Keys & Such!

November 30, 2016

We have posted an excellent FAQ from CMS on the Waiver Implementation page accessible to members which addresses a number of the issues apparently raised on the DBHDS/DMAS Stakeholders call on 30 November.  While the State may insist on higher standards than CMS, the Q&As below illustrate the thinking of CMS: Question: Are there circumstances under which staff or caregivers may or may not enter an individual’s bedroom when the door is locked and the individual is in the bedroom? Answer:  Individuals should be afforded the same respect and dignity as a person not receiving home and community-based services. In an urgent or emergency situation, it may be appropriate for someone providing services to enter an individual’s locked room.  The person-centered planning process and plan should address the circumstances in which this might happen.   Question: Must the individual be given a key to his or her bedroom door and be permitted to carry it outside the residence? What types of staff or caregivers would not be considered appropriate to have keys to an individual’s bedroom? Answer: Individuals should have access to their homes at all times unless appropriate limitations have been determined and justified in the person-centered plan consistent with § 42 CFR section 442.301(c)(4) and 441.530 (a)(1)(vi)(F) that outlines the process for modifying any of the condition’s required for the individual’s assessed need. The staff person(s) allowed to have keys to an individual’s room should be determined by the provider and participant and should be documented in the person-centered plan. The provision of keys to anyone other than the residents of the setting should be limited to those individuals and circumstances identified and for the purposes described in the person-centered planning process.