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Title 902 | Chapter 004 | Regulation 120REG

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CABINET FOR HEALTH AND FAMILY SERVICES
Department for Public Health
Division of Maternal and Child Health
(Amended at ARRS Committee)

902 KAR 4:120.Health Access Nurturing Development Services (HANDS) Program.

RELATES TO:

KRS 13B.080-13B.160, 200.700, 211.090, 211.180, 211.689

STATUTORY AUTHORITY:

KRS 194A.050(1), 211.690

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" or "FSW" means an employee or subcontractor of the local implementing agencya provider's employee or subcontractor who visits participants and performs services.

(3)

"Local implementing agency" means a local health department or a contracted an agency that agrees to participate as a HANDS provider and to employ or contract with staff that :

(a)

meet the qualifications specified in Section 3 of this administrative regulationand training requirements for home visitation service delivery; and

(b)

Agree to abide by all:

1.

HANDS policies and procedures; and

2.

Reporting requirements"HANDS" means Health Access Nurturing Development Services, a voluntary statewide home visitation program for the purpose of providing assistance to at-risk parents during the prenatal period and until the child's third birthday as funding is available.

(4)

"Participant" means the parent and childan individual 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"Provider" means a local health department agency subscribing to staff and training requirements, program policies and procedures, and reporting requirements of the HANDS Program and agreeing to participate as a HANDS provider.

Section 2.

Eligibility Criteria.

(1)

In order to receive a service established in Section 4 of this administrative regulation, an individual shall be:

(a)

Submit ACH-301, Consent for Services, to the local health department or their subcontractor, in accordance with KRS 211.690(4).

(b)

Be:

1.

A pregnant individual who is under twenty (20) years oldwoman who has not reached her 20th birthday;

(b)2.

A pregnant individualwoman who is at least twenty (20) years old and upon assessment is identified as having one or more risk factorsa risk is deemed likely for the pregnancy or the infant;

(c)3.

The child of an individual identified in paragraph (a) or (b) of this subsection who is less than three (3) years of age and assessedUp to the third birthday, an infant or toddler of an individual identified in subparagraph 1. or 2. of this subsection, whose family is determined to be at risk and is screened for eligibility within ninety (90) days post-birth; or

(d)4.

A father or guardian of a child identified in paragraph (c)subparagraph 3. 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 isshall be voluntary.

(7)(3)

Participation in the HANDS Program shall be discontinued ifprevented or terminated if one (1) of the following occurs:

(a)

The child diesDeath of the fetus or infant;

(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.; or

(f)

The goals established for the family are met.

(4)

A screening shall include the following components:

(a)

Using the ACH-300, Referral Record Screen, a provider shall determine eligibilityof an applicant by:

1.

Face-to-face interview; or

2.

Evaluation of health records;

(b)

If an individual's screening indicates eligibility for HANDS services, the individual shall be referred for an assessment; and

(c)

If an individual's screening indicates ineligibility for HANDS services, the individual shall be provided with community resource and referral information.

(5)

An assessment shall:

(a)

Consist of the following components:

1.

Using the ACH-302, Parent Survey Summary, and ACH-303, Parent Survey Score Sheet, a comprehensive needs assessment shall be performed by conducting a face-to-face interview with the child, mother, and family to include information regarding each parent's:

a.

Childhood experience;

b.

Lifestyle behaviors and mental health;

c.

Experience and expectations for parenting;

d.

Coping skills;

e.

Support system;

f.

Stress and anger management skills;

g.

Expectations of the infant's developmental milestones and behaviors;

h.

Plans for the child's discipline;

i.

Perception of the new infant; and

j.

Bonding and attachment to the infant; and

2.

Arrangement for delivery of needed services;

(b)

Be conducted by:

1.

A social worker;

2.

A registered nurse;

3.

A graduate of a four (4) year program in a social or behavioral science, education field, or a related field with one (1) year experience performing case management services, except that A master's degree in a human services field may be substituted for the one (1) year experience; or

4.

A graduate with an associate degree in an early childhood education field and successful completion of the department's home visitation model training; and

(c)

Result in:

1.

Eligibility for HANDS services, in which the individual shall be referred for the development of a home visiting plan; or

2.

Ineligibility for HANDS services, in which the individual shall be provided with community resource and referral information and general parenting information.

Section 3.

Provider Qualifications.

(1)

A family support worker paraprofessional shall be a:

(a)

High school graduate or holder of a general education development credentialGED who:

1.

is at least eighteen (18) years of age;

(b)2.

Has received department training in:

1.a.

Ongoing assessment of family strengths and needs;

2.b.

Service plan development;

3.c.

Evidence-based home visiting model;

4.d.

Coordination of services; and

5.e.

Evaluation; and

(c)3.

Is supervised by a registeredpublic health nurse or licensed social worker.;

(2)

A family support worker professional shall be a:

(a)

Licensed;

(b)

Public health nurse who holdshas a valid Kentucky Board of Nursing license as a registered nurse or advanced practice registered nurse;

(b)(c)

 

1.

Licensed social worker who holds a valid Kentuckymeets the requirements for licensure by the State Board of Examiners of Social Work license;

(c)2.

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)

social work from an accredited institution; or

3.

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.social work from an accredited institution;]

(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)(d)

Graduate of a four (4) year program in a social or behavioral science, education field, or a related field with one (1) year experience performing case management services, except that a master's degree in a human services field may be substituted for the one (1) year experience; or

(e)

Graduate with an associate degree in an early childhood education field and successful completion of the department's home visitation model training.

(2)

A local implementing agencyhealth department shall meet the requirements to provide HANDS services if:

(a)

TheIts staff or subcontractor receives the required training provided by the department to become a family support worker;

(b)

It assures that appropriate staff meet the licensure requirements of the department pursuant to subsection (1) or (2)(b) or (c) of this section;

(b)(c)

It assures supervision by licensed personnel pursuant to subsection (3)(a) or (b)subsection (1)(b) or (c) of this section; and

(c)(d)

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; and

(e)

It abides by the policies of the HANDS program.

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 visitvisitation shall include thefollowing:

(a)

Monitoring the childof the child's, mother's, and family's progress by:

1.

Making referrals to community resources;

2.

Tracking appointments to ensure they are being kept;

3.

Following up on referralsPerforming follow-up services as identified by the provider; and

4.

Performing periodic evaluations of the participant's changing needs;

(b)

The preparation and maintenance of case records that documentwhich shall be documented with contacts, services needed, reports, and progress;

(c)

Consultations with the familyparent or primary caregiver on positive pregnancy outcomes, optimal child growth and development, safe and healthyhealth and safe 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 pursuant to ACH-306, Parent Completion LEVELS .

(b)

The frequency of visitation shall be lessened as the family meets goals agreed to by the provider and the participant.

(3)

Between the second and third birthday, home visitation services shall be limited to a child whose family does not progress beyond level I of ACH-306, Parent Completion LEVELS.]

Section 5.

Appeal Rights.

(1)

A local implementing agencyprovider 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.Incorporation by Reference. (1) Thefollowing material is incorporated by reference:

(a)

"ACH-300, Referral Record Screen", 5/2016;

(b)

"ACH-301, Consent for Services", 5/2016;

(c)

"ACH-302, Parent Survey Summary", 5/2016;

(d)

"ACH-303, Parent Survey Score Sheet", 5/2016; and

(e)

"ACH-306, Parent Completion LEVELS", 5/2016.

(2)

This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Public Health, first floor, Health Services Building, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m.
CONTACT PERSON: Krista Quarles, Policy Analyst, Office of Legislative and Regulatory Affairs, 275 East Main Street 5 W-A, Frankfort, Kentucky 40621; phone 502-564-6746; fax 502-564-7091; email CHFSregs@ky.gov.

7-Year Expiration: 5/9/2030

Last Updated: 12/22/2023

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