Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Amended paragraph (19) and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-101 renumbered to R6-6-201, new Section R6-6-101 adopted effective June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Amended effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4). Amended under an exemption from A.R.S. Title 41, Chapter 6, effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4).

R6-6-102. Rights of Individuals with Development Disabilities

The Division and its service providers shall guarantee the rights of individuals with developmental disabilities in the provision of services in compliance with applicable federal and state laws.

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-102 renumbered to R6-6-202, new Section R6-6-102 adopted effective June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-102 renumbered to R6-6-103, new Section R6-6-102 adopted effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-103. Confidentiality Officer

A. Each district shall designate one Division staff person to act as a confidentiality officer.

B. Confidentiality officers shall completely administer and supervise the maintenance and use of all personally identifiable information in the Division including storage, disclosure, retention, and destruction of this information in accordance with procedures of the Division and applicable state law.

C. At the time of eligibility determination reviews, confidentiality officers or their designees shall notify responsible persons of their rights pursuant to A.R.S. § 36-568.01 regarding disclosure of personally identifiable information.

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-103 renumbered to R6-6-203, new Section R6-6-103 adopted effective June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-103 renumbered to R6-6-104, new Section R6-6-103 renumbered from R6-6-102 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-104. Access to Personally Identifiable Information

A. The Division and its service providers shall each maintain a list of persons or titles who are authorized to have access to personally identifiable information in their files.

B. The service provider shall maintain a main provider record for each client; the file shall be available to responsible persons upon request.

C. Where a service provider uses a centralized recordkeeping system, the service provider shall also make available appropriate records in the program unit.

D. Where particular professional services require the maintenance of separate records, a summary of the information contained therein shall be entered in the main provider record maintained by the client's service provider.

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Corrected subsection (B) and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-104 renumbered to R6-6-204, new Section R6-6-104 adopted effective
June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-104 renumbered to R6-6-105, new Section R6-6-104 renumbered from R6-6-103 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-105. Consent for Release of Information

A. Consent for the release of personally identifiable information shall be:

1. Obtained from the client or responsible person in writing and dated;

2. Maintained in the main record.

B. Consents for release of information obtained during intake shall expire within 90 days.

C. Subsequent consents shall be obtained as needed and shall be valid for six months from the date of execution.

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-105 renumbered to R6-6-205, new Section R6-6-105 adopted effective June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-105 renumbered to R6-6-106, new Section R6-6-105 renumbered from R6-6-104 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-106. Violations and Penalties

A. An employee of the Division or service provider shall not disclose personally identifiable client information unless a consent to release has been given as provided in this Section.

B. An employee of the Division who makes an unlawful disclosure of personally identifiable information is subject to disciplinary action or dismissal. Anyone who has knowledge of an employee's violation of R6-6-106 must report the violation to the employee's supervisor.

C. Violators are subject to penalties pursuant to applicable statute.

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-106 renumbered to R6-6-206, new Section R6-6-106 adopted effective June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-106 renumbered to R6-6-107, new Section R6-6-106 renumbered from R6-6-105 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-107. Least Restrictive Environment

A. Every client has a right to the least restrictive, appropriate alternative in connection with the provision of services or placement in a program.

B. Every client has the right to a semi-annual review of services or programs funded by the Division and received by the client in order to ensure that the client's needs are met.

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-107 renumbered to R6-6-207, new Section R6-6-107 adopted effective June 7, 1993, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-107 renumbered to R6-6-108, new Section R6-6-107 renumbered from R6-6-106 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-108. Safe and Humane Environment

A. This Section does not apply to community residential settings that are governed by the provisions of Article 7, 8, 10, or 11 of this Chapter.

B. Service providers shall have a written and posted plan for meeting potential emergencies and disasters.

C. The plan shall be reviewed annually by the Division and shall include, but shall not be limited to:

1. The assignment of staff to specified duties and responsibilities;

2. A system for notification of appropriate persons;

3. Specification of evacuation routes and procedures including provisions for clients who are incapable of taking action for self-preservation; and

4. Provision for at least one rehearsal per year to evaluate the effectiveness of the plan.

D. Programs operated by the Division, or by a profit or nonprofit agency supervised or financially supported by the Division, shall have an active safety program, which shall include, but shall not be limited to:

1. Staff training for meeting potential emergencies and disasters such as fire, severe weather, and missing persons;

2. Staff training in the use of alarm systems and signals, firefighting, and equipment and evacuation devices;

3. Staff training in administering first aid, including cardiopulmonary resuscitation (CPR) and the Heimlich maneuver, in the presence of accident or illness;

4. Provisions for the avoidance of hazards such as accessibility to dangerous substances, sharp objects, and unprotected electrical outlets;

5. Provisions for the use of glass or other glazing material appropriate to the safety of the individuals served;

6. The use of clean, nonabrasive, slip-resistant, and safe surfaces on floors and stairs;

7. Provisions for the avoidance of heating apparatus and hot water temperatures that constitute a burn hazard to the individuals served; and

8. The use of lead-free paint in areas to which clients have access.

E. Programs operated by the Division, or by a profit or nonprofit agency supervised or financially supported by the Division, shall conform to local fire safety standards and the fire safety standards as approved and promulgated by the Arizona State Fire Marshal's office or by tribal fire department standards, whichever is appropriate.

F. Programs operated by the Division, or by a profit or nonprofit agency supervised or financially supported by the Division, shall provide adequate heating and cooling.

G. Service providers shall keep copies of all licenses, certificates, and correspondence in a separate file to document compliance with sanitation, health, and environmental codes of state and local authorities having primary jurisdiction in these matters. The file shall be available for inspection by the Division employees during regular business hours.

H. Service provider staff shall:

1. Always give clients the least amount of physical assistance necessary to accomplish a task;

2. Ensure that clients be accorded privacy during treatment and care of personal needs;

3. Care for the client's personal needs and, except in cases of emergency, ensure that each client is afforded the right to have care for personal needs provided by a staff member of the gender chosen by the client/responsible person. This choice needs to be specified in the ISPP;

4. Ensure that clients are afforded privacy with regard to written correspondence, telephone communication, and visitations; and

5. Uphold respect for the dignity of individuals with developmental disabilities during tours of client residences, work areas, or classrooms.

Historical Note

Section R6-6-108 adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-108 renumbered to R6-6-208 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Section R6-6-108 renumbered from Section R6-6-107 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-109. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Deleted subsection (O); corrected subsections (E), (H), and (I); amended subsections (J) and (M); and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-208 renumbered from R6-6-108 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-110. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Amended subsection (B) and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-210 renumbered from R6-6-110 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-111. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Amended subsection (B) and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-210 renumbered from R6-6-110 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-112. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-212 renumbered from R6-6-112 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-113. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Amended subsection (C) and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-213 renumbered from R6-6-113 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-114. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-214 renumbered from R6-6-114 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-115. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-215 renumbered from R6-6-115 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-116. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-216 renumbered from R6-6-116 effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-117. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Amended subsections (C), (D), and (F) and adopted as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-217 renumbered from R6-6-117 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-118. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-218 renumbered from R6-6-118 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-119. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-219 renumbered from R6-6-119 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-120. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-220 renumbered from R6-6-120 effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-121. Renumbered

Historical Note

Adopted as an emergency effective January 12, 1987, pursuant to A.R.S. § 41-1026, valid for only 90 days (Supp. 87-1). Emergency expired. Adopted without change as a permanent rule effective September 18, 1987 (Supp. 87-3). Section R6-6-213 renumbered from R6-6-113 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

ARTICLE 2. REPEALED

R6-6-201. Repealed

Historical Note

Former R6-6-201 repealed, new Section R6-6-201 renumbered from R6-6-101 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-201 repealed, new Section R6-6-201 renumbered from R6-6-202 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-202. Repealed

Historical Note

Former R6-6-202 repealed, new Section R6-6-202 renumbered from R6-6-102 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-202 renumbered to R6-6-201, new Section R6-6-202 renumbered from R6-6-203 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-203. Repealed

Historical Note

Former R6-6-203 repealed, new Section R6-6-203 renumbered from R6-6-103 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-203 renumbered to R6-6-202, new Section R6-6-203 renumbered from R6-6-204 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-204. Repealed

Historical Note

Former R6-6-204 repealed, new Section R6-6-204 renumbered from R6-6-104 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-204 renumbered to R6-6-203, new Section R6-6-204 renumbered from R6-6-205 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-205. Repealed

Historical Note

Section R6-6-205 renumbered from R6-6-105 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-205 renumbered to R6-6-204, new Section R6-6-205 renumbered from R6-6-206 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-206. Repealed

Historical Note

Section R6-6-206 renumbered from R6-6-106 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-206 renumbered to R6-6-205, new Section R6-6-206 renumbered from R6-6-207 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-207. Repealed

Historical Note

Section R6-6-207 renumbered from R6-6-107 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-207 renumbered to R6-6-206, new Section R6-6-207 renumbered from R6-6-208 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-208. Repealed

Historical Note

Section R6-6-208 renumbered from R6-6-108 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-208 renumbered to R6-6-207, new Section R6-6-208 renumbered from R6-6-209 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-209. Repealed

Historical Note

Section R6-6-208 renumbered from R6-6-108 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-209 renumbered to R6-6-208, new Section R6-6-209 renumbered from R6-6-210 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-210. Repealed

Historical Note

Section R6-6-210 renumbered from R6-6-110 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-210 renumbered to R6-6-209, new Section R6-6-210 renumbered from R6-6-211 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-211. Repealed

Historical Note

Section R6-6-210 renumbered from R6-6-110 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-211 renumbered to R6-6-210, new Section R6-6-211 renumbered from R6-6-212 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-212. Repealed

Historical Note

Section R6-6-212 renumbered from R6-6-112 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-212 renumbered to R6-6-211, new Section R6-6-212 renumbered from R6-6-213 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-213. Repealed

Historical Note

Section R6-6-213 renumbered from R6-6-113 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-213 renumbered to R6-6-212, new Section R6-6-213 renumbered from R6-6-214 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-214. Repealed

Historical Note

Section R6-6-214 renumbered from R6-6-114 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-214 renumbered to R6-6-213, new Section R6-6-214 renumbered from R6-6-215 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-215. Repealed

Historical Note

Section R6-6-215 renumbered from R6-6-115 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-215 renumbered to R6-6-214, new Section R6-6-215 renumbered from R6-6-216 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-216. Repealed

Historical Note

Section R6-6-216 renumbered from R6-6-116 effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-216 renumbered to R6-6-215, new Section R6-6-216 renumbered from R6-6-217 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-217. Repealed

Historical Note

Section R6-6-217 renumbered from R6-6-117 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-217 renumbered to R6-6-216, new Section R6-6-217 renumbered from R6-6-218 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-218. Repealed

Historical Note

Section R6-6-218 renumbered from R6-6-118 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-218 renumbered to R6-6-217, new Section R6-6-218 renumbered from R6-6-219 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-219. Repealed

Historical Note

Section R6-6-219 renumbered from R6-6-119 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-219 renumbered to R6-6-218, new Section R6-6-219 renumbered from R6-6-220 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-220. Repealed

Historical Note

Section R6-6-220 renumbered from R6-6-120 effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-220 renumbered to R6-6-219, new Section R6-6-220 renumbered from R6-6-221 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Repealed effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-221. Renumbered

Historical Note

Section R6-6-213 renumbered from R6-6-113 and amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-221 renumbered to R6-6-220 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

ARTICLE 3. ELIGIBILITY FOR DEVELOPMENTAL DISABILITIES SERVICES

R6-6-301. Eligibility for Services

A. In order to be eligible for Developmental Disabilities services, a person must be a resident of the state of Arizona and must be developmentally disabled as determined in accordance with A.R.S. § 36-551 and within the guidelines stated in R6-6-302.

B. Notwithstanding the provisions of subsection (A), the requirement of state residency does not apply to federal programs which are not subject to residency rules.

C. As a condition of eligibility, applicants are required to assign rights to insurance benefits in accordance with R6-6-1303.

D. Final determination of eligibility will be the decision of the Division.

E. Even though a person may at one time fully meet the guidelines contained herein, effective services may later reduce functional limitations to the extent that they are no longer substantial. When, in the opinion of the Division, after a review pursuant to R6-6-1801 et seq., it is necessary for a client to receive continued services to maintain skills or to prevent regression, the client will remain eligible for services.

F. Eligibility for infants is determined as follows:

1. A child under the age of six years may be eligible for services if there is a strongly demonstrated potential that the child is or will become developmentally disabled as determined by appropriate tests. To be eligible for Division services, a child from age 0-6 shall:

a. Have a diagnosis of cerebral palsy, epilepsy, autism, or mental retardation;

b. Be at risk for becoming developmentally disabled based on an identified delay in one or more areas of development or if there is a likelihood that without services the child will become developmentally delayed or disabled; or

c. Have demonstrated a significant developmental delay as determined in one or more areas of development as measured on a culturally appropriate and recognized developmental assessment tool. Eligibility is exclusive of cultural or environmental factors.

2. Developmental delay shall be determined by a physician or person formally trained in early childhood development who evaluates the child through the use of culturally appropriate and recognized developmental tools and informed clinical opinion.

Historical Note

Adopted effective October 31, 1978 (Supp. 78-5). Former Section R6-6-301 repealed, new Section R6-6-301 adopted effective March 30, 1983 (Supp. 83-2). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-302. Guidelines for Determining Developmental
Disabilities

A. Autism, cerebral palsy, epilepsy, and mental retardation are determined as follows:

1. Autism -- by a licensed psychiatrist or psychologist whose expertise in diagnosing autism is determined by the Division.

2. Cerebral palsy -- by a licensed physician.

3. Epilepsy -- by a licensed physician,

4. Mental retardation -- by a qualified person who performs psychological evaluations utilizing tests which are culturally appropriate and valid.

B. Substantial functional limitations must be determined in three or more areas of the major life activities. These limitations are defined as follows:

1. Self-care -- when a person requires significant assistance in performing eating, hygiene, grooming, or health care skills or when the time required for a person to perform these skills is so extraordinary as to impair the ability to retain employment or to conduct other activities of daily living.

2. Receptive and expressive language -- when a person is unable to communicate with others, or is unable to communicate effectively without the aid of a third person, a person with special skills, or without a mechanical device.

3. Learning -- when a person's cognitive factors, or other factors, related to the acquisition and processing of new information (such as attentional factors, acquisition strategies, storage, and retrieval) are impaired to the extent that the person is unable to participate in age-appropriate learning activities without utilization of additional resources.

4. Mobility -- when a person's fine or gross motor skills are impaired to the extent that the assistance of another person or mechanical device is required to move from place to place or when the effort required to move from place to place is so extraordinary as to impair ability to retain employment and conduct other activities of daily living.

5. Self-direction -- when a person requires assistance in managing personal finances, protecting self-interest, or making independent decisions which may affect well-being.

6. Capacity for independent living -- when, for a person's own safety or well-being, supervision, or assistance is needed at least on a daily basis in the performance of health maintenance and housekeeping.

7. Economic self-sufficiency -- when a person is unable to perform the tasks necessary for regular employment or is limited in productive capacity to the extent that earned annual income, after extraordinary expenses occasioned by the disability, is below the poverty level.

Historical Note

Adopted effective October 31, 1978 (Supp. 78-5). Former Section R6-6-302 repealed, new Section R6-6-302 adopted effective March 30, 1983 (Supp. 83-2). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-303. Eligibility Review

Determinations of eligibility are subject to review at any time by the Assistant Director or designee.

Historical Note

Adopted effective October 31, 1978 (Supp. 78-5). Repealed effective March 30, 1983 (Supp. 83-2). New Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

ARTICLE 4. APPLICATION

R6-6-401. Application for Admission to Services

A. To apply for Division services, an applicant shall:

1. Participate in a face-to-face interview with a designated Department employee; and

2. File with the Division a written application on a form prescribed by and available from the Division at no charge.

B. The application form shall contain the following information:

1. With respect to the person to receive services:

a. Name, address, and telephone number;

b. Personal information including date of birth, place of birth, age, social security number, sex, primary language, marital status, and citizenship;

c. Monthly income;

d. Medical insurance coverage;

e. Educational background, including current or planned enrollment in a special education program within a school district;

f. Information documenting the existence of a developmental disability, including professional assessments and evaluations;

g. A description of any other disabling conditions or special considerations;

h. If under 18 years of age, total number of persons in the household;

i. Identification of any adults who regularly live in the home by name, date of birth, and relationship to the person to receive services;

j. Identification of natural parents, regardless of whether living in the home, by name, social security number, and business and home telephone numbers; and

k. Identification of two adult persons living outside the home who are familiar with the person to receive services, by name, address, relationship to the person to receive services, and business and home telephone numbers; and

2. With respect to the responsible person, if other than the person to whom services would be provided:

a. Name, business and home addresses, business and home telephone numbers, and social security number;

b. Relationship to person to whom services would be provided; and

c. If a guardianship or conservatorship has been established, a copy of the court order shall accompany the application;

C. The applicant shall provide a description of programs and services requested.

D. The applicant shall provide information regarding prior applications for admission to Division services or services received.

E. The applicant shall provide documentation of application information as defined in R6-6-405.

F. The Division shall not consider an incomplete application.

1. If the Division receives an application that is not complete, the Division shall send written notification of deficiencies to the applicant.

2. If the applicant does not provide the specified information within 15 working days of receipt of notification of deficiencies, or cannot demonstrate a good faith effort to collect the information, the Division shall close the applicant's file and send a letter denying admission.

G. An applicant whose file has been closed and who subsequently desires admission shall submit a new application.

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed, new Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-402. Consent

A. The signature of the responsible person is required on the application materials pursuant to A.R.S. § 36-560(D).

B. If other than the responsible person, the individual to receive Division services, who is capable of giving informed consent, is required to sign the application materials as follows:

1. Signed consent is required from an individual who is aged 18 or above and is to receive Division services.

2. Signed consent is required from an individual who is aged 14 or above and is to receive services in a community residential setting.

C. The Division shall document in the case file its determination as to whether the person to receive services is capable of giving informed consent.

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed, new Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-403. Referrals from Juvenile Court

The Division shall determine eligibility of any child assigned to the Division by a juvenile court pursuant to A.R.S. § 8-242. If determined ineligible, the Division shall immediately refer the matter to the Department's Administration for Children, Youth, and Families.

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed, new Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-404. Eligibility under ALTCS

A. The Division shall refer individuals with developmental disabilities who may be eligible for the Arizona Long-term Care System (ALTCS) to the Arizona Health Care Cost Containment System Administration (AHCCCS) to determine eligibility under ALTCS.

B. The Division shall not provide services, other than emergency services as provided under R6-6-502, to an individual who has been referred for ALTCS eligibility determination until that determination has been completed.

C. Applicants who voluntarily refuse to cooperate in the ALTCS eligibility process are not eligible for Division services pursuant to A.R.S. § 36-559.

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed, new Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-405. Documentation and Verification

The applicant shall provide documentation of the following:

1. Residency.

a. All applicants shall sign an affidavit stating current residency and intent to remain in Arizona.

b. An applicant shall show written proof of Arizona residency by providing one of the following types of documents:

i. Rent or mortgage receipt, or lease in the applicant's name showing the residential address;

ii. Non-relative landlord statement indicating the applicant's name and address as well as the landlord's name and address and telephone, if available;

iii. Applicant's Arizona driver's license;

iv. Applicant's Arizona motor vehicle registration;

v. Signed employment statement from applicant's non-relative employer;

vi. Utility bill in the applicant's name indicating the applicant's address;

vii. Current phone directory showing applicant's name and address;

viii. United States Post Office records which show the applicant's name and address;

ix. A current city directory showing the applicant's name and address;

x. Certified copy of a church membership or enrollment record which indicates the applicant's current name and address; or

xi. Certified copy of a school record which indicates the applicant's current address; or

c. If an applicant has made all reasonable efforts to obtain documented verification as described in subsection (1)(b) and has been unsuccessful, the affidavit signed by the applicant attesting to the applicant's present residence and intent to remain in Arizona shall be sufficient.

2. Age.

a. An applicant shall provide proof of age of the person to receive services by the following:

i. Alien documents;

ii. Federal or state census records;

iii. Hospital records of birth;

iv. Copy of birth certificate;

v. Military records;

vi. Notification of birth registration;

vii. Religious records showing age or date of birth;

viii. Dated school records showing age or school records showing date of birth;

ix. Affidavit signed by the licensed physician, licensed midwife or other health care professional who was in attendance at the time of the birth, attesting to the date of birth; or

x. U.S. Passport.

b. If an applicant has made all reasonable efforts to obtain documented verification as described in subsection (2)(a) and has been unsuccessful, an affidavit signed by the applicant shall be sufficient to verify age of person to receive services.

3. Health Insurance Coverage. An applicant shall provide information regarding current health insurance which relates to the individual for whom application is being made as provided in R6-6-1301 et seq.

4. Income. The Division shall require documentation of income as provided in R6-6-1201 et seq.

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed, new Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-406. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-407. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-408. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-409. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-410. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-411. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-412. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-413. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-414. Repealed

Historical Note

Adopted effective February 2, 1989 (Supp. 89-1). Section repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

ARTICLE 5. ADMISSION/REDETERMINATION/ TERMINATION

R6-6-501. Admission

A. If determined eligible pursuant to A.R.S. § 36-559 and R6-6-301 et seq., the person for whom services are requested shall be considered by the ISPP team for assignment to services and thereby become a client.

B. If the person for whom services are requested is determined ineligible, the Division shall send the applicant written notice of ineligibility by registered mail, return receipt requested.

Historical Note

Repealed effective February 2, 1989 (Supp. 89-1). New Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-502. Emergency Admission to Services

In an emergency, the Division may provide services for a limited period of time, pursuant to A.R.S. § 36-560(L) et seq., without the performance of an ISPP. However, for services to continue, a completed application for regular admission shall be filed and an ISPP conducted within 30 days of the emergency admission date in compliance with this Article.

Historical Note

Repealed effective February 2, 1989 (Supp. 89-1). New Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-503. Redeterminations

A. The Division may redetermine a client's eligibility as a result of periodic evaluations in accordance with R6-6-604.

B. The Division may redetermine a client's eligibility at any time as may be authorized by the Assistant Director or designee.

C. The Division may redetermine a client's financial status, for purposes of client contribution to cost of care, as a result of:

1. Scheduled periodic financial redeterminations.

2. Changes in the financial situation of the client and/or the parents of a client under age 18. The responsible person shall report to the Division any changes in financial situation which may affect the amount of contribution to cost of care within ten days of change.

3. Financial redeterminations conducted at the responsible person's request.

Historical Note

Repealed effective February 2, 1989 (Supp. 89-1). New Section adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-504. Termination of Services

A. Pursuant to A.R.S. § 36-566(A) and (B), the Division shall terminate services to a client following 30 days' written notice to the responsible person of the proposed termination and of the opportunity for administrative review through A.R.S. § 36-563 and R6-6-1801 et seq.:

1. Upon the Division's receipt of a written request from the responsible person for withdrawal from services;

2. When the Division determines that the client no longer meets the conditions of eligibility for services;

3. When the client reaches the age of 18 unless an application for continuation of services has been filed pursuant to R6-6-505;

4. When the responsible person refuses to cooperate or comply with the ISPP.

B. Notwithstanding R6-6-504(A), the Division shall not terminate services to a child with developmental disabilities assigned to the Department by the juvenile court except pursuant to court order.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

R6-6-505. Continuation of Services

Pursuant to A.R.S. § 36-566(C), following the Division's timely written and oral notice to the responsible person of termination, the responsible person may file a written application for the continuation of services in the same manner provided in R6-6-401.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2).

ARTICLE 6. PROGRAM SERVICES

R6-6-601. Case Management

Upon the filing of an application for admission to services, the Division shall assign a case manager to assist the applicant. Upon admission, the case manager shall assist the client and the client's family in all aspects of the developmental disabilities service delivery system as follows:

1. The pursuit of evaluations and professional assessments necessary to substantiate the need for services;

2. The collection and analysis of information regarding eligibility and the prioritization of service needs;

3. The provision of information on available services and referral to appropriate service alternatives; and

4. The development of individual habilitation goals and objectives for the client through the ISPP.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-601 repealed, new Section R6-6-601 renumbered from R6-6-602 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-602. Individual Service and Program Plan

A. Within 30 days following determination of eligibility, the ISPP team shall conduct an evaluation to determine the appropriate services for the client and shall develop an ISPP based on the evaluation.

B. The ISPP team shall recommend specific services based upon:

1. The best interests of the client and factors listed in A.R.S. § 36-560(H);

2. The potential for family support; and

3. The extent to which the services:

a. Promote family competence and independence;

b. Preserve the integrity of the family;

c. Maximize the client's independent living;

d. Involve the family in problem-solving and decision-making;

e. Meet the needs and desires of the family;

f. Prevent the deterioration of the family structure and functioning and improve the quality of life for the client and family;

g. Can be provided in the least obtrusive manner;

h. Provide uninterrupted and orderly transition from one stage of development to another based upon client and family ages;

i. Alleviate abuse or neglect or eliminate conditions that hinder the client's development;

j. Prevent the client from being a danger to himself or to others; and

k. Support a client or family who is experiencing a temporary but remedial crisis including hospitalization, loss of a job, incapacitating illness, or death.

4. In the case of a DD/ALTCS client, the ISPP team shall ensure that the client obtain medically necessary and other necessary medically related remedial and social services.

C. The ISPP shall contain an assessment addressing each consideration listed in R6-6-603(B) and:

1. The service needs of the client, both direct and indirect, irrespective of the Division's resource availability;

2. Individual habilitation goals and objectives, both long- term and short-term;

3. Methods or strategies by which objectives shall be implemented;

4. The financial contributions, if any, which the Department shall require the responsible person to make on behalf of the client pursuant to A.R.S. § 36-562 et seq. and R6-6-1201 et seq.; and

5. Any special considerations.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-602 renumbered to R6-6-601, new Section R6-6-602 renumbered from R6-6-603 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-603. Assignment to Services

A. The case manager shall assign a DD/ALTCS client to appropriate services within 30 days of the Division's receipt of notification from AHCCCS of the client's eligibility under ALTCS.

B. In the case of a DD/non-ALTCS client, the case manager shall, within 30 days of the completion of the ISPP:

1. Assign the client to one or more appropriate services; or

2. Provide written notice of non-assignment, and reason for non-assignment, subject to the right of the responsible person and any joint applicant to request administrative review pursuant to A.R.S. § 36-563 and R6-6-1801 et seq.

C. If an assignment for a DD/non-ALTCS client cannot be made at the time of review:

1. And the reason for non-assignment is lack of space or lack of legislatively appropriated or other funding, the case manager shall place the client's name on a waiting list.

2. The case manager may refer the client to programs, services or other resources available in the community.

3. Unless waived by the responsible person, the case manager shall review the waiting list and referrals at least every six months with the responsible person to determine continuing need for services.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-603 renumbered to R6-6-602, new Section R6-6-603 renumbered from R6-6-604 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-604. Periodic Evaluations

A. Pursuant to A.R.S. § 36-565, the case manager and members of the ISPP team as appropriate shall conduct periodic reviews in six-month intervals, or more frequently as identified in the client's ISPP, and shall either:

1. Determine that no change in services is needed;

2. Determine that services should be terminated;

3. Determine that the client should be transferred to another service; or

4. Determine that other substantial changes in service are required.

B. The findings of the periodic evaluations shall be incorporated into the ISPP.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-604 renumbered to R6-6-603, new Section R6-6-604 renumbered from R6-6-605 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-605. Transfer to Another Service or Changes in Service

A. In addition to a transfer or change which results from a periodic review, a responsible person may request in writing to the Division a transfer or change at any time.

B. The request shall be considered by the ISPP team. The recommendation and review shall be made in the same manner established for recommended periodic reviews of the ISPP.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-605 renumbered to R6-6-604, new Section R6-6-605 renumbered from R6-6-606 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-606. Consent of the Responsible Person

A. Pursuant to A.R.S. § 36-560(D), no admission or assignment of any client to a program, service, or facility may be made by the Division without the written consent of the responsible person.

B. The signature of the responsible person on the appropriate report or ISPP shall serve as the consent to treatment or services required by A.R.S. § 36-560.

C. In the event consent for any or all services is withheld, those services shall be terminated.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-606 renumbered to R6-6-605, new Section R6-6-606 renumbered from R6-6-607 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-607. Renumbered

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-607 renumbered to R6-6-606 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

ARTICLE 7. EXPIRED

R6-6-701. Expired

Historical Note

Former Section R6-6-701 repealed effective February 2, 1989. New Section R6-6-701 adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-702. Expired

Historical Note

Former Section R6-6-702 repealed effective February 2, 1989. New Section R6-6-702 adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-703. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-704. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-705. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-706. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-707. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-708. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-709. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-710. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-711. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-712. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-713. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-714. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-715. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-716. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-717. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-718. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

R6-6-719. Expired

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3). Section expired under A.R.S. § 41-1056(E) at 11 A.A.R. 4308, effective August 30, 2005 (Supp. 05-4).

ARTICLE 8. PROGRAMMATIC STANDARDS AND CONTRACT MONITORING FOR COMMUNITY RESIDENTIAL SETTINGS

R6-6-801. Applicability

This Article applies to services provided in community residential settings except those licensed as child developmental foster homes according to Article 10 of this Chapter and those licensed as adult developmental homes according to Article 11 of this Chapter.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-802. Compliance

A. The licensee shall ensure that the community residential setting is operated in compliance with this Chapter.

B. The licensee shall cooperate with the Division in assessing compliance with this Chapter.

C. If the Division identifies areas of noncompliance with this Chapter in the operation of a community residential setting, the licensee shall take action to achieve or restore compliance with these rules.

D. If the Division identifies areas of noncompliance with A.R.S. Title 36, Chapter 5 in the operation of a community residential setting, the Division may enforce corrective action through licensing, programmatic, or contractual remedies.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-803. General Responsibilities of the Licensee

A. The licensee shall immediately report at least the following types of incidents via telephone or telefax to the Division:

1. The death of a client;

2. Alleged neglect or abuse of a resident;

3. A missing client. The licensee shall report such incident to law enforcement officials and the Division as soon as it determines that a client is missing;

4. An incident related to a resident that involves law enforcement personnel, emergency services, or the media;

5. Suicide attempts by a client;

6. Hospitalization, the intervention of a medical practitioner, or emergency medical care in response to a serious illness, injury, medication errors, or suicidal behavior of a client; and

7. Community complaints about a resident or the setting.

B. The licensee shall cooperate in obtaining and providing any information the Department or a law enforcement agency deems necessary to investigate an incident.

C. The licensee shall maintain staff-to-client ratios which at least conform to the contract.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-804. Rights of Clients

In addition to the rights required in R6-6-102, the licensee shall uphold and safeguard the rights of residents consistent with applicable federal and state laws, including A.R.S. § 36-551.01, unless legally restricted or addressed in the ISPP in accordance with R6-6-901 et seq. In addition to those rights specifically stated in statute, rights shall include, at a minimum:

1. The right to be free from personal and financial exploitation;

2. The right to a safe, clean, and humane physical environment;

3. The right to own and have free access to personal property;

4. The right to associate with persons of the client's own choosing;

5. The right to participate in social, religious, educational, cultural, and community activities;

6. The right to manage personal financial affairs and to be taught to do so;

7. The right to the least amount of physical assistance necessary to accomplish a task;

8. The right to privacy including during treatment and care of personal needs and with regard to written correspondence, telephone communication, and visitations;

9. The right to have care for personal needs provided, except in cases of emergency, by a direct care staff of the gender chosen by the responsible person. This choice shall be specified in the ISPP;

10. The right to be treated with dignity and respect; and

11. The right to be provided choices and to express preferences which will be respected and accepted.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-805. Program Plans

A. Except in cases of emergency, the licensee shall notify the Division and obtain ISPP team approval prior to a client's move from one community residential setting to another setting and prior to relocation of a community residential setting. If the move requires contract modification, the administrator shall also obtain Division approval prior to the move.

B. In cases of emergency, the licensee shall coordinate with the Division regarding the notification of the responsible person when a client moves from one community residential setting to another.

C. The ISPP team shall convene to develop or revise the ISPP within 30 days following either a client's admission to a community residential setting or a change in community residential licensee.

D. The ISPP team shall meet at least annually to develop or amend the complete ISPP for a client, using forms prescribed by the Division.

E. The ISPP team for any client residing in a community residential setting shall include a representative of the community residential setting. The representative shall have direct knowledge of the client.

F. The licensee shall develop a teaching plan or strategy for each objective assigned to the community residential setting by the ISPP team.

1. The teaching plan shall be consistent with any guidelines provided by the ISPP team.

2. The teaching plan shall include:

a. How, when, and by whom objectives will be implemented;

b. The method to be used to record data relative to progress; and

c. The procedure that will be followed should the objective be completed or should progress not be made as planned.

3. The licensee shall provide the teaching plan to the case manager.

G. The licensee shall provide, for the annual ISPP team meeting, complete and accurate information on periodic evaluations and medical care received since the last ISPP.

H. The ISPP for any client residing in a community residential setting shall specify the duration and conditions for the time that the client may spend without supervision provided by the licensee.

I. The licensee shall carry out the objectives, agreements, and assignments specified in the ISPP.

J. The licensee shall provide monthly reports to the case manager summarizing the client's progress toward residential habilitation objectives and the status of agreements and assignments specified in the ISPP.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-806. Health

A. At least annually and on forms prescribed by the Division, the licensee shall obtain written informed consent of the guardian, if applicable, for the provision of emergency medical care, routine medical care, and special procedures.

B. Within 30 calendar days of a client's initial admission to a community residential setting, the licensee shall obtain documentation of the following:

1. A physical examination by a medical practitioner;

2. A tuberculosis screening and results;

3. A hepatitis B screening and results;

4. Type of developmental disability;

5. Medication history;

6. Immunization history;

7. History of significant injuries, illnesses, surgeries, and hospitalizations;

8. History of allergies;

9. Dental history;

10. Seizure history;

11. Developmental history; and

12. Family medical history.

C. The licensee shall maintain records in the place of residence sufficient to document the current health status of the resident. These records shall include, at a minimum:

1. The name, address, and telephone numbers of the health care provider for each resident;

2. The name and telephone numbers of the health plan and insurance carrier for each resident and the process for authorization of health care for each resident;

3. Guardianship status for each resident;

4. The name and telephone number of the responsible party and the person to be contacted in case of emergency for each resident;

5. Reports of accidents, illness, current treatments, and follow-up for at least one year for each resident;

6. A description of the client's individualized health care and safety needs, including, at a minimum:

a. Allergies;

b. Nutritional needs, whether a regular or special diet;

c. Special fluid intake needs;

d. Seizure activity and recommended response;

e. Adaptive equipment, protective devices, and facility adaptations;

f. Required medical monitoring;

g. References to the behavior treatment plan or the ISPP if there are health care-related issues contained therein;

h. Special instructions for carrying, lifting, positioning, bathing, feeding, or other aspects of personal health care; and

i. Other individualized health care routines.

7. The client's medical history, which includes updated information on all components identified in subsection (B);

8. Current medication log for each client;

9. Current health care consents for each client, including:

a. Consent for the use of sedation, mechanical restraint, or protective devices in the course of planned medical or dental procedures or for follow-up;

b. Consent for the ongoing or recurring use of a protective device in response to a medical condition; and

c. Consent for emergency medical care, routine medical care, and special procedures, if applicable;

10. A copy of "do not resuscitate" orders, for each client, signed by the responsible person, if such an order has been effected.

D. The licensee shall maintain medical records in their entirety.

E. The licensee shall maintain documentation of medical consultations which include, at a minimum:

1. The date of the medical consultation;

2. The name and title of the medical professional consulted;

3. The purpose of the consultation;

4. A description of the service or treatment provided; and

5. Instructions for follow-up, if applicable.

F. For medications administered by or under the supervision of the direct care staff, the licensee shall ensure that any prescription or nonprescription medications are administered:

1. To a client only with the written or verbal orders of a medical practitioner; and

2. Only to the person for whom it is prescribed or indicated.

G. The licensee shall maintain a log of all prescribed and nonprescribed medications administered to a client by or under the supervision of direct care staff. The medication log shall contain, at a minimum:

1. The name of the client who received the medication;

2. The name of the medication;

3. The medication dosage;

4. The date and time of administration;

5. The route of administration;

6. Special instructions for administration of the medication; and

7. Signature and initials of the direct care staff who administered or supervised the administration of the medication.

H. The licensee shall maintain, in a location which is readily accessible to direct care staff who are responsible for medication administration, resource information regarding all medications prescribed for clients living in the setting. The resource information shall include, at a minimum:

1. Name of the medication;

2. Common side effects and adverse reactions;

3. Indications for use;

4. Medication interactions; and

5. Recommended monitoring.

I. The licensee shall store medications in the following manner:

1. Under sanitary conditions;

2. Consistent with label instructions;

3. In containers with legible and accurate labels which specify the name of the client for whom the medication is prescribed and the current dosage; and

4. In locked storage, unless otherwise specified in the client's ISPP.

J. The licensee shall remove or dispose of medications which are expired or for which the prescription has been discontinued.

K. When a medication error or reaction is detected, the licensee shall ensure that staff:

1. Immediately consult medical personnel,

2. Notify appropriate persons, and

3. Document the error or reaction and the action taken in response.

L. The licensee shall monitor on an ongoing basis the condition for which any medications have been prescribed and the response to the medications, in accordance with any recommendations of the medical practitioner. The licensee shall report the client's response to the medical practitioner based on the monitoring. The licensee shall document any medication change made by the medical practitioner and share results with agency staff.

M. When a medication is prescribed for the purpose of behavior modification, the licensee shall:

1. Document the behavior for which the medication is prescribed;

2. Monitor the client's response to the medication on an ongoing basis consistent with the client's needs and the recommendations of the ISPP team;

3. Document the client's response to the medication, including the frequency and intensity of target behaviors and the occurrence of side effects;

4. Report to the client's physician regarding the client's response to the medication; and

5. Document the results of any change made by the physician and share that information with direct care staff.

N. Except for treatment of medical emergencies, the licensee shall obtain written informed consent from the responsible person and authorization by a medical practitioner for the use of sedation, mechanical restraint, or protective devices in the course of planned medical or dental procedures or in the course of follow-up to such procedures. The licensee shall not use physical restraints, including mechanical restraints as a negative consequence to a behavior, for the convenience of the licensee, or in lieu of a behavior management plan.

O. The licensee shall ensure that the following conditions are met prior to ongoing or recurring use of a protective device in response to a medical condition:

1. Authorization for use of the protective device is obtained from a medical practitioner;

2. Written informed consent is obtained from the responsible person; and

3. The plan for use of the protective device is reviewed by the ISPP team and reassessed at least annually.

P. The licensee shall ensure that individualized health care instructions for the client are followed.

Q. The licensee shall plan for and prepare nutritional meals in accordance with the client's needs and consistent with the client's preferences. If the client is responsible for planning and preparing meals, the licensee shall assist, monitor, and educate the person regarding preparation of nutritionally adequate meals.

R. The licensee shall keep insecticides, poisonous materials, corrosives, and other hazardous substances in locked storage, unless otherwise specified in the client's ISPP, and in areas away from food and areas where medications are stored or administered.

S. The licensee shall ensure that bodies of water are fenced. Unsupervised access to bodies of water by the client is prohibited unless specifically allowed by the client's ISPP. The ISPP cannot supersede any local ordinance or state law pertaining to the safety of bodies of water or swimming pools.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-807. Records

A. In addition to health care records as required by R6-6-806, the licensee shall maintain the following programmatic records in the client's place of residence:

1. A copy of the client's most current annual ISPP which is placed into the records within 15 calendar days of receipt by the licensee;

2. The teaching plan or strategy for each objective specified in the client's ISPP;

3. A copy of monthly progress reports for the client, as submitted to the case manager;

4. Documentation of incidents involving the client;

5. Behavior treatment plan, if applicable;

6. All required consents, including, as applicable, consent for use of behavior-modifying medications and consent for release of personally identifiable information, unless these consents are maintained in the main provider record; and

7. Reference to the location of other pertinent records.

B. The licensee shall ensure that documents and entries made by agency personnel identify the person making the entry and that all are:

1. Legible;

2. Typed or written in ink;

3. Dated; and

4. Properly corrected, as necessary.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-808. Staff Qualifications, Training, and Responsibilities

A. The licensee shall maintain documentation of the following for each direct care staff:

1. Age 18 years or older;

2. References from persons other than family members;

3. Knowledge, skills, and experience sufficient to carry out the requirements of the position;

4. Fingerprinting, fingerprint clearance, and a statement by the direct care staff regarding criminal record; and

5. Current licenses, certifications, or registrations required for the position or required by Arizona statute.

B. The licensee shall maintain documentation of the fingerprinting, fingerprint clearance for a license renewal, and employee's statement regarding criminal record for each person required to be fingerprinted according to this Article.

C. The licensee shall maintain documentation of successful completion of required training by each direct care staff.

D. The licensee shall have and implement a written training curriculum which lists required training topics and which includes for each topic, at a minimum:

1. Course outline,

2. Timeliness for completion, and

3. Criteria for successful completion.

E. When a community residential service is delivered, and unless a client is utilizing ISPP-authorized unsupervised time, a direct care staff shall be present who has completed the following required training, at a minimum:

1. Orientation to the specific needs of clients living in the community residential setting, including their ISPPs and individualized health and safety needs;

2. Cardiopulmonary resuscitation (CPR), provided by a certified instructor;

3. First aid, provided by a certified instructor;

4. Agency health and safety policies and procedures as required by this Article including, at a minimum:

a. Client behaviors;

b. Incidents;

c. Neglect and abuse;

d. Medications;

e. Detection of signs of injury, illness, infectious diseases, and changes in health status;

f. Response to non-emergency conditions requiring prompt medical attention; and

g. Procedures to be followed in medical emergencies and in rendering emergency medical care.

5. Safety procedures, including the agency plan for meeting potential emergencies and disasters, as required by R6-6-713;

6. Provisions of R6-6-902 related to prohibited practices;

7. Client intervention techniques, if relevant to the needs of clients in the community residential setting, provided by a certified instructor;

8. Medication administration, if relevant to the needs of clients in the community residential setting; and

9. Seizures, if relevant to the needs of clients in the community residential setting.

F. Within 14 calendar days of the date the person begins employment at a community residential setting, each direct care staff shall complete an orientation to specific needs of clients living in the community residential setting, including their ISPPs and individualized health and safety needs.

G. Within 90 calendar days of the date that the person begins employment at the community residential setting, each direct care staff shall complete the following required training:

1. Techniques for meeting the individualized health and safety needs of clients living in the community residential setting;

2. Health and safety, including:

a. Cardiopulmonary resuscitation (CPR), provided by a certified instructor;

b. First aid, provided by a certified instructor;

c. Safety procedures, including the agency plan for meeting potential emergencies and disasters, as required by R6-6-713;

d. Medication administration; and

e. Seizures.

3. Mission and values of the Division and the community residential setting;

4. Agency policies and procedures;

5. Interactions with clients, including:

a. Respect, dignity, and positive interactions with clients;

b. Skill-building techniques;

c. Prevention of behavioral incidents; and

d. Article 9.

6. ISPP process;

7. Communication with families;

8. Client rights; and

9. Confidentiality.

H. Each direct care staff shall also have training relevant to the staff's assigned responsibilities and as necessary to carry out objectives, agreements, and assignments as specified in the ISPP and to meet the client's individualized health care and safety needs.

I. Each direct dare staff shall review, at least annually, agency policies and procedures required by this Article and the plan for meeting potential emergencies and disasters, as required by R6-6-713.

J. After the initial 90-day training, each direct care staff member shall have current training in the following:

1. Cardiopulmonary resuscitation (CPR), provided by a certified instructor;

2. First aid, provided by a certified instructor; and

3. Client intervention techniques, provided by a certified instructor, if relevant to the needs of clients in the community residential setting.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-809. Policies and Procedures

A. The licensee shall develop and implement policies and procedures which address incidents which occur in the operation of the setting. These policies and procedures shall include, at a minimum:

1. Definitions of events and circumstances which constitute incidents;

2. Procedures for verbally reporting and documenting incidents, consistent with the Division's incident reporting procedures; and

3. Procedures for the review of incidents by the licensee and procedures for the development of corrective action to occur in response to incidents.

B. The licensee shall develop and implement policies and procedures on behavior management which are consistent with the requirements of Article 9. These policies and procedures shall include, at a minimum:

1. Descriptions of positive approaches to behavior management;

2. Procedures for the documentation of maladaptive behaviors not included in the definition of incidents, if applicable;

3. Procedures for the development of behavior treatment plans; and

4. Procedures for the licensee to monitor the effectiveness of behavior treatment plans.

C. The licensee shall develop and implement written policies and procedures for residents for:

1. The following health-related issues:

a. Detection of signs of injury, illness, and changes in health status;

b. Detection of infectious diseases and notification to the Division and other appropriate persons;

c. Response to non-emergency conditions requiring prompt medical attention; and

d. Procedures to be followed in medical emergencies and in rendering emergency medical care.

2. Medications, including nonprescription medications, used by residents which shall include, at a minimum:

a. The training to administer medications;

b. The specific, step-by-step procedures staff are to use in the administration of medications. These procedures shall include:

i. Prevention of contamination;

ii. Instructions for handling various types of medication, including oral, topical, or rectal;

iii. Instructions for verifying that the right medication is given to the right person, at the right time, in the proper dosage, and via the proper route; and

iv. Instructions for documenting the administration of medication on a log or chart.

c. Procedures for recording and reporting medication errors and reactions for residents;

d. Procedures for the agency review and corrective action to occur in response to medication errors;

e. Procedures for having prescriptions filled and maintenance of an adequate supply of medications;

f. Procedures for the safe disposal of expired or discontinued medications;

g. Procedures for the storage and inventory of medications;

h. Provision for self-administration of medications by a client, with the written approval of the ISPP team, if applicable, including criteria for self-administration and requirements for documentation of administration; and

i. Procedures for authenticating, within 72 hours, a medical practitioner's verbal orders for medication.

D. The licensee shall develop and implement policies and procedures which address alleged neglect and abuse of residents. These policies and procedures shall include, at a minimum:

1. Definitions and prohibitions in accordance with A.R.S. § 36-569;

2. Detection of neglect and abuse, including cases occurring outside the agency;

3. Immediate intervention to prevent further neglect and abuse;

4. Reporting in accordance with A.R.S. §§ 13-3620 and 46-454 and R6-6-1601 et seq.;

5. Investigation of alleged neglect and abuse; and

6. Community residential setting review and corrective action to occur in response.

E. The licensee shall develop and implement policies and procedures which address smoking in the community residential setting and which take into account the rights of all residents living in the setting.

F. The licensee shall develop policies and procedures which address the storage and use of alcoholic beverages in the community residential setting and which take into account the rights of all residents living in the setting.

G. The licensee shall develop and implement policies and procedures regarding the internal communication among agency personnel of events affecting clients living in the community residential setting.

H. The licensee shall develop and implement policies and procedures regarding the communication to responsible persons of significant events affecting clients living in the community residential setting.

I. The licensee shall develop and implement policies and procedures which address safeguarding, accounting for, and replacing client property and funds.

J. The licensee shall develop and implement policies and procedures which ensure adequate staffing, consistent with rules related to staff training as specified in R6-6-808 and staff-to-client ratios as specified in R6-6-803. The policies and procedures shall address, at a minimum, planned and unexpected absenteeism, emergencies, and community activities.

K. The licensee shall submit all new or modified policies and procedures required by this Article to the Division for approval.

L. The licensee shall incorporate into policies and procedures any revisions required by the Division.

M. The licensee shall develop and implement policies and procedures which address the role of the community residential setting in the ISPP process, consistent with the requirements of this Article.

N. The licensee shall develop and implement policies and procedures for the maintenance and use of all personally identifiable client information. These policies and procedures shall be consistent with A.R.S. § 36-568.01 and shall address storage, disclosure, retention, and destruction of this information and actions to be taken in the event of violations of these policies and procedures by agency personnel.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-810. Consent for Release of Personally Identifiable Information

A. When consent for the release of personally identifiable information is required pursuant to A.R.S. § 36-568.01 for a client residing in a community residential setting, the licensee shall obtain consent from the responsible person. The consent shall:

1. Be signed and dated,

2. Specify the purposes for the release.

B. Notwithstanding the provisions of R6-6-105(B) and (C), the consent for a person residing in a community residential setting is valid for a period of one year from date of signature or up to the date specified in the consent, whichever is less.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-811. Exemption

A licensee may submit to the Division a written request for an exemption of a rule contained in this Article. The request shall demonstrate that the intent of the rule will be met by alternate means and that the exemption will not endanger the lives or health of clients or staff.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

ARTICLE 9. MANAGING INAPPROPRIATE BEHAVIORS

R6-6-901. Applicability

These rules apply to:

1. All programs operated, licensed, certified, supervised or financially supported by the Division.

2. All habilitation programs as defined in A.R.S. § 36-551(18), as well as all interventions included in this Article, shall be addressed in the client's ISPP.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-901 repealed, new Section R6-6-901 renumbered from R6-6-902 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended effective August 30, 1994, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-902. Prohibitions

A. The following behavioral intervention techniques are prohibited:

1. The use of seclusion (locked time-out rooms).

2. The use of overcorrection.

3. The application of noxious stimuli.

4. Physical restraints, including mechanical restraints, when used as a negative consequence to a behavior.

B. The use of behavior modifying medications is prohibited, except as specified in R6-6-909, if:

1. They are administered on an "as needed" or "PRN" basis; or

2. They are in dosages which interfere with the client's daily living activities; or

3. They are used in the absence of a behavior treatment plan.

C. No person shall implement a behavior treatment plan which:

1. Is not included as a part of the ISPP; and

2. Falls under R6-6-903(A), without approval of the PRC.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-902 renumbered to R6-6-901, new Section R6-6-902 renumbered from R6-6-903 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-903. Program Review Committee (PRC)

A. The ISPP team shall submit to the PRC and Human Rights Committee any behavior treatment plan which includes:

1. Techniques that require the use of force.

2. Programs involving the use of response cost.

3. Programs which might infringe upon the rights of the client pursuant to applicable federal and state laws, including A.R.S. § 36-551.01.

4. The use of behavior-modifying medications.

5. Protective devices used to prevent a client from sustaining injury as a result of the client's self-injurious behavior.

B. The PRC shall be responsible for approving or disapproving plans specified in subsection (A) above and any other matters referred by an ISPP team member.

C. The PRC shall review and respond in writing within ten working days of receipt of a behavior treatment plan from the ISPP team, either approving or disapproving the plan. The response shall be signed and dated by each member present and shall be transmitted to the ISPP team with a copy to the chairperson of the Human Rights Committee for review and recommendations at its next regularly scheduled meeting pursuant to R6-6-1701 et seq. The response shall include:

1. A statement of agreement that the interventions approved are the least intrusive and present the least restrictive alternative.

2. Any special considerations or concerns including any specific monitoring instructions.

3. Any recommendations for change, including an explanation of the recommendations.

D. Each PRC shall issue written reports, as prescribed by the Division, summarizing its activities, findings and recommendations while maintaining client confidentiality.

1. On a monthly basis, report to a designated Division representative, with a copy to the chairperson of the Human Rights Committee.

2. On an annual basis, by December 31 of each calendar year, report to the Assistant Director of the Division of Developmental Disabilities, with a copy to the Developmental Disabilities Advisory Council.

E. The PRC shall be composed of, but not be limited to, the following persons designated by the District Program Manager:

1. The District Program Manager or his designee, who shall act as a chairperson.

2. A person directly providing habilitation services to clients.

3. A person qualified, as determined by the Division, in the use of behavior management techniques, such as a psychologist or psychiatrist.

4. A parent of an individual with a developmental disability but not the parent of the individual whose program is being reviewed.

5. A person with no ownership in a facility and who is not involved with providing services to individuals with developmental disabilities.

6. An individual with a developmental disability when appropriate.

F. A PRC shall be separate from but a complement to the ISPP team, and the Human Rights Committee established pursuant to R6-6-1701 et seq.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-903 renumbered to R6-6-902, new Section R6-6-903 renumbered from R6-6-904 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-904. ISPP Team Responsibilities

Upon receipt of the PRC's response and as part of its development of the client's ISPP, the ISPP team shall either:

1. Implement the approved behavior treatment plan; or

2. Accept the PRC recommendation and incorporate the revised behavior treatment plan into the ISPP; or

3. Reject the recommendation in whole or in part and develop a new behavior treatment plan to be resubmitted to the PRC and Human Rights Committee.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-904 renumbered to R6-6-903, new Section R6-6-904 renumbered from R6-6-905 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-905. Monitoring Behavior Treatment Plans

Each ISPP team shall specifically designate and record in the ISPP the name of a member of the team, excluding those direct service staff responsible for implementing the approved behavior treatment plan, who shall:

1. Ensure that the behavior treatment plan is implemented as approved.

2. Ensure that all persons implementing the behavior treatment plan have received appropriate training as specified in R6-6-906.

3. Ensure that objective, accurate data are maintained in the client's record.

4. Evaluate, at least monthly, collected data and other relevant information as a measure of the effectiveness of the behavior treatment plan.

5. Conduct on-site observations not less than twice per month and prepare, sign, and place in the client's record a report of all observations.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-905 renumbered to R6-6-904, new Section R6-6-905 renumbered from R6-6-906 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-906. Training

A. Any person who is involved in the use of a behavior treatment plan shall be trained by the Division or trained by an instructor approved by the Division prior to such involvement.

B. Initial training shall cover at a minimum:

1. Provisions of law related to:

a. Interventions; particularly this Article and 42 CFR 483.450 October 1, 1992), incorporated herein by reference and on file with the Office of the Secretary of State;

b. Legally mandated rights of individuals with developmental disabilities; particularly A.R.S. §§ 36-551.01, 36-561 and 42 CFR 483.420 (October 1, 1992), incorporated herein by reference and on file with the Office of the Secretary of State;

c. Confidentiality; particularly A.R.S. §§ 41-1959 and 36-586.01 and 42 CFR 483.410(c)(2) (October 1, 1992), incorporated herein by reference and on file with the Office of the Secretary of State.

d. Abuse and neglect prohibitions pursuant to A.R.S. § 36-569.

2. Intervention techniques, treatment and services, particularly addressing the risks and side effects that may adversely affect clients.

3. A general orientation to:

a. Division goals with respect to the provision of services to people with developmental disabilities.

b. Related policies and instructions of the Division.

C. With respect to the use of interventions, training shall include hands-on or practical experience to be conducted by instructors approved by the Division, using a curriculum approved by the Division, and who have experience in the actual use of interventions as opposed to administrative responsibility for such use.

D. In addition to initial training, the Division shall ensure that refresher training is available as necessary to maintain currency in knowledge and recent technical trends related to intervention for the management of inappropriate behavior.

E. Physical management techniques shall only be used by those persons specifically trained in their use.

F. The following records and documents related to training shall be maintained by the Division for five years and be available for public inspection.

1. A summary of the training plan adopted by the Division in compliance with this Section, including schedules, instructors, topics, and expressed parameters of the hands-on or practical experience component of the training.

2. Required special knowledge, skills, training, education or experience of the instructors related to managing inappropriate behaviors.

3. A list of persons satisfactorily completing initial and refresher courses and course dates.

G. The Division shall review the training plan at least every two years for compliance with all applicable provisions of law and Division policy as well as for the protection of clients.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-906 renumbered to R6-6-905, new Section R6-6-906 renumbered from R6-6-907 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-907. Sanctions

For programs operated, licensed, certified, supervised or financially supported by the Division, failure to comply with any part of this Article may be grounds for suspension or revocation of a license, for termination of contract, employment, or for any other applicable administrative or judicial remedy.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-907 renumbered to R6-6-906, new Section R6-6-907 renumbered from R6-6-908 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-908. Emergency Measures

A. Physical management techniques employed in an emergency to manage a sudden, intense, or out-of-control behavior shall:

1. Use the least amount of intervention necessary to safely physically manage an individual.

2. Be used only when less restrictive methods were unsuccessful or are inappropriate.

3. Be used only when necessary to prevent the individual from harming self or others or causing severe damage to property.

4. Be used concurrently with the uncontrolled behavior.

5. Be continued for the least amount of time necessary to bring the individual's behavior under control.

6. Be appropriate to the situation to ensure safety.

B. When an emergency measure, including the use of behavior modifying medications pursuant to R6-6-909(D), is employed to manage a sudden, intense, out-of-control behavior, the person employing that measure shall:

1. Immediately report the circumstances of the emergency measure to the person designated by the Division and to the responsible person.

2. Provide, within one working day, a complete written report of the circumstances of the emergency measure to the responsible person, the case manager, the chairperson of the Program Review Committee, and the Human Rights Committee.

3. Request that the case managers reconvene the ISPP team to determine the need for a new or revised behavior treatment plan when any emergency measure is used two or more times in a 30-day period or with any identifiable pattern.

C. Upon receipt of a written report as specified in subsection (B)(2) above, the PRC shall:

1. Review, evaluate and track reports of emergency measures taken; and

2. Report, to a person designated by the Division, instances of possible excessive or inappropriate use of emergency measures on a case-by-case basis for corrective action.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-908 renumbered to R6-6-907, new Section R6-6-908 renumbered from R6-6-909 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-909. Behavior-modifying Medications

A. The Division shall make available the services of a consulting psychiatrist who shall review cases and provide recommendations to prescribing physicians to ensure that the medication prescribed is the most appropriate in type and dosage to meet the client's needs.

B. Behavior-modifying medications shall be prescribed and administered only:

1. When, in the opinion of a licensed physician, they will be effective in producing an increase in appropriate behaviors; and it can be justified that the harmful effects of the behavior clearly outweigh the potential negative effects of the behavior modifying medication.

2. As part of a behavior treatment plan in the ISPP.

3. With the informed consent of the responsible person.

C. The Division shall provide the following monitoring, in addition to that specified in R6-6-905, for all behavior treatment plans that include the use of a behavior-modifying medication:

1. Ensure that collected data relative to the client's response to the medication is evaluated, at least quarterly, at a medication review by the physician and the member of the ISPP team designated pursuant to R6-6-905 and other members of the ISPP team as needed.

2. Ensure that each client receiving a behavior-modifying medication is screened for side effects, and Tardive Dyskinesia as needed, and that the results of such screening are:

a. Documented in the client's case record;

b. Provided immediately to the physician, responsible person, and ISPP team for appropriate action if the screening results are positive; and

c. Provided to the Program Review Committee and the Human Rights Committee within 15 working days for review of screening results that are positive.

D. In the event of an emergency, a physician's order for a behavior modifying medication may, if appropriate, be requested for a specific one-time emergency use. The person administering the medication shall immediately report it pursuant to R6-6-908(B).

E. The responsible person shall immediately be notified of any changes in medication type or dosage.

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-909 renumbered to R6-6-908, new Section R6-6-909 renumbered from R6-6-910 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-910. Renumbered

Historical Note

Adopted effective February 21, 1990 (Supp. 90-1). Amended effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-910 renumbered to R6-6-909 effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

ARTICLE 10. CHILD DEVELOPMENTAL FOSTER HOME LICENSE

R6-6-1001. Application for License

A. Married or single persons desiring to be licensed as a child developmental foster home shall apply for a license to the Division on the prescribed forms.

B. The license applicant and any adult member of the household shall be fingerprinted for a criminal history record check. Any adult living on the premises and not residing in the home may be required to be fingerprinted for a criminal history record check.

C. The license applicant, any adult member of the household, and any adult living on the premises shall authorize the Division to perform a background check through Adult Protective Services and Child Protective Services referral files.

D. The license applicant shall participate in interviews with the Division and the home-study process as required by the Division. The home-study process shall include:

1. An interview of all members of the license applicant's household,

2. An interview of other knowledgeable parties as the Division determines appropriate, and

3. An inspection of the physical premises by the Arizona Department of Health Services and the Division for compliance with this Article.

E. To be eligible for licensure as a Child Developmental Foster Home, the license applicant shall:

1. Be at least 21 years of age,

2. Have income or resources independent of the Division room-and-board payments to meet the needs of the license applicant's family unit,

3. Not have employment that conflicts with the care and supervision of the foster child,

4. Be of reputable and honest character; and

5. Submit documentation that each child living in the home has received the immunizations appropriate to the child's age and state of health unless the license applicant has submitted a signed statement that the children have not been immunized because of affiliation with a religion which is opposed to such immunizations or because the license applicant is opposed to such immunizations.

F. The license applicant and members of the household shall cooperate with the Division in obtaining information necessary to determine if the home meets the requirements of this Article. Such cooperation shall include, but is not limited to:

1. Providing releases of information;

2. Authorizing release of medical records; and

3. Submitting to psychological, psychiatric, drug testing, or other evaluations as required by the Division.

G. The license applicant shall provide the Division with a minimum of three references who are familiar with the applicant's family and are not related to the license applicant by blood or by marriage. The Division may contact the references for further information regarding the character of the license applicant and ability of the license applicant to care for children with developmental disabilities.

H. The Division may require the license applicant to submit references from current or previous employers.

I. All members of the license applicant's household shall agree with the decision to be licensed as a child developmental foster home.

J. The license applicant shall demonstrate an understanding of and the ability to meet the emotional, physical, social, developmental, educational, and intellectual needs of children.

K. The license applicant shall demonstrate the ability to nurture, to provide intellectual stimulation, to be sensitive to the needs of the foster children, and to protect children placed in the applicant's home from harm.

L. The license applicant shall not have any medical or emotional problems that may prevent the person from properly caring for foster children or that may negatively impact on foster children in the home.

1. Following approval of the home study by the Division, the license applicant shall submit, on forms prescribed by the Division, written statements from a licensed medical practitioner for each adult living in the home. The statement shall include the following:

a. Confirmation that the physician has examined the adult in the last six months,

b. A description of the person's general physical and emotional health,

c. A list of all regularly prescribed medications and the purpose of the medication, and

d. Identification of any medical or emotional problems that may prevent the person from caring for foster children or may impact on foster children in the home.

2. The Division may require the license applicant to submit physician statements as described in this Section for other adults living on the premises.

M. The license applicant shall attend prelicensure training as required by R6-6-1005.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-1002. Issuing an Initial License

A. The license applicant shall comply with the requirements of this Article.

B. Except as provided in R6-6-1004(C), a regular license is effective for one year from the date of issuance.

C. Based upon records, reports, and observations, if the Division determines that the license applicant may be unable to meet the physical or emotional needs of clients, the Division may require further psychological or physical evaluations, at no expense to the license applicant, to determine whether a license may be issued.

D. A regular license for a child developmental foster home is not transferable and is valid only for the licensee and the address stated on the license.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1003. Issuing a Renewal License

A. A regular license is renewable annually for a one-year period.

B. The Division shall renew a child developmental foster home regular license when:

1. The licensee has met the annual training requirements of R6-6-1005;

2. The home meets the requirements of R6-6-1001, except as noted in this subsection:

a. The licensee shall submit a written statement every three years from the date of initial licensure from a licensed medical practitioner indicating that no adult living in the home or on the premises has any medical, emotional, or psychological problems that would adversely impact on the health and welfare of a child with developmental disabilities.

b. References are not required for license renewal.

c. The child developmental foster home shall receive a health inspection from the Arizona Department of Health Services every three years prior to license renewal, unless otherwise indicated by this Article.

3. Any person fingerprinted pursuant to R6-6-1001(B) and who is still residing in the home shall have a criminal record check every three years.

C. Based upon records, reports, and observations, if the Division determines that the license applicant for license renewal may be unable to meet the physical or emotional needs of clients, the Division shall have the authority to require further mental or physical evaluations, at no expense to the license applicant, to determine whether to renew a license.

D. A license to provide child developmental foster home services is not transferable and is valid only for the licensee and the address stated on the license.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1004. Issuing a Provisional License

A. The Division may issue a provisional license for up to six months when:

1. The license applicant is temporarily unable to meet the requirements of this Article, and

2. The Division is satisfied that the listed deficiencies can be corrected within six months or less by the license applicant.

B. The Division shall not issue a provisional license pursuant to A.R.S. § 36-592 when conditions exist which could endanger the health or safety of the children.

C. When the licensee has met the requirements of the provisional license and a regular license is issued, the regular license is valid for one year from the date the Division issued the provisional license.

D. A provisional license for a child developmental foster home is not transferable and is valid only for the licensee and the address stated on the license.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1004.01. Time-Frame for Granting or Denying a License

For the purpose of A.R.S. § 41-1073, the Division establishes the following licensing time-frames:

1. Administrative completeness review time-frame:

a. For an initial license, 90 days;

b. For a renewal license, 30 days; and

c. For an amended license, 30 days.

2. Substantive review time-frame:

a. For an initial license, 30 days;

b. For a renewal license, 31 days; and

c. For an amended license, 10 days.

3. Overall time-frame:

a. For an initial license, 120 days;

b. For a renewal license, 61 days; and

c. For an amended license, 40 days.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1004.02. Administrative Completeness and Substantive Review Process

A. The Division shall send the license applicant a written notice within the administrative completeness review time-frame indicating that the application package is either complete or incomplete.

B. If the application package is incomplete, the Division shall list the missing information in the notice and ask the license applicant to supply the missing information within 60 days from the date of notice. If the license applicant fails to do so, the Division may close the file.

C. A license applicant whose file has been closed and who later wishes to become licensed may reapply to the Division. The administrative completeness time-frame starts over when the Division receives the written request to reapply.

D. When the application is complete, the Division shall complete a substantive review of the license applicant's qualifications. The Division shall:

1. Review the application form and all required documents to ensure compliance with this Article;

2. Complete a home study as prescribed in R6-6-1001(D); and

3. Gather additional information needed to determine the license applicant's fitness to serve as a foster parent and ability to comply with foster care requirements, which may include:

a. Interviewing the license applicant;

b. Contacting references;

c. Verifying information provided in the application;

d. Visiting the license applicant's home; and

e. Requesting additional information, assessments, or tests as prescribed in R6-6-1001(F) and R6-6-1003(C).

E. If a license is denied, the Division shall send a notice to the license applicant as prescribed in R6-6-1018(F) and A.R.S. § 41-1076.

F. An applicant shall submit a license application package to DES/DDD, P.O. Box 6123, Site Code 791A, Phoenix, Arizona 85005-6123, Attention: Developmental Home Licensing Unit.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1004.03. Contents of a Complete Application Package - Initial License

An initial application package is complete when the Division has all of the following information:

1. From the license applicant, a completed application form as prescribed in R6-6-1001(A) which contains the following information:

a. Personally identifying information, as follows:

i. Name and gender,

ii. Date and place of birth,

iii. Social security number,

iv. Ethnicity and religious preference,

v. Current and previous address,

vi. Dates resided at previous address,

vii. Length of Arizona residency,

viii. Current marital status and marital history, and

ix. Any other names by which the license applicant has been known.

b. Personally identifying information on the license applicant's household members, as follows:

i. Name,

ii. Gender,

iii Date of birth,

iv. Relationship to license applicant, and

v. Length of time living in the home.

c. Personally identifying information on the license applicant's children who do not live with the license applicant, including emancipated children, as follows:

i. Name;

ii. Current address;

iii. Date of birth; and

iv. Occupation or school, if currently attending.

d. Any current or prior licenses or certificates held by the license applicant to provide care to a child or adult, as follows;

i. Type of license or certificate;

ii. Date of each license and certificate;

iii. State in which each license or certificate was issued;

iv. Any license or certificate which was revoked, denied, voluntarily surrendered, or suspended, and the circumstances; and

v. Name of any other agency with which the license applicant is currently licensed or certified to provide services to children or adults.

e. A description of the license applicant's home, as follows:

i. The name of the school district in which the license applicant's home is located;

ii. Identification and description of any swimming pool, spa, fish pond, or other body of water; and

iii. Number of bedrooms.

f. Information about the license applicant, as follows:

i. Educational background;

ii. Employment history;

iii. Previous experience in providing room and board for any person;

iv. Any contact with Child Protective Services (CPS) or Adult Protective Services (APS) and the circumstances;

v. Any arrests and the circumstances;

vi. Any history of mental illness or treatment for a mental illness or emotional disorder including hospitalization for alcohol, drug, or mental health issues and the circumstances;

vii. If currently or previously employed by the Department of Economic Security or the Division, position, title, name of the supervisor, and name of the program;

viii. The reason for wanting to provide foster care;

ix. Gender, age, characteristics, and special needs of the individual the license applicant would prefer to take into the home;

x. Any experience caring for individuals who have special needs;

xi. Discipline techniques used or believed appropriate for rearing children; and

xii. Anticipated changes in the license applicant's family in the next 12 months.

g. Information about the license applicant's household members, as follows:

i. Any contact with CPS or APS by anyone currently or formerly residing with the license applicant and the circumstances;

ii. Any arrests and the circumstances;

iii. Any history of mental illness or treatment for a mental illness or emotional disorder including hospitalization for alcohol, drug, or mental health issues and the circumstances;

iv. If currently or previously employed by the Department of Economic Security or the Division, position, title, name of supervisor, and name of the program;

v. Any experience caring for individuals with special needs; and

vi. Discipline techniques used or believed appropriate for rearing children.

h. Reference information for the license applicant, as follows:

i. Three references who can attest to the license applicant's character and skill; and

ii. If the license applicant is working or has worked with children or adults with developmental disabilities, one employment reference;

i. List of any individuals who live on the property on which the license applicant's home is located but not in the license applicant's home.

2. From the license applicant, the following documents as listed on the application form:

a. A completed declaration of criminal history for the license applicant and each adult household member on a Division form with the following information:

i. Name,

ii. Social security number,

iii. Date of birth,

iv. Address,

v. A declaration of whether the individual has committed any of the crimes listed in A.R.S. § 36-594(3) and R6-6-1018, and

vi. Dated signature.

b. Documentation showing that the license applicant and each adult household member have been fingerprinted;

c. Documentation showing that the license applicant has a current driver's license, and current vehicle liability insurance as prescribed in R6-6-1012(A);

d. A completed monthly budget on a Division form showing the license applicant's monthly income, and monthly expenses, and the circumstances for any declaration of bankruptcy;

e. A physician's statement for the license applicant and each adult household member as prescribed in R6-6-1001(L);

f. Documentation of current immunizations for each child living in the license applicant's home as prescribed in R6-6-1001(E)(5);

g. Documentation that the license applicant has completed training as prescribed in R6-6-1005(A).

3. From sources other than the applicant, the documents listed on the application form, as follows:

a. Three letters of reference for the license applicant as prescribed in R6-6-1001(G);

b. If the license applicant works with children or adults with developmental disabilities, one employment letter of reference as prescribed in R6-6-1001(H);

c. Documentation that the license applicant and each adult household member have had a criminal history check as prescribed in R6-6-1001(B);

d. Documentation showing that the license applicant's home has passed:

i. A fire inspection as prescribed in R6-6-1011(E), and

ii. A health and safety inspection as prescribed in R6-6-1011(D).

e. Documentation that vehicles used for transporting foster children have passed a Division safety inspection to meet the safety requirements set forth in R6-6-1012(B); and

f. Documentation that the CPS/APS Central Registry has been checked as prescribed in R6-6-1001(C).

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1004.04. Contents of a Complete Application Package - Renewal License

A license renewal application package is complete when the Division has all the following information:

1. From the license applicant, a completed renewal application form as prescribed in R6-6-1001(A) which contains the following information:

a. Personally identifying information, as follows:

i. Name,

ii. Address, and

iii. Phone number.

b. Personally identifying information on the license applicant's household members, as follows:

i. Name,

ii. Gender,

iii. Age,

iv. Relationship to the license applicant, and

v. School or occupation.

c. Personally identifying information on the license applicant's children who do not live with the license applicant, including emancipated children, as follows:

i. Name;

ii. Age;

iii. Address; and

iv. Occupation or school, if currently attending.

d. Information about the license applicant, as follows:

i. Any arrest or investigation for a criminal offense, including charge, and arresting agency; and

ii. Any referral to or treatment for a psychiatric or psychological problem, including substance abuse, in the last year.

e. Information about the license applicant's household members, including:

i. Any arrest or investigation for a criminal offense, including charge, and arresting agency;

ii. Any referral to or treatment for a psychiatric or psychological problem, including substance abuse, in the last year.

f. Any current or prior license or certificate held by the license applicant to provide care to a child or adult, as follows;

i. Type of license or certificate;

ii. Date of each license and certificate;

iii. State in which the license or certificate was issued;

iv. Any license or certificate which was revoked, denied, voluntarily surrendered, or suspended, and the circumstances; and

v. Name of any other agency with which the license applicant is currently licensed or certified to provide services to children or adults.

g. List of any individuals who live on the property on which the license applicant's home is located, but not in the license applicant's home;

h. List of the household members and their relationship to the applicant and each other;

i. Any changes that should be made to the license conditions;

j. Dated signature.

2. From the license applicant, the items listed in R6-6-1004.03(2)(c), (2)(d), (2)(f), and the following:

a. A completed declaration of criminal history for each new adult household member and, at three-year intervals, a completed declaration for all adult household members;

b. Documentation showing that each new adult household member has been fingerprinted and, at three-year intervals, that all adult household members have been fingerprinted;

c. A physician's statement every three years from the date of the initial license for the license applicant and all adult household members; and

d. Documentation that the license applicant has completed training as prescribed in R6-6-1005(B).

3. From sources other than the applicant, the documents listed in R6-6-1004.03(3)(d)(i), (3)(e), and (3)(f) and the following:

a. Documentation that each new adult household member has had a criminal history check and that all adult household members have had a criminal history check every three years, and

b. Documentation that the license applicant's home has passed a health and safety inspection every three years since the date of the initial license.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1004.05. Contents of a Completed Request for an Amended License

A request for an amended license is complete when the Division has the following:

1. A description of the change requested to the license, and

2. Documentation that the requested change complies with this Article.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1005. Training Requirements for Child Developmental Home Foster Parents

A. A license applicant for an initial license as a Child Developmental Foster Home shall meet the following training requirements:

1. Prelicensing training in the following subjects:

a. Cardiopulmonary resuscitation appropriate for children and adults provided by an instructor certified in cardiopulmonary resuscitation;

b. First aid provided by an instructor certified in first aid; and

c. Child developmental foster home parent orientation training of 16 to 20 hours, as determined by the Division.

2. Up to ten additional hours of training based upon the needs of the license applicant or the foster child, as determined by the Division.

B. The licensee shall annually complete a minimum of ten hours of training, as required by the Division, prior to license renewal and must maintain all certifications obtained for the initial licensure. Up to four hours of the annual training may be allowed for training related to maintenance of certifications.

C. The license applicant or licensee shall participate in additional training based upon the specific needs of the foster family or a child placed in the foster home, as required by the Division, or shall demonstrate the ability to meet the needs of a specific child.

D. The license applicant or licensee shall submit documentation which demonstrates satisfactory completion of these training requirements to the Division.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1006. Foster Parent Responsibilities in Child Developmental Foster Homes

A. The licensee shall provide the child with positive emotional support and guidance including but not limited to:

1. Including the child in daily activities;

2. Providing the child with positive reinforcement;

3. Assisting the child with day-to-day concerns with school, with friends, and with family;

4. Providing appropriate care, concern, and support;

5. Protecting the child from harm; and

6. Assisting the child in developing and fostering personal relationships.

B. The licensee shall follow written and verbal instructions and orders from qualified professionals regarding the medical, dental, habilitative, and therapeutic needs of the child.

C. The licensee shall provide opportunities for social and physical development appropriate to the child's developmental level and interest, through recreation and leisure-time activities.

D. The licensee shall cooperate with the Division in providing opportunities for the child to pursue the child's own religious beliefs or those of the child's parent, family, or guardian. The licensee shall not require the child to participate in the licensee's religious activities or practices.

E. The licensee shall assign tasks and work appropriate to the child's age and abilities and which do not present a health or safety hazard and do not interfere with the child's educational or recreational activities.

F. The licensee shall ensure children are dressed each day in clothing which is clean and appropriate to the age of the child, the climate, and the situation.

G. The licensee shall provide a well-balanced and adequate diet to meet the nutritional needs of the child.

H. The licensee shall ensure that the child has transportation to meet the educational, medical, habilitative, therapeutic, and social needs of the child.

I. The licensee shall make reasonable efforts to support and maintain the child's relationships with parents, guardians, other family members, and other persons important to the child's life, approved or as required by the Division, the child-placing agency, or the courts.

J. The licensee shall ensure that visitations or outings with other adults, without the licensee present, have the prior approval of the Division or are consistent with the child's ISPP or case plan.

K. The licensee shall ensure that money designated for the child is only used for the specific purpose intended and for the benefit of the child.

L. The licensee shall provide appropriate hygiene for the child including bathing, tooth brushing, hair care, toileting, diapering, menstrual care, and shaving, as appropriate.

M. The licensee shall not provide foster care or respite care to adults in the licensee's home.

N. The licensee shall provide care only for the number of children and conditions listed on the license.

O. The licensee shall obtain approval from the Division before accepting placements from other agencies or private parties.

P. When the child developmental foster home also provides respite services, the licensee shall ensure that the respite placement is within the conditions stated on the Child Developmental Foster Home license.

Q. The licensee shall not accept adult roomers or boarders without prior approval of the Division.

R. The licensee shall treat information concerning a child placed in the licensee's home and the child's family and guardian as confidential in accordance with A.R.S. § 36-568.

S. The licensee shall participate in the IEP meetings, unless otherwise specified by the Division, and advocate for the implementation of the IEP.

T. The licensee shall participate in the ISPP meetings, shall carry out the tasks identified by the ISPP team as being the responsibility of the licensee, and shall advocate for the implementation of the ISPP.

U. The licensee shall cooperate with the Division when a foster child moves from the foster home by:

1. Providing information, including the records required in R6-6-1010(A) and (C);

2. Ensuring personal belongings such as usable clothing, furniture, television sets, bicycles, toys, and other items purchased specifically for the child go with the child; and

3. Assisting the Division in preparing the child for the move.

V. The licensee shall comply with the terms of the Child Developmental Foster Home Parent Agreement.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1007. Behavior Management

A. The licensee shall comply with the Division's requirements for behavior management as specified in Article 9.

B. The licensee shall establish well-defined rules which set the limits of behavior.

C. The licensee shall provide discipline appropriate to the age, life experience, and individuality of each child:

1. The licensee shall develop and implement fair, reasonable, age and developmentally appropriate, and consistent rewards and consequences for implementing the rules established in subsection (B).

2. The licensee shall not use discipline which deprives the child of food, shelter, or medical care.

3. The licensee shall not use any form of corporal or physical punishment.

4. The licensee shall not participate in the use of verbal abuse or derogatory remarks.

D. The licensee shall identify behavioral issues and report them to the Division.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1008. Sleeping Arrangements

The licensee shall provide appropriate, comfortable, and safe sleeping arrangements for each child consistent with the requirements of this Section.

1. Each child shall have his or her own bed and place to store clothing and personal belongings.

2. No child shall sleep in an unfinished room, a hallway, or any room which is normally used for other than sleeping arrangements by family members.

3. A child six years of age or older shall not share a bedroom with persons of the opposite sex.

4. A child shall not share a bedroom with an adult except in the following circumstances:

a. A child under two years of age may share a bedroom with the licensee.

b. A child two years of age and older may share a bedroom with the licensee for special temporary care, such as during the child's illness or as specified in the ISPP.

5. The licensee shall sleep within hearing distance of the child.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1009. Notification Requirements

A. The licensee shall notify the Division or placing agency of the following events:

1. An addition to the foster home, structural remodeling of the foster home, or addition of a swimming pool or spa. The licensee shall provide prior notification to the Division and shall cooperate with the Division in obtaining an Arizona Department of Health Services inspection as prescribed in A.R.S. § 8-504;

2. Changes in marital status or living arrangement of the licensee;

3. A plan to make a change in location of residence;

4. Arrests, indictments, or convictions of any household member or of persons living on the premises;

5. Serious injury, illness, illegal substance use or substance abuse, suicidal behavior, attempted suicide, or death of any foster family member. The Division may require the licensee provide written documentation from a physician regarding the change in medical status;

6. Changes which impact on the ability of the foster family to meet the needs of the child;

7. Addition of a new household member shall be made to the Division prior to the addition;

8. A temporary visitor staying more than one month; and

9. A change in the primary care giver or a person leaving the household who contributed to the care of the child. Notification shall be made to the Division prior to the change.

B. For children placed by the Division in the licensee's home, the licensee shall notify the Division of incidents including but not limited to:

1. Possible child abuse or neglect as per A.R.S. § 13-3620 and R6-6-1601;

2. Hospitalization, the intervention of a medical practitioner, or emergency medical care as a result of serious illness, injury, medication error, or suicidal behavior;

3. Death of a child;

4. A child missing. A child missing must be reported to law enforcement officials and the Division as soon as the child is determined to be missing;

5. Theft of money or property;

6. Incidents which involve or may potentially involve the police or media;

7. Significant damage to the property of the child, the property of the state, the property of the licensee, or the property of others; and

8. Illegal substance use or substance abuse.

C. The licensee shall obtain prior approval from the Division for alternative supervision plans. Alternate supervision shall only be provided by persons 18 years of age or older.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1010. Recordkeeping

A. The licensee shall maintain a record for each child which shall include the child's medical history, dental history, educational experiences, and habilitation services.

B. The licensee shall obtain and provide to the Division receipts for expenditures for the child, as required by the Division.

C. The licensee shall maintain a personal record for the child, which may include mementos, photos, letters, cards, report cards, school projects, art, and toys.

D. The licensee shall keep copies of all licenses, certificates, and correspondence in a separate file to document compliance with sanitation, health, and environmental codes of state and local authorities.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1011. Health and Safety Standards in Child Developmental Foster Homes

A. The licensee shall maintain the premises of the child developmental foster home in a clean and sanitary condition to the degree that it does not present a health or safety hazard.

B. The child developmental foster home shall not have an accumulation of litter, rubbish, or garbage on the premises. Litter, rubbish, and garbage shall be contained in cleanable containers with lids or sealed disposable containers and shall be removed from the property not less than once a week.

C. The licensee shall ensure that the child developmental foster home is free from, or has an ongoing system to eradicate, insects, rodents, and other vermin.

D. Before initial licensure and every three years thereafter, the child developmental foster home shall be inspected and meet the safety and sanitation guidelines of the Department of Health Services unless otherwise specified by the Division.

E. Child developmental foster homes located in mobile homes shall pass an annual fire safety inspection as arranged by the Division.

F. The licensee shall keep toxic, poisonous, hazardous, and corrosive materials in locked storage separate from food or medications, unless otherwise specified in the ISPP.

G. The licensee shall keep medicines in locked storage separate from food, toxic, poisonous, hazardous, or corrosive materials.

H. The licensee shall keep firearms in locked storage and shall keep ammunition locked separately from the firearms.

I. Bedrooms shall have light, ventilation, and a usable, unobstructed exit to the outside in case of an emergency.

J. Telephone service or similar two-way communication methods shall be available in the home and shall be in working order.

K. Any permanent body of water shall be fenced and inaccessible to children and shall meet the guidelines of the Arizona Department of Health Services unless otherwise specified by the Division.

L. The licensee shall not allow foster children in swimming pool areas or in the area of other bodies of water unless supervised by a responsible adult or as specified in the ISPP.

M. The licensee shall store alcoholic beverages responsibly.

N. The licensee shall not use tobacco products while in an enclosed area with a foster child.

O. The licensee shall make reasonable efforts to ensure family pets do not present a health or safety hazard to foster children.

P. The licensee shall develop a fire evacuation plan and shall periodically practice the plan with the household members. The licensee shall update the fire evacuation plan as needed based on placement changes, household member changes, or structural changes to the foster home.

Q. The licensee shall equip the child developmental foster home with smoke detectors and fire extinguishers which are in good working order.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1012. Transportation

A. A licensee who transports foster children shall have a current and valid driver's license and shall have liability insurance for any vehicle which will be used to transport foster children. A child developmental foster home household member who transports children must be 18 years of age or older and must be identified to the Division.

B. A licensee shall ensure that each vehicle used for transporting foster children is maintained in a safe operating condition.

C. The licensee shall ensure foster children wear seat belts or use an appropriate child safety seat while being transported.

D. A vehicle used to transport children in wheelchairs shall also be equipped with floor-mounted seat belts and wheelchair lock-downs for each wheelchair being transported.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1013. Dual Licensure or Certification of Child Developmental Foster Homes

A. Foster parents licensed pursuant to A.R.S. § 8-509 shall cooperate with the certification process of the Division to care for children with developmental disabilities.

1. To be granted certification the home shall meet all requirements of this Article.

2. The licensee shall cooperate with the Division in the annual certification study.

3. A licensee certified by the Division shall not be certified to serve more than a total of three children.

4. The licensee shall cooperate with a home visit as part of the certification process.

B. Foster parents residing off-reservation and licensed by a tribal jurisdiction shall also be licensed by the Division for children placed by the Division.

1. To be granted licensure, the home shall meet all requirements of this Article.

2. Foster parents licensed by a tribal jurisdiction, seeking licensure by the Division, shall sign a release of information from the tribal licensure files.

3. A person licensed by the Division as a Child Developmental Foster Home shall not be licensed to serve more than a total of three children.

4. The licensee shall notify the Division of a pre-placement conference with another agency or jurisdiction.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1014. Rights of Children in Child Developmental Foster Homes

The licensee shall uphold and safeguard the rights of clients consistent with applicable federal and state laws, specifically including A.R.S. § 36-551.01, unless legally restricted or as addressed in the ISPP in accordance with Article 9. Rights for children shall allow for reasonable standards of parental guidance and protection. In addition to those rights specifically stated in statute, rights shall include, at a minimum:

1. The right to be provided choices and to express preferences which will be respected and accepted whenever appropriate and possible;

2. The right to be free from personal and financial exploitation;

3. The right to a safe, clean, and humane physical environment;

4. The right to own and have appropriate access to personal property;

5. The right to associate with persons of the child's own choosing as appropriate to the age and developmental level of the child;

6. The right to participate in social, religious, educational, cultural, and community activities;

7. The right to have access to their personal spending money and to be taught to manage their spending money;

8. The right to the least amount of physical assistance necessary to accomplish a task;

9. The right to privacy, including during treatment and care of personal needs, and with regard to written correspondence, telephone communications, and visitations;

10. The right to have care for personal needs provided, except in cases of emergency, by a caregiver of the gender appropriate to the age of the child or as specified in the ISPP; and

11. The right to be treated with dignity and respect.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1015. Exemption

A licensee may request from the Division an exemption of a rule contained in this Article. The request shall demonstrate that the intent of the rule will be met by alternate means and that the exemption will not endanger the lives or health of clients.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1016. Home Inspections and Monitoring

A. The licensee shall cooperate with the Division in assessing compliance with this Article.

B. The licensee shall allow the Division access to the setting for inspections and monitoring visits and shall allow the Division access to the licensee's records, reports, and vehicles used to transport clients.

C. Inspections and monitoring visits shall include, at a minimum:

1. An annual home visit as part of the license renewal process; and

2. Two monitoring visits each year, at least one of which will be unannounced.

D. The licensee shall comply with corrective action plans as required by the Division.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

Editor's Note: The following Section was adopted under an exemption from the provisions of A.R.S. Title 41, Chapter 6, pursuant to Laws 1994, Ch. 214, § 7. Exemption from A.R.S. Title 41, Chapter 6 means that the Department did not submit these rules to the Secretary of State's Office for publication in the Arizona Administrative Register; the Department did not submit the rules to the Governor's Regulatory Review Council for review; the Department was not required to hold public hearings; and the Attorney General has not certified these rules.

R6-6-1017. Complaints

A. Any person who has a complaint about a child developmental foster home may make the complaint known verbally or in writing to the Department.

B. A complainant who has provided his name and address shall be notified that his complaint has been received and the notice shall indicate what investigative actions shall be taken.

C. The Department shall investigate complaints about child developmental foster homes within ten calendar days of the receipt of the complaint and shall notify the licensee of the investigation. In a case where there is reason to believe that imminent danger exists, the investigation shall be conducted immediately and the licensee shall be notified.

D. The name or identifying characteristics of the complainant shall not be disclosed unless the complainant consents in writing to the disclosure or investigation of the complaint results in a legal proceeding and disclosure is ordered by an appropriate authority.

E. The Department shall notify the licensee of the results of an investigation conducted pursuant to this rule and the requirement for any corrective action that the Department deems necessary.

F. The licensee shall cooperate with the Division in completing investigations of complaints or concerns regarding the Child Developmental Foster Home and regarding children placed in the home.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1018. Denial, Suspension, and Revocation of Child Developmental Foster Home Licenses

A. The Division may deny, suspend, or revoke a license for violations of A.R.S. § 36-594.

B. The Division may deny or revoke a license if a license applicant or licensee has been arrested for, convicted of, charged with, or pled no contest to any of the following criminal acts:

1. Sexual abuse of a child or vulnerable adult,

2. Incest,

3. First- or second-degree murder,

4. Kidnapping,

5. Arson,

6. Sexual assault,

7. Sexual exploitation of a child or vulnerable adult,

8. Commercial sexual exploitation of a child or vulnerable adult,

9. Felony offenses within the previous ten years involving the manufacture or distribution of marijuana or dangerous or narcotic drugs,

10. Robbery,

11. Child prostitution as defined in A.R.S. § 13-3206,

12. Child abuse or abuse of a vulnerable adult,

13. Sexual conduct with a child,

14. Molestation of a child or vulnerable adult,

15. Voluntary manslaughter, or

16. Aggravated assault.

C. Upon notification that a member of the household or person living on the premises of a Child Developmental Foster Home is found to have been arrested for, convicted of, charged with, or pled no contest to any of the criminal acts listed in subsection (B), the licensee shall immediately take the following actions:

1. Remove the person from direct contact with children;

2. Notify the Division, unless the licensee initially received notice from the Division.

D. If a licensee fails to comply with subsection (C), the Division shall revoke or suspend the license.

E. If the criminal record check indicates that an individual has been convicted of or found by a court to have committed, or is reasonably believed to have committed, offenses pursuant to A.R.S. § 36-594, other than those listed in subsection (B), the Division shall consider the following factors when determining what corrective action to take against the licensee:

1. The extent of the individual's criminal record;

2. Length of time since the commission of the offense;

3. Nature of the offense;

4. Mitigating circumstances surrounding commission of the offense. The burden is on the person to demonstrate that there were mitigating circumstances;

5. The degree of the person's participation in the offense. The burden is on the person to demonstrate that the involvement was not direct; and

6. The extent of the person's rehabilitation, including but not limited to:

a. The person shall provide that probation has been completed and complete restitution or compensation for the offense has been made, and

b. Evidence of positive action to change criminal behavior such as completion of a drug treatment program or counseling.

7. Personal references attesting to the person's rehabilitation.

F. When an application for a license is denied, or a license is suspended or revoked, pursuant to A.R.S. § 36-594, the Division shall deliver a written notice of the action in person or send a written notice of the action by certified mail to the license applicant or licensee. The notice shall state the reasons for the denial, suspension, or revocation with reference to applicable statutes and rules.

G. If the reason for denial, suspension, or revocation of a license involves the health, welfare, or safety of clients, the clients shall be immediately removed from the child developmental foster home.

H. When a license is denied, suspended, or revoked, the license applicant or licensee has the right to appeal the decision pursuant to Article 20.

I. The Division may suspend a child developmental foster home license for:

1. Up to six months during an investigation or while the licensee completes a corrective action plan.

2. Up to 12 months due to the temporary inability of the licensee to provide services.

J. No child can be placed in the foster home during a suspended license status.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1019. Appeals

A. When an application for a license is denied, or a license is suspended or revoked, the Division shall notify the license applicant or licensee of the right of appeal pursuant to R6-6-2001 et seq. (Appeals and Hearings), except that appeals from the decision of a hearing officer shall be in accordance with A.R.S. § 41-1992 (Hearing Officers Powers and Duties).

B. If the license applicant or licensee appeals a licensing decision, the denial, suspension, or revocation of the license shall not become final until the appeal decision is rendered.

C. If the children have been removed from the child developmental foster home because of a health, welfare, or safety issue, they shall remain out of the home while the appeal is pending.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

ARTICLE 11. ADULT DEVELOPMENTAL HOME LICENSE

R6-6-1101. Application for License

A. Married or single persons desiring to be licensed as an adult developmental home shall make written application for a license to the Division on the prescribed forms.

B. The license applicant and any adult member of the household shall be fingerprinted for a criminal history record check as prescribed by the Division. Any adult living on the premises, not residing in the home, may be required to be fingerprinted for a criminal history record check.

C. The license applicant and any adult member of the household shall authorize the Division to perform a background check through Adult Protective Services and Child Protective Services referral files. Any adult living on the premises may be required to authorize a background check through Adult Protective Services and Child Protective Services referral files.

D. The license applicant and all members of the license applicant's household shall participate in interviews with the Division and the home-study process as required by the Division. The home-study process shall include:

1. Interviews with all members of the license applicant's household.

2. Interviews with other knowledgeable parties as the Division determines appropriate.

3. Inspection of the home and grounds by the Arizona Department of Health Services and the Division for compliance with this Article.

E. To be eligible for licensure as an adult developmental home provider, the license applicant shall:

1. Be at least 21 years of age,

2. Have income or resources independent of the Division room-and-board payments to meet the needs of the license applicant's family unit,

3, Not have employment that conflicts with the care and supervision of adults placed by the Division,

4. Be of reputable and honest character, and

5. The license applicant shall submit documentation that each child living in the home has received the immunizations appropriate to the child's age and state of health unless the license applicant has submitted a signed statement that the children have not been immunized because of affiliation with a religion which is opposed to such immunizations or because the license applicant is opposed to such immunizations.

F. The license applicant and members of the household shall cooperate with the Division in obtaining information regarding the license applicant or household members necessary to determine if the home meets licensing standards. Such cooperation shall include, but is not limited to:

1. Providing releases of information;

2. Authorizing release of medical records; and

3. Submitting to psychological, psychiatric, drug testing, or other evaluations as required by the Division.

G. The license applicant shall provide the Division with a minimum of three references who are familiar with the family and are not related to the license applicant by blood or marriage. The Division may contact the references for further information regarding the license applicant's character and ability to care for individuals with developmental disabilities.

H. The Division may require the license applicant to submit references from current or previous employers.

I. All members of the household shall agree with the decision to be licensed as an adult developmental home.

J. The license applicant shall demonstrate an understanding of and the ability to meet the emotional, physical, social, developmental, educational, and intellectual needs of individuals with developmental disabilities.

K. The license applicant shall demonstrate the ability to provide encouragement, guidance, and support; to be sensitive to the needs of the individuals with developmental disabilities; and to protect individuals with developmental disabilities from harm.

L. The applicant shall not have any medical or emotional problems that may prevent the person from properly caring for adults with developmental disabilities or may negatively impact on clients in the home.

1. Following approval of the home study by the Division, the license applicant shall submit, on forms prescribed by the Division, written statements from a licensed medical practitioner for each adult living in the home. The statement shall include, at a minimum:

a. Confirmation that the physician has examined the adult within the last six months,

b. A description of the person's general physical and emotional health,

c. A list of all regularly prescribed medications and the purpose of the medication, and

d. Identification of any medical or emotional problems that may prevent the person from caring for adults with developmental disabilities or may impact on clients in the home.

2. The Division may require the license applicant to submit physician statements as described in this Section regarding the physical and emotional health of other adults living on the premises.

M. The license applicant shall attend prelicensure training as required by R6-6-1105.

Historical Note

Former Section R6-6-1101 repealed effective September 18, 1987. New Section R6-6-1101 adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-1102. Issuing an Initial License

A. The license applicant shall comply with the requirements of this Article.

B. Except as provided in R6-6-1104(C), a regular license is effective for one year from the date of issuance.

C. Based upon records, reports, and observations, if the Division determines that the license applicant may be unable to meet the physical or emotional needs of clients, the Division may require further psychological or physical evaluations, at no expense to the license applicant, to determine whether a license shall be denied.

D. A regular license to provide adult developmental home services is not transferable and is valid only for the licensee and the address stated on the license.

Historical Note

Former Section R6-6-1102 repealed effective September 18, 1987. New Section R6-6-1102 adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-1103. Issuing a Renewal License

A. A regular license is renewable annually for a one-year period.

B. The Division shall renew an adult developmental home regular license when:

1. The licensee has met the annual training requirements according to R6-6-1105;

2. The home meets the requirements of R6-6-1101 except as noted in this subsection:

a. The licensee shall submit a written statement every three years from the date of initial license from a licensed medical practitioner as required by R6-6-1101(M);

b. References are not required for license renewal;

c. The adult developmental home shall receive a health inspection from the Department of Health Services every three years prior to license renewal unless otherwise indicated by this Article;

3. Any person fingerprinted pursuant to R6-6-1101(B) and still residing in the home or on the premises shall have a criminal history record check every three years.

C. Based upon records, reports, and observations, if the Division determines that the license applicant for license renewal may be unable to meet the physical or emotional needs of adults with developmental disabilities, the Division shall have the authority to require further psychological or physical evaluations at no expense to the developmental home provider to determine whether to renew a license.

D. A license to provide adult developmental home services is not transferable and is valid only for the licensee and the address stated on the license.

Historical Note

Former Section R6-6-1103 repealed effective September 18, 1987. New Section R6-6-1103 adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6 (Supp. 94-3).

R6-6-1104. Issuing a Provisional License

A. The Division may issue a provisional license for up to six months when:

1. The license applicant is temporarily unable to meet the requirements of this Article, and

2. The Division is satisfied that the listed deficiencies can be corrected within six months or less by the license applicant.

B. When conditions exist which could endanger the health or safety of adults with developmental disabilities, the Division shall not issue a provisional license pursuant to A.R.S. § 36-592.

C. When the license applicant has met the requirements of the provisional license and a regular license is issued, the regular license is valid for one year from the date the Division issued the provisional license.

D. A provisional license to provide adult developmental home services is not transferable and is valid only for the licensee and the address stated on the license.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1104.01. Time-Frame for Granting or Denying a License

For the purpose of A.R.S. § 41-1073, the Division establishes the following licensing time-frames:

1. Administrative completeness review time-frame:

a. For an initial license, 90 days;

b. For a renewal license, 30 days; and

c. For an amended license, 30 days.

2. Substantive review time-frame:

a. For an initial license, 30 days;

b. For a renewal license, 31 days; and

c. For an amended license, 10 days.

3. Overall time-frame:

a. For an initial license, 120 days;

b. For a renewal license, 61 days; and

c. For an amended license, 40 days.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1104.02. Administrative Completeness and Substantive Review Process

A. The Division shall send the license applicant a written notice within the administrative completeness review time-frame indicating that the application package is either complete or incomplete.

B. If the application package is incomplete, the Division shall list the missing information in the notice and ask the license applicant to supply the missing information within 60 days from the date of notice. If the license applicant fails to do so, the Division may close the file.

C. A license applicant whose file has been closed and who later wishes to become licensed may reapply to the Division. The administrative completeness time-frame starts over when the Division receives the written request to reapply.

D. When the application is complete, the Division shall complete a substantive review of the license applicant's qualifications. The Division shall:

1. Review the application form and all required documents to ensure compliance with this Article,

2. Complete a home study as prescribed in R6-6-1101(D), and

3. Gather additional information needed to determine the license applicant's fitness to serve as an Adult Developmental Home service provider and ability to comply with Adult Developmental Home requirements, which may include:

a. Interviewing the license applicant;

b. Contacting references;

c. Verifying information provided in the application;

d. Visiting the license applicant's home; and

e. Requesting additional information, assessments, or tests as prescribed in R6-6-1101(F) and R6-6-1103(C).

E. If a license is denied, the Division shall send a notice to the license applicant as prescribed in R6-6-1118(F) and A.R.S. § 41-1076.

F. An applicant shall submit a license application package to DES/DDD, P.O. Box 6123, Site Code 791A, Phoenix, Arizona 85005-6123, Attention: Developmental Home Licensing Unit.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1104.03. Contents of a Complete Application Package - Initial License

An initial application package is complete when the Division has all of the following information:

1. From the license applicant, a completed application form as prescribed in R6-6-1101(A) which contains the following information:

a. Personally identifying information, as follows:

i. Name and gender,

ii. Date and place of birth,

iii. Social security number,

iv. Ethnicity and religious preference,

v. Current and previous address,

vi. Dates resided at previous address,

vii. Length of Arizona residency,

viii. Current marital status and marital history, and

ix. Any other names by which the license applicant has been known.

b. Personally identifying information on the license applicant's household members, as follows:

i. Name,

ii. Gender,

iii Date of birth,

iv. Relationship to license applicant, and

v. Length of time living in the home.

c. Personally identifying information on the license applicant's children who do not live with the license applicant, including emancipated children, as follows:

i. Name;

ii. Current address;

iii. Date of birth; and

iv. Occupation or school, if currently attending.

d. Any current or prior licenses or certificates held by the license applicant to provide care to a child or adult, as follows;

i. Type of license or certificate;

ii. Date of each license and certificate;

iii. State in which each license or certificate was issued;

iv. Any license or certificate which was revoked, denied, voluntarily surrendered, or suspended and the circumstances; and

v. Name of any other agency with which the license applicant is currently licensed or certified to provide services to children or adults.

e. A description of the license applicant's home, as follows:

i. The name of the school district in which the license applicant's home is located;

ii. Identification and description of any swimming pool, spa, fish pond, or other body of water; and

iii. Number of bedrooms.

f. Information about the license applicant, as follows:

i. Educational background;

ii. Employment history;

iii. Previous experience in providing room and board for any person;

iv. Any contact with CPS or APS and the circumstances;

v. Any arrest and the circumstances;

vi. Any history of mental illness or treatment for a mental illness or emotional disorder including hospitalization for alcohol, drug, or mental health issues and the circumstances;

vii. If currently or previously employed by the Department of Economic Security or the Division, position, title, name of the supervisor, and name of the program;

viii. The reason for wanting to provide care to an adult;

ix. Gender, age, characteristics, and special needs of the individual the license applicant would prefer to take into the home;

x. Any experience caring for individuals who have special needs;

xi. Discipline techniques used or believed appropriate; and

xii. Anticipated changes in the license applicant's family in the next 12 months.

g. Information about the license applicant's household member, as follows:

i. Any contact with CPS or APS by anyone currently or formerly residing with the license applicant and the circumstances;

ii. Any arrests and the circumstances;

iii. Any history of mental illness or treatment for a mental illness or emotional disorder including hospitalization for alcohol, drug, or mental health issues and the circumstances;

iv. If currently or previously employed by the Department of Economic Security or the Division, position, title, name of the supervisor, and name of the program;

v. Any experience caring for individuals with special needs; and

vi. Discipline techniques used or believed appropriate.

h. Reference information for the license applicant, as follows:

i. Three references who can attest to the license applicant's character and skill; and

ii. If the license applicant is working or has worked with children or adults with developmental disabilities, one employment reference;

i. List of any individuals who live on the property on which the license applicant's home is located, but not in the license applicant's home.

2. From the license applicant, the following documents listed on the application form:

a. A completed declaration of criminal history for the license applicant and each adult household member on a Division form with the following information:

i. Name,

ii. Social security number,

iii. Date of birth,

iv. Address,

v. A declaration of whether the individual has committed any of the crimes listed in A.R.S. § 36-594(3) and R6-6-1118, and

vi. Dated signature.

b. Documentation showing that the license applicant and each adult household member have been fingerprinted;

c. Documentation showing that the license applicant has a current driver's license, and current vehicle liability insurance as prescribed in R6-6-1112(A);

d. A completed monthly budget on a Division form showing the license applicant's monthly income, and monthly expenses, and the circumstances for any declaration of bankruptcy;

e. A physician's statement for the license applicant and each adult household member as prescribed in R6-6-1101(L);

f. Documentation of current immunizations for each child living in the license applicant's home as prescribed in R6-6-1101(E)(5);

g. Documentation that the license applicant has completed training as prescribed in R6-6-1105(A).

3. From sources other than the applicant, the documents listed on the application form, as follows:

a. Three letters of reference for the license applicant as prescribed in R6-6-1101(G);

b. If the license applicant works with children or adults with developmental disabilities, one employment letter of reference as prescribed in R6-6-1101(H);

c. Documentation that the license applicant and each adult household member have had a criminal history check as prescribed in R6-6-1101(B);

d. Documentation showing that the license applicant's home has passed:

i. A fire inspection as prescribed in R6-6-1111(E), and

ii. A health and safety inspection as prescribed in R6-6-1111(D).

e. Documentation that vehicles used for transporting individuals with developmental disabilities have passed a Division safety inspection to meet the safety requirements in R6-6-1112(B); and

f. Documentation that the CPS/APS Central Registry has been checked as prescribed in R6-6-1101(C).

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1104.04. Contents of a Complete Application Package - Renewal License

A license renewal application package is complete when the Division has all the following information:

1. From the license applicant, a completed renewal application form as prescribed in R6-6-1101(A) which contains the following information:

a. Personally identifying information, as follows:

i. Name,

ii. Address, and

iii. Phone number.

b. Personally identifying information on the license applicant's household members, as follows:

i. Name,

ii. Gender,

iii. Age,

iv. Relationship to the license applicant, and

v. School or occupation.

c. Personally identifying information on the license applicant's children who do not live with the license applicant, including emancipated children, as follows:

i. Name;

ii. Age;

iii. Address; and

iv. Occupation or school, if currently attending.

d. Information about the license applicant, as follows:

i. Any arrest or investigation for a criminal offense, including charge, and arresting agency;

ii. Any referral to or treatment for a psychiatric or psychological problem, including substance abuse, in the last year.

e. Information about the license applicant's household member, including:

i. Any arrest or investigation for a criminal offense, including charge, and arresting agency;

ii. Any referral to or treatment for a psychiatric or psychological problem, including substance abuse, treatment in the last year.

f. Any current or prior license or certificate held by the license applicant to provide care to a child or adult, as follows:

i. Type of license or certificate;

ii. Date of each license and certificate;

iii. State in which the license or certificate was issued;

iv. Any license or certificate which was revoked, denied, voluntarily surrendered, or suspended and the circumstances; and

v. Name of any other agency with which the license applicant is currently licensed or certified to provide services to children or adults.

g. List of any individuals who live on the property on which the license applicant's home is located, but not in the license applicant's home;

h. List of the household members and their relationship to the applicant and to each other;

i. Any changes that should be made to the license conditions;

j. Dated signature.

2. From the license applicant, the items listed in R6-6-1104.03(2)(c),(2)(d), (2)(f), and the following:

a. A completed declaration of criminal history for each new adult household member and, at three-year intervals, a completed declaration for all adult household members;

b. Documentation showing that each new adult household member has been fingerprinted and, at three-year intervals, that all adult household members have been fingerprinted;

c. A physician's statement every three years from the date of the initial license for the license applicant and all adult household members; and

d. Documentation that the license applicant has completed training as prescribed in R6-6-1105(B).

3. From sources other than the applicant, the documents listed in R6-6-1104.03(3)(d)(i), (3)(e), and (3)(f) and the following:

a. Documentation that each new adult household member has had a criminal history check and that all adults household members have had a criminal history check every three years; and

b. Documentation that the license applicant's home has passed a health and safety inspection every three years since the date of the initial license.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1104.05. Contents of a Complete Request for an Amended License

A request for an amended license is complete when the Division has the following:

1. A description of the change requested to the license, and

2. Documentation that the requested change complies with this Article.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1105. Training Requirements for Adult Developmental Home Providers

A. An applicant for an initial license as an adult developmental home provider shall meet the following training requirements:

1. Prelicensing training in the following subjects:

a. Cardiopulmonary resuscitation appropriate for children and adults provided by an instructor certified in cardiopulmonary resuscitation;

b. First aid provided by an instructor certified in first aid; and

c. Orientation training of 12 to 20 hours, as prescribed by the Division.

2. Up to ten additional hours of training based upon the needs of the license applicant or the adult placed by the Division, as determined by the Division.

B. The licensee shall annually complete a minimum of ten hours of training, as required by the Division, prior to license renewal and must maintain cardiopulmonary resuscitation and first-aid certifications obtained for the initial license. Up to four hours of the annual training may be allowed for training related to maintenance of certificates.

C. The licensee shall participate in additional training, as required by the Division, based upon the specific needs of the license applicant or licensee or an adult placed by the Division or shall demonstrate the ability to meet the needs of the specific client.

D. The license applicant or licensee shall submit documentation to the Division demonstrating satisfactory completion of the training requirements.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1106. Adult Developmental Home Licensee Responsibility

A. The licensee shall provide the client with positive emotional support and guidance including but not limited to:

1. Including the client in daily activities;

2. Providing the client with positive reinforcement;

3. Assisting the client with day-to-day concerns with school, work, friends, and family;

4. Providing appropriate care, concern, and support;

5. Protecting the client from exploitation; and

6. Assisting the client in developing and fostering personal relationships.

B. The licensee shall follow written and verbal instructions and orders from qualified professionals regarding the medical, dental, habilitation, and therapeutic needs of the client.

C. The licensee shall provide opportunities for social and physical development appropriate to the client's abilities and interest, through recreation and leisure-time activities.

D. The licensee shall provide opportunities for the client to pursue the client's own religions beliefs. The licensee shall not require the client to attend or participate in the licensee's religious activities or practices.

E. The licensee shall develop an agreement with the client for shared household tasks which do not present a health or safety hazard and do not interfere with the client's school, work, day programs, or recreational activities.

F. The licensee and any client who smokes tobacco products shall develop mutually acceptable rules regarding the smoking of tobacco products.

G. The licensee shall provide appropriate direction in the selection of clothing while allowing individual choice.

H. In cooperation with the client, the licensee shall plan and provide well-balanced and adequate meals to meet the nutritional needs of the client.

I. The licensee shall ensure transportation is arranged to meet the educational, employment, medical, habilitative, therapeutic, and social needs of the client.

J. The licensee shall make reasonable efforts to support and maintain the client's relationships with parents, guardians, other family members, and other persons important to the client's life as indicated in the ISPP.

K. The licensee shall ensure that money designated for or earned by the client is only used for the specific purpose intended and for the benefit of the client consistent with the Individual Spending Plan.

L. The licensee shall ensure that the client is provided opportunities to make choices regarding the client's own spending money.

M. The licensee shall not provide residential care or respite services to children in the adult developmental home.

N. The licensee shall provide care only for the number of clients and conditions listed on the license.

O. The licensee shall obtain approval from the Division before accepting placements from other agencies or private parties.

P. When the licensee also provides respite services, the licensee shall ensure that the respite placement is within the conditions stated on the license.

Q. The licensee shall not accept roomers or boarders without prior approval of the Division.

R. The licensee shall treat information concerning a client placed in the licensee's home and the client's family or guardian as confidential in accordance with A.R.S. § 36-568.

S. When the client is attending school, the licensee shall encourage and promote the educational development of the client by participating in the IEP meetings, unless otherwise specified by the Division, and by advocating for the implementation of the IEP.

T. The licensee shall participate in the ISPP meetings, shall carry out the tasks identified by the ISPP team as being the responsibility of the licensee, and shall advocate for the implementation of the ISPP.

U. The licensee shall cooperate with the Division when a client moves from the adult developmental home. The licensee shall:

1. Provide information including records of the client's medical and dental history, educational experience, and progress on ISPP activities.

2. Ensure personal belongings such as usable clothing, furniture, television sets, bicycles, the personal record, and other items purchased specifically for the client go with the client.

3. Assist the Division is preparing the client for the move.

V. The licensee shall assist the client in maintaining an inventory of the client's personal property such as furniture, bicycles, radios, television sets, and adaptive equipment.

W. The licensee shall comply with the terms of the Adult Developmental Home Agreement.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1107. Behavior Management

A. The licensee shall comply with the Division requirements for behavior management as specified in Article 9.

B. The licensee shall establish, with the client, house rules for sharing the living environment which are appropriate to the life experience and individuality of each client.

1. The licensee and the client shall develop and implement a fair and reasonable process for resolving disputes.

2. The licensee shall contact the Division is a dispute cannot be resolved.

3. The licensee shall not deprive the client of meals, shelter, or medical care.

4. The licensee shall not allow any form of corporal or physical punishment.

5. The licensee shall not allow the use of verbal abuse or derogatory remarks.

6. The licensee shall identify and report to the Division behavioral issues which may impact the health, safety, or training needs of the client.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1108. Sleeping Arrangements

The licensee shall provide appropriate, comfortable, safe, and private sleeping arrangements for each client.

1. Clients shall have their own beds and places to store clothing in the bedroom and a place for storing personal belongings.

2. The client's bedrooms shall not be unfinished rooms, hallways, or rooms which are normally used for other than sleeping arrangements by family members.

3. A client shall not share a bedroom with another person unless each person agrees to the arrangement and each client has a separate bed and space for storing clothing in the bedroom and a place for storing personal belongings.

4. A client shall not share a bedroom with a person of the opposite sex unless otherwise specified in the ISPP.

5. An adult client and a child shall not share a bedroom.

6. The licensee shall sleep within hearing distance of the client if indicated by the needs of the client.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1109. Notification Requirements

A. The licensee shall notify the Division of the following events:

1. Prior to building an addition to the home or structural remodeling of the home, or adding a swimming pool or spa, and shall cooperate with the Division in obtaining an Arizona Department of Health Services inspection as prescribed in A.R.S. § 8-504 for any home additions.

2. Changes in marital status or living arrangement of the licensee.

3. A plan to make a change in residence.

4. Known arrests, indictments, or convictions of any house hold member or of persons living on the premises.

5. Serious injury, major illness, illegal substance use or substance abuse, suicidal behavior, attempted suicide, or death of any household member. The Division may require the licensee to provide written documentation from a physician regarding the change in medical status.

6. Changes which may impact on the ability of the licensee to meet the needs of the client.

7. Notification shall be made to the Division prior to the addition of a household member.

8. A temporary visitor staying more than one month.

9. The licensee shall notify the Division prior to a change in primary caregiver or a person moving from the household who contributed to the care of the client.

B. For adults placed by the Division in the licensee's home, the licensee shall notify the Division of incidents including but not limited to:

1. Possible abuse or neglect as per A.R.S. § 13-3620 and R6-6-1601.

2. Hospitalizations, the intervention of a medical practitioner, or emergency medical care as a result of serious illness, injury, medication errors, or suicidal behavior.

3. Death of the client.

4. A client missing. A client missing must be reported to law enforcement officials and the Division as soon as the client is determined to be missing.

5. Theft of money or property.

6. Incidents which have involved or may potentially involve the police or media.

7. Significant damage to client property, licensee property, state property, or the property of others.

8. Illegal substance use or substance abuse.

C. The licensee shall obtain Division prior approval for alternative supervision plans.

1. The licensee shall involve the client in the development of alternative supervision plans.

2. The licensee shall ensure that alternative supervision is only provided by persons 18 years of age or older.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1110. Recordkeeping

A. The licensee shall maintain a record for each client of medical history, dental history, educational experiences, and progress on ISPP activities.

B. The licensee shall obtain and provide to the Division receipts for expenditures for the client as required by the Division.

C. The licensee shall assist the client in maintaining a personal record of mementos, photos, letters, cards, report cards, and special projects.

D. The licensee shall keep copies of all licenses, certificates, and correspondence in a separate file to document compliance with sanitation, health, and environmental codes of state and local authorities.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1111. Health and Safety Standards in an Adult Developmental Home

A. The licensee shall maintain the premises of the adult developmental home in a clean and sanitary condition to the degree that it does not present a health or safety hazard.

B. The adult developmental home shall not have an accumulation of litter, rubbish, or garbage on the premises. Litter, rubbish, and garbage shall be contained in cleanable containers with lids or sealed disposable containers and shall be removed from the property not less than once a week.

C. The licensee shall ensure that the adult developmental home is free from, or has an ongoing system to eradicate, insects, rodents, and other vermin.

D. Before initial licensure and every three years thereafter, the adult developmental home shall be inspected and meet the safety and sanitation guidelines of the Department of Health Services unless otherwise specified by the Division.

E. Adult developmental homes located in mobile homes shall pass an annual fire safety inspection as arranged by the Division.

F. The licensee shall keep toxic, poisonous, hazardous, and corrosive materials in locked storage unless otherwise specified in the ISPP of each client in the household.

G. The licensee shall keep medicines in separate locked storage unless otherwise specified in the ISPP of each client in the household.

H. The licensee shall keep firearms in locked storage and shall keep ammunition locked separately from the firearms.

I. Bedrooms shall have light, ventilation, and a usable and unobstructed exit to the outside in case of an emergency.

J. Telephone service or similar two-way communication methods shall be available in the home and shall be in working order.

K. Any permanent body of water shall be fenced and inaccessible to clients and shall meet the guidelines of the Department of Health Services unless otherwise specified by the Division.

L. The licensee shall not allow clients in swimming pool areas or in the area of other bodies of water unless supervised by a responsible adult or as specified in the ISPP.

M. The licensee shall store alcoholic beverages responsibly.

N. The licensee shall ensure that smoking of tobacco products does not occur while in an enclosed area with residents who do not smoke tobacco products.

O. The licensee shall make reasonable efforts to ensure family pets do not present a health or safety hazard to clients.

P. The licensee shall develop a fire evacuation plan and shall periodically practice the plan with the family members. The licensee shall update the fire evacuation plan as needed based on placement changes, household member changes, and structural changes to the adult developmental home.

Q. The licensee shall equip the adult developmental home with smoke detectors and fire extinguishers which are in good working order.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1112. Transportation

A. A licensee who transports clients shall have a current and valid driver's license and shall have liability insurance for any vehicle which will be used to transport clients. An Adult Developmental Home household member who transports clients must be 18 years of age or older and must be identified to the Division.

B. The licensee shall ensure that vehicles used for transporting clients are maintained in a safe operating condition.

C. The licensee shall ensure that clients wear seat belts or use an appropriate safety restraint while being transported.

D. A vehicle used to transport clients in wheelchairs shall also be equipped with floor-mounted seat belts and wheelchair lock-downs for each wheelchair being transported.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1113. Dual Licensure of Adult Developmental Homes

Adult Developmental Home providers licensed by another jurisdiction, such as a county or a state agency other than the Department, or licensed by a tribal authority but located off-reservation, shall be licensed by the Division before the Division places a client in the setting.

1. To be granted a license, the setting shall meet all requirements of this Article.

2. An Adult Developmental Home, licensed by another jurisdiction, seeking licensure by the Division shall sign a release of information to provide the Division access to the licensing files of the other jurisdiction.

3. An Adult Developmental Home licensed by another jurisdiction shall not be licensed by the Division to serve more than a total of three adults regardless of the placing agency.

4. The licensee shall not accept private placements or placements from other agencies or jurisdictions without prior approval of the Division.

5. The licensee shall notify the Division of any pre-placement conference with another agency or jurisdiction.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1114. Client Rights in Adult Developmental Homes

The licensee shall uphold and safeguard the rights of clients consistent with applicable federal and state laws, specifically including A.R.S. § 36-551.01, unless legally restricted or as addressed in the ISPP in accordance with Article 9. In addition to those rights specifically stated in statute, rights shall include, at a minimum:

1. The right to be provided choices and to express preferences which will be respected and accepted whenever appropriate and possible;

2. The right to be free from personal and financial exploitation;

3. The right to a safe, clean, and humane physical environment;

4. The right to own and have free access to personal property;

5. The right to associate with persons of the client's own choosing;

6. The right to participate in social, religious, educational, cultural, and community activities;

7. The right to manage personal financial affairs and to be taught to do so;

8. The right to the least amount of physical assistance necessary to accomplish a task;

9. The right to privacy, including during treatment and care of personal needs and with regard to written correspondence, telephone communications, and visitations;

10. The right to have care for personal needs provided, except in cases of emergency, by a caregiver of the gender chosen by the responsible person or as specified in the ISPP; and

11. The right to be treated with dignity and respect.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1115. Exemption

A license applicant or licensee may request from the Division an exemption of a rule contained in this Article. The request shall demonstrate that the intent of the rule will be met by alternate means and that the exemption will not endanger the lives or health of clients.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1116. Home Inspections and Monitoring

A. The licensee shall cooperate with the Division in assessing compliance with this Article.

B. The licensee shall allow the Division access to the setting for home inspections and monitoring visits and shall allow the Division access to records, reports, and vehicles used to transport clients.

C. Monitoring visits shall include, at a minimum:

1. An annual license renewal home visit; and

2. Two monitoring visits each year, at least one of which will be unannounced.

D. The licensee shall comply with corrective action plans as required by the Division.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1117. Complaints

A. Any person who has a complaint about an adult developmental home may make the complaint known verbally or in writing to the Department.

B. A complainant who has provided his name and address shall be notified that the complaint has been received and the notice shall indicate what investigative actions shall be taken.

C. The Department shall investigate complaints about adult developmental homes within ten calendar days of the receipt of the complaint and shall notify the licensee of the investigation. In a case where there is reason to believe that imminent danger exists, the investigation shall be conducted immediately and the licensee shall be notified.

D. The name or identifying characteristics of the complainant shall not be disclosed unless the complainant consents in writing to the disclosure or investigation of the complaint results in a legal proceeding and disclosure is ordered by an appropriate authority.

E. The Department shall notify the licensee of the results of an investigation conducted pursuant to this rule and the requirement for any corrective action that the Department deems necessary.

F. The licensee shall cooperate with the Division in completing investigations into complaints or concerns regarding the licensee and regarding clients placed in the home.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1118. Denial, Suspension, and Revocation of Adult Developmental Home Licenses

A. The Division may deny, suspend, or revoke a license for violations of A.R.S. § 36-594.

B. The Division may deny or revoke a license if a license applicant or licensee has been arrested for, convicted of, charged with, or pled no contest to any of the following criminal acts:

1. Sexual abuse of a child or vulnerable adult,

2. Incest,

3. First- or second-degree murder,

4. Kidnapping,

5. Arson,

6. Sexual assault,

7. Sexual exploitation of a child or vulnerable adult,

8. Commercial sexual exploitation of a child or vulnerable adult,

9. Felony offenses within the previous ten years involving the manufacture or distribution of marijuana or dangerous or narcotic drugs,

10. Robbery,

11. Child prostitution as defined in A.R.S. § 13-3206,

12. Child abuse or abuse of a vulnerable adult,

13. Sexual conduct with a child,

14. Molestation of a child or vulnerable adult,

15. Voluntary manslaughter, or

16. Aggravated assault.

C. Upon notification that a member of the household or person living on the premises of an Adult Developmental Home is found to have been arrested for, convicted of, charged with, or pled no contest to any of the criminal acts listed in subsection (B), the licensee shall immediately take the following actions:

1. Remove the person from direct contact with children;

2. Notify the Division, unless the licensee initially received notice from the Division.

D. If a licensee fails to comply with subsection (C), the Division shall revoke or suspend the license.

E. If the criminal record check indicates that an individual has been convicted of or found by a court to have committed, or is reasonably believed to have committed, offenses pursuant to A.R.S. § 36-594, other than those listed in subsection (B), the Division shall consider the following factors when determining what corrective action to take against the licensee:

1. The extent of the individual's criminal record;

2. Length of time since the commission of the offense;

3. Nature of the offense;

4. Mitigating circumstances surrounding commission of the offense. The burden is on the person to demonstrate that there were mitigating circumstances;

5. The degree of the person's participation in the offense. The burden is on the person to demonstrate that the involvement was not direct; and

6. The extent of the person's rehabilitation, including but not limited to:

a. The person shall prove that probation has been completed and complete restitution or compensation for the offense has been made, and

b. Evidence of positive action to change criminal behavior, such as completion of a drug treatment program or counseling.

7. Personal references attesting to the person's rehabilitation.

F. When an application for a license is denied, or a license is suspended or revoked, pursuant to A.R.S. § 36-594, the Division shall deliver a written notice of the action in person or send a written notice of the action by certified mail to the license applicant or licensee. The notice shall state the reasons for the denial, suspension, or revocation with reference to applicable statutes and rules.

G. If the reason for denial, suspension, or revocation of a license involves the health, welfare, or safety of clients, the clients shall be immediately removed from the Adult Developmental Home.

H. When a license is denied, suspended, or revoked, the license applicant or licensee has the right to appeal the decision pursuant to Article 20.

I. The Division may suspend an Adult Developmental Home license for:

1. Up to six months during an investigation or while the licensee completes a corrective action plan.

2. Up to 12 months due to the temporary inability of the licensee to provide services.

J. No child can be placed in the adult developmental home during a suspended-license status.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

R6-6-1119. Appeals

A. When an application for a license is denied, or a license is suspended or revoked, the Division shall notify the license applicant or licensee of the right of appeal pursuant to R6-6-2001 et seq. (Appeals and Hearings), except that appeals from the decision of a hearing officer shall be in accordance with A.R.S. § 41-1992 (Hearing Officers Powers and Duties).

B. If the license applicant or licensee appeals a licensing decision, the denial, suspension, or revocation of the license shall not become final until the appeal decision is rendered.

C. If the adults placed by the Division have been removed from the home because of a health, welfare, or safety issue, they shall remain out of the home while the appeal is pending.

Historical Note

Adopted effective August 30, 1994, under an exemption from the provisions of A.R.S. Title 41, Chapter 6
(Supp. 94-3).

ARTICLE 12. COST OF CARE PORTION

Correction: See Historical Notes, R6-6-1201 through R6-6-1204, correction to Emergency Certification effective August 12, 1981 (Supp. 83-1).

R6-6-1201. Cost of Care Portion for Services

A. This Article prescribes the cost of care contribution requirements for clients, parents of minor clients, and trusts, estates, and annuities of which the client is a beneficiary. This Article applies to:

1. Non-ALTCS clients receiving any services;

2. ALTCS clients receiving residential services from the Division.

B. The Division may include all services provided in calculating the cost of care for a non-ALTCS client.

Historical Note

Adopted as an emergency effective October 31, 1978, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 78-5). New Section R6-6-1201 adopted effective July 9, 1979 (Supp. 79-4). Repealed as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-4). Former Section R6-6-1201 repealed, new Section R6-6-1201 adopted as an emergency effective November 16, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-6). Former Section R6-6-1201 repealed, new Section R6-6-1201 adopted as an emergency effective November 16, 1981 now adopted and amended as a permanent rule effective February 17, 1982 (Supp. 82-1). Correction to emergency effective August 12, 1981, should read: Former Section R6-6-1201 repealed, new Section R6-6-1201 adopted as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 83-1). Section repealed, new Section adopted effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended under an exemption from A.R.S. Title 41, Chapter 6, effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4).

R6-6-1202. Determination of the Cost of Care Portion for Services

A. The Cost of Care Portion Table (Appendix A) shows the percentage of the cost of services that a client is responsible for paying.

B. The Cost of Care Portion Table (Appendix A) also shows the percentage of the cost of services that the parent of a minor client is responsible for paying.

1. If the parents of a client are not married to each other, the Division determines the cost of care portion based on the custodial parent's income.

2. If the parent is married to an individual who is not legally responsible for the client, the Division determines the parent's cost of care portion using the community income, plus any sole and separate income of the parent.

3. If a parent has more than one minor client receiving services from the Division, the parent's cost of care portion shall not exceed the maximum amount the parent would be required to pay for the minor client receiving the most expensive services.

Historical Note

Adopted as an emergency effective October 31, 1978, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 78-5). New Section R6-6-1202 adopted effective July 9, 1979 (Supp. 79-4). Repealed as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-4). Former Section R6-6-1202 repealed, new Section R6-6-1202 adopted as an emergency effective November 16, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-6). Former Section R6-6-1202 repealed, new Section R6-6-1202 adopted as an emergency effective November 16, 1981 now adopted and amended as a permanent rule effective February 17, 1982 (Supp. 82-1). Correction to emergency effective August 12, 1981, should read: Former Section R6-6-1202 repealed, new Section R6-6-1202 adopted as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 83-1). Section repealed, new Section adopted effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended under an exemption from A.R.S. Title 41, Chapter 6, effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4).

R6-6-1203. Determination of the Cost of Care for Services for a Client who is the Beneficiary of an Estate, Trust, or Annuity

A. For a client who is the beneficiary of an estate, trust, or annuity, the cost of care for services is the actual cost of all services and programs provided by the Division until the client meets the financial eligibility requirements for federal social security supplemental income benefits or the financial eligibility requirements for the Arizona Long-term Care System.

B. The responsible party shall pay the client's cost of care.

C. When billing a trust, the Division is not limited to the trust income, but shall also bill the trust corpus.

Historical Note

Adopted as an emergency effective October 31, 1978, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 78-5). New Section R6-6-1203 adopted effective July 9, 1979 (Supp. 79-4). Repealed as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-4). Former Section R6-6-1203 repealed, new Section R6-6-1203 adopted as an emergency effective November 16, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-6). Former Section R6-6-1203 repealed, new Section R6-6-1203 adopted as an emergency effective November 16, 1981 now adopted and amended as a permanent rule effective February 17, 1982 (Supp. 82-1). Correction to emergency effective August 12, 1981, should read: Former Section R6-6-1203 repealed, new Section R6-6-1203 adopted as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 83-1). Section repealed, new Section adopted effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Amended under an exemption from A.R.S. Title 41, Chapter 6, effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4).

R6-6-1204. Special Provisions for Cost of Care Portion from Clients Receiving Residential Services

A. The cost of care portion for a client receiving residential services is based on the amount of benefits the client receives, including Social Security, Veteran's, and Railroad Retirement benefits.

B. The client shall keep either 30% or $50 of the client's monthly benefits, whichever is greater, until the client's personal savings reach the maximum amount allowed by the federal agency providing the benefits, before federal benefits are cut off.

C. When a client reaches the maximum allowable limit of personal savings as described in subsection (A) the client's monthly cost of care portion is the actual cost of residential services until the client's personal savings drop below the maximum allowable limit.

D. If a client receives a retroactive benefit payment, the client shall retain the greater of either 30% of the total amount of the retroactive payments or the maximum amount allowed by the benefit source before federal benefits are cut off. The client shall pay the rest of the retroactive benefit payments, up to the actual cost of the client's residential services, to the Division to cover the months of placement in residential services for which the benefits are being paid.

E. If a client receiving residential services uses the client's own income to pay either all or part of the rent, food, or utilities, the Division shall reduce the cost of care for the client by the documented amount the client pays for these items.

Historical Note

Adopted as an emergency effective October 31, 1978, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 78-5). New Section R6-6-1204 adopted effective July 9, 1979 (Supp. 79-4). Repealed as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-4). Former Section R6-6-1204 repealed, new Section R6-6-12-04 adopted as an emergency effective November 16, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 81-6). Former Section R6-6-1204 repealed, new Section R6-6-1204 adopted as an emergency effective November 16, 1981 now adopted and amended as a permanent rule effective February 17, 1982 (Supp. 82-1). Correction to emergency effective August 12, 1981, should read: Former Section R6-6-1204 repealed, new Section R6-6-1204 adopted as an emergency effective August 12, 1981, pursuant to A.R.S. § 41-1003, valid for only 90 days (Supp. 83-1). Former Section R6-6-1204 renumbered to R6-6-1206, new Section R6-6-1204 adopted effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Former Section R6-6-1204 repealed, new Section renumbered from R6-6-1205 and amended under an exemption from A.R.S. Title 41, Chapter 6 effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4).

R6-6-1205. Billing for the Cost of Care Portion

A. Each year, prior to July 1, the Division shall send a financial information form to each responsible party.

B. The responsible party shall return the financial information form to the Division within 30 days of the date of the request.

C. The responsible party shall provide the following information on the financial information form:

1. Client name;

2. Parent or responsible party name;

3. Parent or responsible party address;

4. Declaration of income from the prior year federal tax return;

5. Declaration of the assets of the client's estate, including any amount held in trust or in an annuity for the benefit of the client; and

6. Date and signature of the individual filling out the form.

D. The responsible party shall provide documentation that fully discloses the assets of the client's estate and a copy of the prior year federal tax return.

E. If the responsible party does not return the financial information form, the Division shall charge 100% of the cost of care. If a change occurs in financial circumstances or family size during any year, the responsible party shall contact the Division to amend the financial statement.

F. The Division shall determine the cost of care portion based on the cost of care and the financial information submitted by the responsible party.

G. Along with the monthly billing, the Division shall provide the responsible party with the information used to determine the cost of care for the client.

H. If the Division does not receive the required cost of care portion for two consecutive months, the Office of Accounts Receivable and Collections shall send a delinquent notice to the responsible party. If the responsible party fails to make the overdue payment within 30 days after the date of the delinquent notice, the Office of Accounts Receivable and Collections may take further action to collect, including requesting a change in the representative payee for benefits or referring the case to the Office of the Attorney General.

I. The Division reserves the right to terminate services to a client for nonpayment.

Historical Note

Adopted effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Former Section R6-6-1205 repealed, new Section renumbered from R6-6-1206 and amended under an exemption from A.R.S. Title 41, Chapter 6 effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4).

R6-6-1206. Review and Appeal

A. If a responsible party wants a review of the decision for the cost of care portion, the responsible party shall request the review, either orally or in writing, within 10 business days of the date on the billing statement to the Assistant Director, Division of Developmental Disabilities.

B. A responsible party who contests the cost of care portion assessed according to this Article may request a fiscal administrative review pursuant to R6-6-1801 et seq. The responsible party may file a formal appeal as described in R6-6-2001 et seq. after exhausting the fiscal administrative review.

Historical Note

Section R6-6-1206 renumbered from R6-6-1204 and amended effective September 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3). Former Section R6-6-1206 renumbered to R6-5-1205, new Section adopted effective December 1, 1996; filed in the Office of the Secretary of State November 22, 1996 (Supp. 96-4). Amended by exempt rulemaking at 10 A.A.R. 205, effective January 1, 2004 (Supp. 03-4).

Appendix A. Cost of Care Portion Table

DIVISION OF DEVELOPMENTAL DISABILITIES
COST OF CARE PORTION TABLE

Income based on 200% of federal poverty guidelines issued February 17, 2003

To determine amount to pay:

1. Find family size, include any children out of the home that are receiving Division services.

2. Find Monthly Family Income (round to the nearest whole dollar).

3. Move down the correct family size column to the cell that contains the range corresponding to the monthly family income.

4. From that cell, move to the far left to the percent pay column.

5. The percent is the percent you are required to pay monthly for the services your family/child received.

6. The payment amount shall not exceed the cost of services provided.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Section repealed, new Section R6-6-1301 renumbered from R6-6-1302 effective September, 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-1302. Assignment of Rights to Benefits

A. As a condition of eligibility, each applicant shall assign to the Division rights to health insurance payments applicable to the person to receive services and agree to cooperate with the Division in obtaining medical support and insurance payments pursuant to A.R.S. § 36-596.

B. If the responsible person refuses to assign health insurance benefits to the Division, the Division shall deny or terminate eligibility for the client.

C. If the policy holder is someone other than the responsible person and refuses to cooperate with the requirements of this Article, the Division may deny or terminate eligibility for the client.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-1302 renumbered to Section R6-6-1301, new Section R6-6-1302 renumbered from R6-6-1303 effective September, 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-1303. Collections of Health Insurance

A. Service providers shall identify and pursue collections of reimbursement from all probable sources of third-party liability.

B. Service providers shall identify and notify the Division of any and all changes in health insurance information for clients.

C. The Division is the payor of last resort for DD/non-ALTCS Division-covered services, unless specifically prohibited by law. Service providers shall submit all claims covered by health insurance to the insurer prior to submitting a claim for payment to the Division.

D. When submitting a claim for payment to the Division, service providers shall include a copy of the explanation of benefits from the health insurer. The Division shall not pay for covered services if the client has insurance coverage which will pay for the service.

E. If a responsible person receives an insurance or benefit payment for a service provided through the Division, the amount received as payment is immediately due and payable to the Division. If the amount is not paid, the Division shall terminate eligibility.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-1303 renumbered to Section R6-6-1302, new Section R6-6-1303 renumbered from R6-6-1304 and amended effective September, 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-1304. Monitoring and Compliance

The Division shall monitor third-party payments made to service providers. The Division shall determine whether a service provider is in compliance with the requirements set forth in this Article by inspecting documents to assess:

1. Verifiability and reliability;

2. Appropriateness of recovery attempt;

3. Timeliness of billing;

4. Accounting for reimbursements;

5. Auditing of receipts;

6. Provision of claim and explanation of benefits to the Division;

7. Auditing of receipts;

8. Other monitoring which the Division deems reasonably necessary to ensure compliance.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-1304 renumbered to Section R6-6-1303, new Section R6-6-1304 renumbered from R6-6-1305 and amended effective September, 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-1305. Notification of Liens

A. When a service provider renders service to a client, the service provider shall notify the Division with the information listed in R6-6-1305(B) not later than five days after rendering such service for an injury or condition for which a third party may be liable.

B. The service provider shall send the Division the following information:

1. Name of service provider;

2. Address of service provider;

3. Name of client;

4. Client's social security or Division identification number;

5. Address of the responsible person;

6. Date of client's injury or accident;

7. Amount due for care of client;

8. Name of the county in which injuries were sustained; and

9. Names and addresses of all persons, firms or corporations and their insurance carriers which the responsible person asserts may be liable for damages.

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-1305 renumbered to Section R6-6-1304, new Section R6-6-1305 renumbered from R6-6-1306 and amended effective September, 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

R6-6-1306. Renumbered

Historical Note

Adopted effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). Former Section R6-6-1306 renumbered to Section R6-6-1305 effective September, 30, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-3).

ARTICLE 14. GUARDIANSHIP AND CONSERVATORSHIP

R6-6-1401. Guardianship

A. The Department shall evaluate the need for, and extent of, guardianship and conservatorship for each recipient at least annually.

B. If the appointment of a guardian or conservator is required for a Native American Indian recipient who is a member of an Indian Tribe and who has significant contacts with that tribe but who is not an Indian child within the scope of 25 U.S.C.1901 et seq., the appointment of a guardian or conservator shall first be requested through the appropriate tribal court, if any, unless the request through the tribal courts is not in the recipient's best interests.

Historical Note

Adopted effective January 13, 1981 (Supp. 81-1).

ARTICLE 15. STANDARDS FOR CERTIFICATION OF HOME AND COMMUNITY-BASED SERVICE (HCBS) PROVIDERS

Editor's Note: Article 15, consisting of Sections R6-6-1501 and R6-6-1502, was repealed under an exemption from the provisions of A.R.S. Title 41, Chapter 6, pursuant to Laws 1992, Ch. 355, § 9. A new Article 15 was subsequently adopted under the regular rulemaking process.

R6-6-1501. Definitions

The following definitions apply in this Article:

1. "AHCCCS provider type" means the descriptive category of service types assigned to a provider by AHCCCS during the registration process for individuals or agencies providing services to ALTCS clients.

2. "Applicant" means an agency or individual that has applied to the Division to become certified or to renew a certificate as an HCBS service provider.

3. "Certified instructor" means an individual who has a current certificate to provide instruction for CPR, First Aid, or client intervention techniques.

4. "Client intervention techniques" means methods which provide an individual with defensive skills for dealing with aggressive behaviors and is designed to reduce the chance of physical injury and property destruction and to prevent reinforcement of those aggressive behaviors.

5. "Compliance audit" means an examination of service provider records and interviews which the Division conducts to assess compliance with HCBS certification.

6. "Corrective action plan" means a specific activity prescribed by the Division which directs the service provider to remedy violations of HCBS certification requirements within a specific period of time.

7. "Direct services" means services provided specifically for the benefit of an individual client.

8. "Direct care" means those services provided to a client which result in attention to personal needs and supervision of the client.

9. "HCBS" or "Home and Community-based Services" means one or more of the following services provided to clients:

a. Attendant Care,

b. Day Treatment and Training for Children or Adults,

c. Habilitation,

d. Home Health Aide,

e. Home Health Nurse,

f. Hospice Care,

g. Housekeeping-Chore/Homemaker,

h. Non-Emergency Transportation,

i. Occupational Therapy,

j. Personal Care,

k. Physical Therapy,

l. Respiratory Therapy,

m. Respite services,

n. Speech/Hearing Therapy,

o. Supported Employment,

p. Other comparable services as approved by the AHCCCS Director.

10. "HCBS certificate" means the document the Division issues to a service provider or applicant as evidence the service provider has met the Home and Community-based Service standards in this Article.

11. "HCBS certification" means the process by which the Division ensures that an applicant or service provider meets the standards in this Article for Home and Community-based Services.

12. "Housekeeping" means providing assistance in the performance of activities related to routine household maintenance at a client's residence but does not include any direct care for the client.

13. "Immediate relative" means natural parent, stepparent, adoptive parent, natural child, natural sibling, adoptive child, adoptive sibling, stepchild, stepbrother, stepsister, spouse, father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, or sister-in-law.

14. "Medicare certified" means having received Medicare certification through the Arizona Department of Health Services.

Historical Note

Adopted effective May 12, 1982 (Supp. 82-3). Section R6-6-1501 repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). New Section adopted effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4).

R6-6-1502. Applicability

This Article applies to an individual or agency that provides or wishes to provide Home and Community-based Services to clients.

Historical Note

Adopted effective May 12, 1982 (Supp. 82-3). Section R6-6-1501 repealed effective June 7, 1993, under an exemption from A.R.S. Title 41, Chapter 6 (Supp. 93-2). New Section adopted effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4).

R6-6-1503. Requirement for an HCBS Certificate

A. No individual shall provide Home and Community-based Services to clients unless the Division has certified the individual in accordance with this Article and, if providing services through ALTCS, registered the applicant with AHCCCS.

B. The Division shall register the applicant with AHCCCS, if required, as part of HCBS certification.

Historical Note

Adopted effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4).

R6-6-1504. Application for an Initial HCBS Certificate

A. To become certified to provide a Home and Community-based Service to a client, an applicant shall file an application for an HCBS certificate with the Division and meet the requirements of this Article.

B. The applicant shall complete application for an initial HCBS certificate on a form prescribed by the Division. The form shall contain the following information:

1. Name,

2. Home and business address,

3. Specific services for which application is made,

4. Phone number,

5. Social security number or tax identification number,

6. Self declaration regarding criminal history of offenses listed in R6-6-1514(B),

7. Description of work experience, and

8. Description of educational background.

C. The applicant shall provide a copy of any other license or certificate required by this Article to provide a specific service.

D. Except as provided by R6-6-1521, the applicant shall provide forms for three letters of reference to individuals who are not the applicant's family members and who have personal knowledge about the applicant's employment history, education, or character. The letters will be on forms provided by the Division. The individual giving the reference shall send the completed reference form to the Division.

E. The Division shall be in receipt of a completed application and three letters of reference before considering certification of the applicant.

F. The applicant shall provide the Division with written documentation signed by the person performing the inspection of the completion of the requirements of R6-6-1505.

G. Within 60 days of receipt of an application, the Division shall notify the applicant of any missing documents or information. The Division shall allow 30 days from the date of notification to the applicant for submission of the remaining documents or information and, if not received at that time, may close the record.

H. The Division shall conduct background checks with Child Protective Services and Adult Protective Services on applicants when information in the application indicates a past history of child or elder abuse. The Division shall utilize the background check information when determining whether to certify an applicant.

Historical Note

Adopted effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4).

R6-6-1504.01. Time-Frame for Granting or Denying an HCBS certificate

For the purpose of A.R.S. § 41-1073, the Division establishes the following HCBS certificate time-frames:

1. Administrative completeness review time-frame:

a. For an initial certificate, 60 days;

b. For a renewal certificate, 25 days; and

c. For an amended certificate, 25 days.

2. Substantive review time-frame:

a. For an initial certificate, 60 days;

b. For a renewal certificate, 5 days; and

c. For an amended certificate, 5 days.

3. Overall time-frame:

a. For an initial certificate, 120 days;

b. For a renewal certificate, 30 days; and

c. For an amended certificate, 30 days.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1504.02. Administrative Completeness and Substantive Review Process

A. The Division shall send the applicant a written notice within the administrative completeness review time-frame indicating that the application package is either complete or incomplete.

B. If the application package is incomplete, the Division shall list the missing information in the notice and ask the applicant to supply the missing information within 30 days from the date of notice. If the applicant fails to do so, the Division may close the file.

C. An applicant whose file has been closed and who later wishes to become certified may reapply to the Division. The administrative completeness time-frame starts over when the Division receives the written request to reapply.

D. When the application is complete, the Division shall complete a substantive review of the applicant's qualification. The Division shall:

1. Review the application form and all required documents to ensure compliance with this Article,

2. Conduct CPS/APS background checks, and

3. Verify previous licensure or certification.

E. If an HCBS certificate is denied, the Division shall send a notice to the applicant and include the following information:

1. The reason for the denial with citation to supporting statutes or rules,

2. The applicant's right to appeal the denial, and

3. The time periods for appealing the denial.

F. An applicant shall submit an HCBS certificate application package to DES/DDD, P.O. Box 6123, Site Code 791A, Phoenix, Arizona 85005-6123, Attention: HCBS Certification Unit.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1504.03. Contents of a Complete Application Package - Initial Certificate

An initial application package is complete when the Division has all of the following information:

1. From the applicant, a completed application form as prescribed in R6-6-1504 (B); and

2. From the applicant, the following documents listed on the application form:

a. A completed AHCCCS provider participation agreement form as prescribed in R6-6-1503 which contains the following information:

i. The applicant's name, social security number or tax identification number, and business address;

ii. Terms of the agreement between the provider and AHCCCS; and

iii. Signature of the applicant.

b. A completed declaration of criminal history as prescribed in R6-6-1504(B)(6) on a Division form which contains the following information:

i. Name of the applicant,

ii. Social security number,

iii. Date of birth,

iv. Applicant address,

v. A declaration of whether or not the applicant has committed any of the crimes listed in R6-6-1514, and

vi. Dated signature.

c. Documentation showing that fingerprints have been taken as prescribed in R6-6-1506;

d. Documentation showing current CPR training as prescribed in R6-6-1520;

e. Documentation showing current First Aid training as prescribed in R6-6-1520;

f. Documentation showing Article 9 review as prescribed in R6-6-1520;

g. Documentation showing that the applicant has a current driver's license, vehicle registration, and liability insurance as prescribed in R6-6-1520(D);

h. Copies of any applicable professional license or certification as prescribed in R6-6-1504(C); and

i. AHCCCS provider registration form as prescribed in R6-6-1503 which contains the following information:

i. Name, social security number, and Federal Employer Identification (FEI) number of the applicant;

ii. Physical and mailing address of the applicant;

iii. Telephone number and telefacsimile number, if applicable for the applicant;

iv. Categories of service provided;

v. Changes from the prior year, if necessary;

vi. AHCCCS provider identification number;

vii. Districts and counties served;

viii. Place and date of birth; and

ix. Dated signature.

3. From sources other than the applicant, the documents listed on the application form as follows:

a. Three letters of reference as prescribed in R6-6-1504(D), and

b. Documentation showing that the applicant's home or office has passed:

i. A fire inspection as prescribed in R6-6-1505, and

ii. A health and safety inspection as prescribed in R6-6-1505.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1504.04. Contents of a Complete Application Package - Renewal Certificate

A renewal application is complete when the Division has all the following information:

1. From the applicant, the following items:

a. AHCCCS provider registration form;

b. Documentation of current CPR and First Aid training, current driver's license, and applicable professional licenses and certifications, if prior documentation has expired;

c. A completed declaration of criminal history every three years since the date of initial certification; and

d. Documentation that fingerprints have been taken at three-year intervals.

2. From sources other than the applicant, documentation that the applicant's home or office has passed a fire inspection every two years since the date of initial certification.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1504.05. Contents of a Complete Request for an Amended Certificate

A request for an amended HCBS certificate is complete when the Division has the following information:

1. AHCCCS provider registration form, and

2. Documentation to support the requested change.

Historical Note

Adopted effective February 1, 1998 (Supp. 98-1).

R6-6-1505. Setting Requirements for HCBS Service Providers

A. Except as provided by R6-6-1521, the applicant shall cooperate with an initial health and safety inspection by ensuring the residence or facility which the applicant owns, rents, or leases, and in which the services are to be provided, if other than the client's home is fully accessible to an inspector approved by the Division. The health and safety inspection focuses on such areas as general appearance and cleanliness of the residence or facility, heating and cooling, ventilation, lighting, safety hazards, swimming pools, yard, and the storage of toxic materials and medicines.

B. Except as provided by R6-6-1521, the applicant shall have a fire department or individual approved by the Division perform a fire inspection at the time of initial application and every two years after, on each residence or facility which the applicant owns, rents, or leases, and in which services are to be provided, unless the services are provided in the client's home. The applicant shall maintain the results of the fire inspection on file.

Historical Note

Adopted effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4).

R6-6-1506. Fingerprinting Requirements

A. Except as otherwise provided by R6-6-1521, each applicant shall be fingerprinted by:

1. Filing a request with the Department on a form prescribed by the Department and paying the applicable fees; or

2. Filing a request with an agency authorized by state or federal statute to obtain fingerprints, paying the applicable fees, and having the fingerprints forwarded to the Department of Economic Security's Office of Special Investigations, located in Phoenix, Arizona.

B. Except as otherwise provided by R6-6-1521, the following individuals shall be fingerprinted for a criminal record check at the time of initial application or initial employment, and every three years from the date of clearance, thereafter:

1. All applicants, including individuals and agency administrators;

2. Direct-care staff;

3. Supervisors of direct-care staff; and

4. All individuals age 18 and above who reside in the home when services are to be delivered in the applicant or service provider's home.

C. Each applicant who has been fingerprinted shall maintain a file which includes:

1. A clearance letter from the Department dated within six months of the date the fingerprints were taken; or

2. A copy of a letter sent by the service provider to the Division stating that the clearance letter was not received within the required six months.

Historical Note

Adopted effective February 1, 1996; filed in the Office of the Secretary of State December 26, 1995 (Supp. 95-4).

R6-6-1507. Application for an HCBS Certificate Renewal

A. The Division shall send a notice of renewal to the service provider 60 days prior to the expiration of the HCBS certificate.

B. Not more than 30 days and not less than 10 days prior to the expiration date of a current HCBS certificate, an applicant shall apply to the Division for renewal on a form provided and prescribed by the Division. The form shall contain the following information:

1. Name;

2. Home and business address;

3. Social security number or tax identification number;

4. AHCCCS registration number;

5. Phone number; and