leading to a participant’s inability at the program to perform any 3 or more ADLs. A severely impaired participant demonstrates an inability to perform these ADLs at the ADCC unless assistance, supervision or prompting is provided.

DHS 105.14(7)(c)2. 2. At least one qualified caregiver shall be on the premises at all times when one or more participant are present.

DHS 105.14(7)(c)3. 3. The ADCC shall provide sufficient caregiver staff at all times to implement the program goals and participant service plans based on a comprehensive assessment of each participant’s needs, including physical health, physical disabilities and mobility status, mental and emotional health, emergency evacuation capabilities, and participant’s preferences and interests.

DHS 105.14(7)(c)4. 4. There shall be a minimum of one caregiver for every 8 non-severely impaired participants at the ADCC.

DHS 105.14(7)(c)5. 5. There shall be a minimum of one caregiver for every 4 severely impaired participants at the ADCC.

DHS 105.14(7)(c)6. 6. The ADCC shall maintain a current written schedule for every caregiver at the ADCC. The schedule shall include each caregiver’s full name, job assignment, and time worked.

DHS 105.14(7)(c)7. 7. A volunteer who meets the same standards, requirements, and training as a caregiver and who have signed a written job description may be counted as a caregiver to meet staffing requirements.

DHS 105.14(7)(d) (d) Medication administration.

DHS 105.14(7)(d)1. 1. The ADCC shall have a written policy for medication management and shall designate which caregivers are authorized and trained to administer medications. The caregiver administering medications shall be 18 years of age or older. The policy shall indicate the program’s role in the supervision of self-administered medications and caregiver administered medications.

DHS 105.14(7)(d)2. 2. Self-administered medications may be supervised by a caregiver who may prompt the participant and observe the participant taking the medication. To self-administer medications, the participant shall have the physical and mental capacity to obtain, dispense, and ensure the correct medications are taken in the prescribed dosages. When medications are self-administered, the medication list shall be reviewed and updated annually by the prescribing practitioner, physician, physician’s assistant, or nurse practitioner.

DHS 105.14(7)(d)3. 3. Caregiver-administered medications shall be stored, obtained, and assembled for the participant. The caregiver is responsible for ensuring the correct medication, in the correct dose, at the correct time is administered to the correct participant. Medications administered by a caregiver shall meet all of the following conditions:

DHS 105.14(7)(d)3.a. a. A written order from the prescribing practitioner shall be in the participant’s record.

DHS 105.14(7)(d)3.b. b. A listing of current medications with the dosage, frequency, and route of administration shall be in the participant’s record.

DHS 105.14(7)(d)3.c. c. Over-the-counter and prescription medications shall remain in the original labeled containers and be stored in a locked, safe place.

DHS 105.14(7)(d)3.d. d. Non-licensed caregivers shall consult with the prescribing practitioner or pharmacist about each medication to be administered.

DHS 105.14(7)(d)3.e. e. Written information describing side effects and adverse reactions of each medication shall be kept in the participant’s record.

DHS 105.14(7)(d)3.f. f. The administration of medications shall be documented in the participant’s permanent record to include the name of the medication, dosage, method of administration, date and time administered, and name of the caregiver who administered the medication.

DHS 105.14(7)(d)3.g. g. Medication administration by routes to include: injectable, nebulizers, stomal and enteral medications, and medications, treatments or preparations delivered vaginally or rectally shall be administered by a registered nurse or by a licensed practical nurse within the scope of their license, or may be delegated to a non-licensed caregiver pursuant to s. N 6.03 (3).

DHS 105.14(7)(e) (e) Program services. Based on the written description of the program, the ADCC shall provide or arrange for services to meet the needs of each participant in all of the following areas:

DHS 105.14(7)(e)1. 1. ‘Leisure activities.’ The ADCC shall provide programming for individual and group activities that encourage creativity, social interaction, and physical exercise. Activities shall include outings to points of interest and involvement in the general community which take into consideration individual functional abilities, needs, and interests of each participant.

DHS 105.14(7)(e)2. 2. ‘Personal care.’ The ADCC shall provide assistance to meet a participant’s assessed needs for ADLs.

DHS 105.14(7)(e)3. 3. ‘Supervision.’ The ADCC shall provide supervision appropriate to the participant’s needs.

DHS 105.14(7)(e)4. 4. ‘Communication skills.’ The ADCC shall provide services to meet the participant’s communication needs.

DHS 105.14(7)(e)5. 5. ‘Health monitoring.’ The ADCC shall monitor the health of a participant by observing and documenting changes in each participant’s health and referring a participant to health care providers when necessary. At a minimum, a quarterly note shall document how a participant is responding to the service plan. The ADCC shall immediately notify the participant’s legal representative and the participant’s residential provider, if any, when there is a significant change in a participant’s physical or mental condition.

DHS 105.14(7)(e)6. 6. ‘Behavior management.’ The ADCC shall provide services to manage a participant’s behaviors that may be harmful to themselves or others.

DHS 105.14(7)(e)7. 7. ‘Transportation.’ An ADCC program providing transportation for any participant shall carry liability insurance and ensure the vehicle is safe and well-maintained.

DHS 105.14(7)(f) (f) Food services.