Rehabilitation Services
Service Standard
Rehabilitation Services Service Standard print version
| Subcategories | Service Units |
|---|---|
| Rehabilitative Services – Physical Therapy | Per visit |
| Rehabilitative Services – Occupational Therapy | Per visit |
| Rehabilitative Services – Speech Therapy | Per visit |
| Rehabilitative Services – Low vision training services | Per visit |
Health Resources & Services Administration (HRSA) Description:
Rehabilitation Services provide HIV-related therapies to improve or maintain a client’s quality of life and optimal capacity for self-care on an outpatient basis, and in accordance with an individualized plan of HIV care.
Program Services:
Language assistance must be provided to individuals who have limited English proficiency and/or other communication needs at no cost to them in order to facilitate timely access to all health care and services.
Subrecipients must provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area to inform all individuals of the availability of language assistance services.
All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations’ planning and operations.
Limitations:
Rehabilitation services provided as part of inpatient hospital services, nursing homes, and other long-term care facilities are not allowable.
Services:
Funds may be used for physical and occupational therapy, speech pathology services, and vocational therapy.
Physical therapy helps to maximize client’s capabilities. Typical programs may include:
- Therapeutic exercise
- Strength and mobility training
- Gait and balance training
- Muscle re-education
- Innovative treatment modalities such as heat, cold, and electrical stimulation
By concentrating on daily living activities, skilled occupational therapists help clients adjust to everyday environments. Therapies may include:
- Education and training in daily living skills, including eating, bathing, dressing, and grooming
- Sensory-motor skills re-training
- Strength and range of motion training
- Cognitive integration techniques
- Selection and use of adaptive equipment
- Design, fabrication, and application of orthoses (splints)
Speech and language pathology therapies maintain the ability to communicate. Therapies may include:
- Exercises to stimulate receptive, integrative, and expressive processes
- Sensory-motor activities to stimulate chewing, swallowing, articulatory, and voice processes
- Selection and training in the use of no-oral communications aids, including augmentative systems
- Specialized swallowing therapy
- Cognitive skills training
- Compensatory swallowing technique
Low vision training teaches the client how to use their remaining vision more effectively. Services may include rehabilitation training for:
- Reading
- Writing
- Shopping
- Cooking
- Lighting
- Glare control
Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. For the Ryan White Part B/SS funded providers and Administrative Agencies, telehealth and telemedicine services are to be provided in real-time via audio and video communication technology which can include videoconferencing software.
DSHS HIV Care Services requires that for Ryan White Part B or SS funded services providers must use features to protect ePHI transmission between client and providers. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance.
Service Standard and Measure
The following Standards and Measures are guides to improving healthcare outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.
| Standard | Measure |
|---|---|
|
Comprehensive Assessment: Provider will complete a comprehensive assessment within five (5) business days of the referral to include:
|
Percentage of clients with documented evidence in the client’s primary record of a completed comprehensive assessment within five (5) business days of referral. |
|
Plan of Care: In collaboration with the client a plan of care will be developed within ten (10) business days of the completed comprehensive assessment. The plan of care should be signed and dated by the client and located in the client’s primary record. A copy of the plan will be offered to the client and documented in the client’s record. The plan of care should include:
Documentation that the plan of care is being followed will include date therapy received, therapy performed, and progress toward meeting objectives in the client’s primary record. Plan of care must be reviewed not less than every six (6) months to determine if progress is being met towards meeting objectives with documentation in the client’s primary record. |
Percentage of clients with documented evidence in the client’s primary record of a plan of care developed within ten (10) business days of the completed comprehensive assessment. Percentage of clients with documented evidence in the client’s primary record of the plan of care reviewed not less than every six (6) months for progress met toward objective. |
|
Referrals: If the needs of the client are beyond the scope of the services provided by the agency/provider, an appropriate referral to another level of care is made. Documentation of referral and outcome of the referral is present in the client’s primary record. |
Percentage of clients with documented evidence in the client’s primary record of referrals, as applicable, for services necessary. Percentage of clients with documented evidence of the outcome of the referral made as indicated in the client’s primary record. |
|
Discharge: The agency and client will collaborate on a discharge plan once objectives have been met. Reasons for discharge may include:
|
Percentage of clients with documented evidence in the client’s primary record of a discharge plan, as appropriate. |
References
HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards – Part A April 2013. p. 45-46. Accessed on October 12, 2020.
HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards – Program Part B April, 2013. p. 44-45. Accessed on October 12, 2020.