22VAC30-130-50: Service planning

A. A variety of interventions including referral to public assistance and other resources, case management, and other programs may be provided depending on the adult's needs.

B. The services or activities may be provided directly by local department staff or volunteers, purchased from local department approved providers or contracted vendors, or provided through referral to other community resources.

C. If an adult is determined eligible for home-based services, the local department shall develop a service plan, enter the plan into the department-designated case management system, and review the plan at least annually. A service plan shall not be required when the only intervention or activity provided by the local department is screening for long-term services and supports, public pay assisted living facility annual assessment, or review of an annual guardian report. The local department, the adult and the adult's family, the responsible person, or other social supports, if applicable, shall collaborate to evaluate progress toward meeting the goals and objectives of the service plan. The local department shall document progress toward meeting service plan goals and objectives at least quarterly in the department-designated case management system.

D. For any services for which a payment is made on behalf of an adult, the service, service provider, and payment authorization shall be documented in the service plan. Any local department hard copy records documenting the provision of adult services shall be made available to the department upon request.