Chapter 245D — Home and Community-Based Services Standards

245D.01 Citation This chapter is officially called the 'Home and Community-Based Services Standards' or 'HCBS Standards.' It covers the … 245D.02 Definitions This section defines the key terms used in the HCBS Standards, including what counts as a 'service,' 'direct support … 245D.03 Applicability and Effect This section lists which services are covered by the HCBS Standards, including day services, residential support, … 245D.04 Service Recipient Rights Service providers must protect the rights of the people they serve, including the right to be treated with dignity, … 245D.05 Health Services Providers must do a thorough assessment of each person before starting services and use that assessment to create a … 245D.051 Psychotropic Medication Use and Monitoring When a person first starts services, the provider and the person's support team must create an individual service plan. … 245D.06 Protection Standards Providers must use positive support strategies to help people manage their behavior. The use of restraints and other … 245D.061 Emergency Use of Manual Restraints Emergency use of manual restraints is only allowed when a person's behavior poses an immediate danger. Staff must be … 245D.07 Service Planning and Delivery Providers must keep their programs safe by following specific health and safety requirements, including having emergency … 245D.071 Service Planning and Delivery; Intensive Support Services Providers must report certain incidents to the state, the person receiving services, and their family or guardian. … 245D.08 Providers must have enough qualified staff to safely deliver services. This section covers staff qualifications, … 245D.081 Program Coordination, Evaluation, and Oversight Providers must ensure that direct support staff complete required training, including orientation training before … 245D.09 Staffing Standards Providers must keep accurate records for each person they serve, including the service plan, assessments, incident … 245D.091 Intervention Services Providers must maintain administrative records about their program, including staff records, policies and procedures, … 245D.095 Record Requirements Providers that manage their clients' money or property must follow strict rules to protect those funds. This includes … 245D.10 Policies and Procedures The commissioner licenses providers of home and community-based services and can impose conditions on a license, deny an … 245D.11 Policies and Procedures; Intensive Support Services The commissioner can issue correction orders to providers who violate the HCBS standards. If problems are serious, the … 245D.12 Integrated Community Supports; Setting Capacity Report Some HCBS provisions are specifically excluded from the rulemaking process, meaning the commissioner can implement them … 245D.13 Out-of-home Respite Care Services for Children This section clarifies the transition from the old chapter 245B standards to the new chapter 245D standards, including … 245D.21 Facility Licensure Requirements and Application Process Community residential settings and day service facilities must pass fire, health, building, and zoning inspections … 245D.22 Facility Sanitation and Health Licensed facilities must be kept clean, safe, and in good repair. This section covers rules for maintenance, hazardous … 245D.23 Community Residential Settings; Satellite Licensure Requirements and Application Process Each community residential setting at a different address needs its own satellite license. These homes are treated as … 245D.24 Community Residential Settings; Physical Plant and Environment Community residential settings must have proper furnishings, bedrooms with enough space, and personal storage for each … 245D.25 Community Residential Settings; Food and Water Community residential settings must provide safe drinking water, three nutritious meals per day, and snacks. Food must … 245D.26 Community Residential Settings; Sanitation and Health Community residential settings must provide clean linens, household supplies, and a clean living environment. This … 245D.261 Community Residential Settings; Remote Overnight Supervision Community residential settings may use technology for remote overnight supervision instead of having staff on-site, but … 245D.27 Day Services Facilities; Satellite Licensure Requirements and Application Process Day service providers must get a separate satellite license for each facility where they provide services. If the … 245D.28 Day Services Facilities; Physical Plant and Space Requirements Day service facilities must have at least 40 square feet of primary space per person and provide each person with … 245D.29 Day Services Facilities; Health and Safety Requirements Day service facilities must have proper refrigeration for food, drinking water for all participants, a resting area for … 245D.31 Day Services Facilities; Staff Ratios and Facility Coverage Day service facilities must maintain staff-to-participant ratios based on each person's individual needs. Case managers … 245D.32 Alternative Licensing Inspections Providers with a strong track record of compliance and a qualifying national accreditation may request an alternative … 245D.33 Adult Mental Health Certification Standards The commissioner can issue a voluntary mental health certification for providers licensed under this chapter who meet …