Section 20. Individuals to be assessed

Part II. Assessment Services

A. All individuals applying to or residing in an ALF shall be assessed face-to-face using the UAI prior to admission, at least annually, and whenever there is a significant change in the individual's condition.

B. For private pay individuals, qualified staff of the ALF or an independent physician may complete the UAI. Qualified staff are ALF employees who have successfully completed state-approved training on the UAI for either public or private pay assessments. The ALF maintains documentation of the completed training. The administrator or the administrator's designated representative shall approve and sign the completed UAI for private pay individuals. A private pay individual may request the assessment be completed by a qualified public human services agency assessor. When a public human services agency assessor completes the UAI for a private pay individual, the agency may determine and charge a fee for private pay assessments that may not exceed the amount DMAS reimburses for public pay assessments.

C. For public pay individuals, the UAI shall be completed by a case manager or a qualified assessor to determine the need for residential care or assisted living care services. The assessor is qualified to complete the assessment if the assessor has completed a state-approved training course on the UAI. Assessors who prior to January 1, 2004, routinely completed UAIs as part of their job descriptions may be deemed to be qualified assessors without the completion of the training course. Qualified assessors who may initially authorize ALF services for public pay individuals are employees of:

1. Local departments of social services;

2. Area agencies on aging;

3. Centers for independent living;

4. Community services boards or behavioral health authorities;

5. Local departments of health;

6. State facilities operated by the Department of Behavioral Health and Developmental Services;

7. Acute-care hospitals;

8. Department of Corrections; and

9. Independent physicians who have a contract with DMAS to conduct ALF assessments.

D. For public pay individuals, the ALF shall coordinate with the assessor to ensure that the UAI is completed as required. If the individual has not been assessed, the local department of social services eligibility worker shall inform the individual or the individual's legal representative of the need to be assessed by a qualified assessor prior to admission. If the individual has not applied for an auxiliary grant, the qualified assessor conducting the assessment shall inform the individual or the individual's legal representative of the need to submit an application for an auxiliary grant.

Historical Notes

Former 22VAC40-745-20, derived from VR615-46-02 § 2.1, eff. February 1, 1996; amended, Volume 23, Issue 01, eff. November 1, 2006; amended and renumbered as 22VAC30-110-20, Virginia Register Volume 30, Issue 01, eff. October 9, 2013; amended, Virginia Register Volume 31, Issue 11, eff. February 25, 2015.

Statutory Authority

§ 51.5-131 of the Code of Virginia.