††††† 902 KAR 4:120. Health Access Nurturing Development Services (HANDS) Program.
††††† RELATES TO: KRS 194A.030(4), 211.690
††††† STATUTORY AUTHORITY: KRS 194A.050(1)
††††† NECESSITY, FUNCTION, AND CONFORMITY: KRS 211.690 authorizes the Cabinet for Health Services to implement a voluntary statewide home visitation program for the purpose of providing assistance to at-risk parents during the prenatal period until the childís third birthday. This administrative regulation establishes the eligibility criteria, services, provider qualifications, and hearing rights for participants of the Health Access Nurturing Development Services (HANDS) Program.
††††† Section 1. Definitions. (1) "HANDS" means Health Access Nurturing Development Services, a voluntary statewide home visitation program, for the purpose of providing assistance to at-risk parents during the prenatal period and until the childís third birthday.
††††† (2) "Authority" means the Early Childhood Development Authority as established in KRS 200.700.
††††† (3) "Provider" means a local agency subscribing to staff and training requirements, program model and reporting requirements of the HANDS Program and agreeing to participate as a HANDS provider.
††††† (4) "Program model" means a model of home visitation that meets the twelve (12) critical elements of home visitation.
††††† (5) "Participant" means an individual who meets the criteria established in Section 2 of this administrative regulation.
††††† (6) "Standardized assessment tool" means the program adopted tool to determine the level of need of the pregnant woman or parent.
††††† (7) "Department" means the Department for Public Health or its designated representative.
††††† (8) "Home visitor" or "family support worker" or "FSW" means a:
††††† (a) High school graduate or holder of a GED who:
††††† 1. Is at least eighteen (18) years of age;
††††† 2. Has received training in:
††††† a. Ongoing assessment of family strengths and needs;
††††† b. Service plan development;
††††† c. Home visiting;
††††† d. Coordination of services; and
††††† e. Evaluation; and
††††† 3. Is supervised by a public health nurse or licensed social worker;
††††† (b) Public health nurse who has a valid Kentucky Board of Nursing license as a registered nurse or advanced registered nurse practitioner; or
††††† (c)1. Licensed social worker who meets the requirements for licensure by the State Board of Examiners of Social Work;
††††† 2. An individual with a masters degree in social work;
††††† 3. A social worker with a bachelorís degree in social work from an accredited institution;
††††† (d) A graduate of a four (4) year program in a social or behavioral science or a related field with one (1) year experience performing case management services, except that a masterís degree in a human services field may be substituted for the one (1) year experience; or
††††† (e) An associate degree in an early childhood education field and home visitation model training.
††††† Section 2. Eligibility Criteria. (1) In order to receive a service established in Section 4 of this administrative regulation, an individual shall be:
††††† (a) A pregnant woman who has not reached her 20th birthday and who will be a first-time parent;
††††† (b) A pregnant woman who is at least twenty (20) years old, will be a first-time parent and a risk is deemed likely for the pregnancy or the infant;
††††† (c) An infant or toddler, up to his third birthday, of an individual identified in paragraph (a) or (b) of this subsection;
††††† (d) A firstborn up to twelve (12) weeks of age whose family is determined to be at risk; or
††††† (e) A first-time father or guardian of a child identified in paragraph (c) or (d) of this subsection.
††††† (2) Participation in the HANDS Program shall be voluntary.
††††† (3) Participation in the HANDS Program shall be terminated if one (1) of the following occurs:
††††† (a) Death of the fetus;
††††† (b) The family elects to withdraw from the program;
††††† (c) The family moves out of state;
††††† (d) Contact with the family is lost;
††††† (e) The family repeatedly fails to participate in program activities;
††††† (f) Death of the infant; or
††††† (g) The goals established for the family are met.
††††† Section 3. Provider Qualifications. (1) A HANDS service shall be provided by a local health department or a subcontractor.
††††† (2) A local health department shall meet the requirements to provide HANDS services if:
††††† (a) Its staff or contractor receives training provided by the department;
††††† (b) It assures that appropriate staff meet the licensure requirements of the department pursuant to Section 1(8)(b) or (c) of this administrative regulation;
††††† (c) It assures supervision by licensed personnel pursuant to Section 1(8)(b) and (c) of this administrative regulation;
††††† (d) It reports program data on a schedule as directed by the department; and
††††† (e) It meets the twelve (12) critical elements of home visitation programs.
††††† Section 4. Services: The HANDS Program shall consist of the following services:
††††† (1) Screening. A screening shall include the following components:
††††† (a) Using the standardized screening tool, a provider shall determine eligibility of an applicant by:
††††† 1. Face-to-face interview; or
††††† 2. Evaluation of health records.
††††† (b) If an individualís screening indicates eligibility for additional HANDS services, the individual shall be referred for an assessment to a social worker or a registered nurse, employed directly or contracted by the department; and
††††† (c) If an individualís screening indicates ineligibility for additional HANDS services, the individual shall be provided with community resource and referral information;
††††† (2) Assessment.
††††† (a) An assessment shall consist of the following components:
††††† 1. A comprehensive needs assessment, obtained by conducting a face-to-face interview with the child, mother, and family, to include information regarding the parentís:
††††† a. Childhood experience;
††††† b. Lifestyle behaviors and mental health;
††††† c. Experience and expectations for parenting;
††††† d. Coping skills;
††††† e. Support system;
††††† f. Stress and anger management skills;
††††† g. Expectations of the infantís developmental milestones and behaviors;
††††† h. Plans for the childís discipline;
††††† i. Perception of the new infant; and
††††† j. Bonding and attachment to the infant.
††††† 2. Arrangement for delivery of needed services, as determined by the assessment;
††††† (b) An assessment shall be conducted by:
††††† 1. A social worker;
††††† 2. A registered nurse;
††††† 3. A graduate of a four (4) year program in a social or behavioral science or a related field with one (1) year experience performing case management services, except that a masterís degree in a human services field may be substituted for the one (1) year experience; or
††††† 4. An associate degree in an early childhood education field and home visitation model training.
††††† (c) If an assessment of an individual results in a determination that the individual meets one (1) of the criteria in Section 2(3) of this administrative regulation, home visitation services established in subsection (3) of this section shall not be provided.
††††† (3) Home visitation may take place in the clientís home or another community site if justified in the record. A home visitation shall include the following:
††††† (a) Monitoring of the childís, motherís, and familyís progress by:
††††† 1. Making referrals to community resources;
††††† 2. Tracking appointments to ensure they are being kept;
††††† 3. Performing follow-up services as identified by the provider; and
††††† 4. Performing periodic evaluations of the participantís changing needs;
††††† (b) The preparation and maintenance of case records which shall be documented with contacts, services needed, reports, and progress;
††††† (c) Consultations; and
††††† (d) Crisis assistance.
††††† (4) Service frequency shall be provided in accordance with the level of need of the parent or family.
††††† (5) The frequency of visitation shall be lessened as the family meets goals agreed to by the provider and the participant.
††††† (6) Between the second and third birthday, home visitation services shall be limited to a child whose family does not progress beyond Level I of the assessment tool.
††††† Section 5. Appeal Rights. (1) A provider shall notify an individual who does not meet criteria for admission or continuation in the program or who has had a service discontinued, in writing, within ten (10) days of the denial or discontinuance.
††††† (2) An individual wishing to appeal an adverse action by the agency shall notify the department, within thirty (30) days of the date of the notice identified in subsection (1) of this section that he requests a hearing.
††††† (3) Notice of an administrative hearing shall be provided in accordance with KRS 13B.050.
††††† (4) The administrative hearing process shall be conducted in accordance with KRS 13B.080 through 13B.160.
††††† Section 6. Incorporation by Reference. (1) The following material is incorporated by reference:
††††† (a) Twelve (12) Critical Elements of Home Visitation Programs;
††††† (b) Referral Record Screen Consent Form (ACH-301), 7/00 edition;
††††† (c) HANDS Screening Tool, 5/1/00 edition;
††††† (d) HANDS Assessment Tool, 5/1/00 edition;
††††† (e) Levels form; and
††††† (f) Every Child Succeeds Screening and Assessment Tool, 3/8/00 edition.
††††† (2) This material may be inspected, copied, or obtained, subject to applicable copyright law, at the Department for Public Health, first floor, Health Services Building, 275 East Main Street, Frankfort, Kentucky 40621, Monday through Friday, 8 a.m. to 4:30 p.m. (27 Ky.R. 1407; Am. 1846; 2162; eff. 2-1-2001.)