Health and Human Services

Human Services Program Licensing

Rule R501-23: Division of Services for People with Disabilities Certification

Effective Date: 06/11/2025

Admin. Code Reference: R501-23

Rule Type: Current Rule

R501. Health and Human Services, Human Services Program Licensing.

R501-23. Division of Services for People with Disabilities Certification.

R501-23-1. Authority and Purpose.

(1) Subsection 26B-1-202(1) authorizes this rule.

(2) This rule provides the minimum health and safety standards for OL DSPD-certified providers and the enforcement actions OL may take in response to noncompliance.

R501-23-2. Definitions.

Terms used in this rule are defined in Sections 26B-2-101 and 26B-2-701. Additionally:

(1) "Abuse" means the same as defined in Sections 26B-6-201 and 80-1-102.

(2) "Applicant" means the same as defined in Section 26B-2-120.

(3) "Associated" means affiliated with the OL DSPD certification, contract, or licensee as a:

(a) department contractor;

(b) direct care staff member;

(d) employee;

(e) human services program owner;

(f) individual with direct access as defined in Section 26B-2-101;

(g) intern;

(h) member of the governing body;

(i) provider of care; or

(j) volunteer.

(4) "Certification" means a site or program that serves up to three people in either a residential support certification or day support certification setting.

(5) "Client" means the same as defined in Section 26B-2-101 and includes any individual for whom the provider receives compensation for care.

(6) "Compliance" means adherence to contract requirements, governing rule, and statute with no current penalty actions or pending resolution of noncompliance.

(7) "Critical incident" means an event out of the range of normal experience, including:

(a) a death of a minor;

(b) a death related to an adverse event;

(d) a medication error resulting in:

(i) a telephone call to or a consultation with a poison control center or an emergency department;

(ii) an urgent care visit; or

(iii) hospitalization;

(e) a missing client;

(f) an allegation or confirmation of abuse, neglect, or exploitation;

(g) an allegation or confirmation of waste, fraud, or abuse of Medicaid funds;

(h) any medical emergency requiring treatment beyond first aid;

(i) any cruel, severe, unusual, or unnecessary practice, as described in Section 26B-2-123, including misuse or unauthorized use of restrictive interventions, seclusion, or body cavity search;

(j) any property damage or infestation that jeopardizes services; or

(k) any significant criminal activity.

(8) "Day support certification setting" means a human services program that provides non-residential services to a total of three or fewer individuals, regardless of whether the individuals receive services at the same time, site, or in the same groups.

(9) "Department" means the Department of Health and Human Services.

(10) "Direct Access Clearance System" or "DACS" means the online system used by OBP for processing and monitoring background checks for any individual with direct access to a client in a health or human services program.

(11) "Direct care staff" means staff working directly with the clients.

(12) "DSPD" means the Division of Services for People with Disabilities;

(13) "Eligible" means an OBP determination of:

(a) direct access qualified for a human services program, in accordance with Section 26B-2-120;

(b) OL DSPD certification for direct patient access in a health care facility, in accordance with Section 26B-2-240; or

(c) no findings in an individual's background check that would prohibit that individual from being involved in child care, as outlined in rules under Titles R381 and R430.

(14) "Exploitation" means:

(a) the use of a client's property, labor, or resources without the client's consent or in a manner that is contrary to the client's best interests or for the gain of a person other than the client, including spending a client's funds for the benefit of another;

(b) using the labor of a client without paying the client a fair wage or without providing the client with just or equivalent nonmonetary compensation, where such use is inconsistent with therapeutic practices;

(d)(i) sexual exploitation of a minor, as described in Section 76-5b-201;

(ii) sexual exploitation of a vulnerable adult, as described in Section 76-5b-202; or

(iii) abuse of a vulnerable adult, as described in Subsection 76-5-111(2).

(15)(a) "Fraud" means a false or deceptive statement, act, or omission that causes, or attempts to cause, property or financial damages or for personal gain.

(b) Fraud also means any offenses identified as fraud in Title 76, Chapter 6, Offenses Against Property.

(16) "Good standing" means in compliance, as defined in Subsection (6).

(17) "Inspection" means an announced or unannounced visit to monitor ongoing compliance at the provider's site.

(18) "Investigation" means an announced or unannounced inquiry into an internal or external complaint or a reported incident that alleges noncompliance to determine compliance with contract requirements or rule.

(19)(a) "Neglect" means abandonment or the failure to provide necessary care, including bedding, clothing, education, health care, hygiene, nutrition, protection from harm, shelter, sleep, supervision, or treatment.

(b) Neglect also means the same as defined in Sections 26B-6-201, 76-5-110, and 80-1-102.

(20) "OBP" means the Office of Background Processing in the Division of Licensing and Background Checks under the Department of Health and Human Services.

(21) "OL" means the Office of Licensing in the Division of Licensing and Background Checks under the Department of Health and Human Services.

(22) "OL penalty" means the denial of an OL DSPD certification or the placement of a condition on, suspension of, or revocation of an OL DSPD certification due to the provider's noncompliance with rule or statute.

(23) "Provider" means the license or OL DSPD certificate holder, or the legally responsible individual, providing services regulated by OL.

(24) "Residential support certification" means an OL DSPD certification to operate a residential facility that serves three or fewer clients in a setting that is integrated in the community.

(25) "Settings rule" means 42 CFR 430, 431, 435, 436, 440, 441, and 447 (2025) that impacts Medicaid home- and community-based services funding in settings that serve people with disabilities.

(26) "Significant criminal activity" means any unlawful activity by or against a client, provider, or on-duty staff that poses a serious threat to a client or on-duty staff's health, safety, or wellbeing, including:

(a) any criminal activity that involves law enforcement;

(b) illegal physical or sexual misconduct or assault;

(d) suspected exploitation; or

(e) suspected fraud.

(27) "Site" means a human services program location that serves up to three individuals in either a residential support certification or day support certification setting.

R501-23-3. Scope.

(1) Each provider shall comply with:

(a) each department contract requirement; and

(b) any applicable federal, state, or local law, rule, or ordinance, including:

(i) Rule R380-80;

(ii) Rule R501-14; and

(iii) this rule.

(2) If there is a conflict between any rule requirement and the settings rule, the settings rule shall prevail.

R501-23-4. Certification Required.

(1) OL DSPD certification is required for a provider to enter into a department contract to provide residential or day support certification services.

(2)(a) For a site-based OL DSPD certification, the provider may not serve more than three clients at each site, as serving four or more clients requires a day treatment or residential support license, in accordance with Section 26B-2-101.

(b) For a community-based OL DSPD certification, the provider may not serve more than three clients in total, as serving four or more clients requires a day treatment license in accordance with Subsection 26B-2-101(12).

(3)(a) An OL DSPD certification is for a provider and is specific only to an approved site.

(b) An OL DSPD certification is not assignable or transferable.

(4) If the department places a condition or suspension on or revokes a DSPD provider's OL DSPD certification, the provider must comply with each condition before an OL DSPD certification, contract, or license in good standing is granted by the department.

(5) In addition to complying with this rule, a DSPD provider must be in good standing with the department to:

(a) renew or to enter into a contract with the department;

(b) renew or start a new OL DSPD certification; or

(c) have any sanction removed, including a conditional, suspension, or contractual sanction status issued by the department.

(6) OL may not issue or renew an OL DSPD certification when:

(a) OBP determines an applicant's background check status is not eligible;

(b) OL finds that an applicant or provider maintains association with any individual with an OL DSPD certification, contract, or license revoked by the department if the application is submitted within five years from the time of the revocation;

(d) the provider is not present for the site inspection;

(e) the provider does not show compliance with rule and requirements within 60 calendar days of submitting the application;

(f) OL finds that the provider is in noncompliance with any inspection by the required date outlined in Subsection R501-23-6(2);

(g) there is another active department license or OL DSPD certification at the same address; or

(h) the provider fails to cooperate with any inspection.

(7) If OL does not issue an OL DSPD certification for a reason listed in Subsection (6), the provider may not reapply for an OL DSPD certification for at least three months.

R501-23-5. Initial and Renewal Certification and Certification Changes.

(1) To receive an OL DSPD certification, the provider must:

(a) submit a completed OL DSPD certification application for each site or program requiring OL DSPD certification;

(b) submit, adhere to, and maintain the applicable residential or non-residential attestation agreement and self-assessment forms that are on the OL website;

(d) certify the provider understands and will comply with rule and contract requirements;

(e) demonstrate compliance with this rule; and

(f) schedule, participate, and comply with an OL site inspection.

(2) To receive a renewed OL DSPD certification, the provider must:

(a) submit a renewal request in the licensing provider portal at least 30 days before the expiration date of the current OL DSPD certification;

(b) participate in a site inspection; and

(3) For any OL DSPD certification or certification change, the provider shall:

(a) notify OL of any change of email address, name, or telephone number when the change is made; and

(b) submit a complete OL DSPD certification application for any change of site before the change is made.

(4) If the provider receives a department revocation notice, the provider shall:

(a) notify the client and their legal guardian, if applicable, of the action within five calendar days of receiving the notice; and

(b) post the notice on the provider website and leave the notice posted for as long as the notice remains in effect.

(5) If the department contract is terminated, any corresponding OL DSPD certification is revoked and becomes inactive on the same date and may only be reinstated if the contract is reinstated or a new contract is approved.

R501-23-6. Program or Facility Changes.

(1) An OL DSPD certificate holder shall submit a complete program change application to amend an existing OL DSPD certification at least 30 days before:

(a) an increase or decrease of capacity, including any change to the amount of space used to provide services;

(b) a change in the name of the program or facility;

(d) a change that transfers less than 50% ownership or controlling interest to a new owner.

(2) A provider may proceed with a change or make the change public after the office approves the change.

(3) A provider shall submit a complete office application for a new OL DSPD certification at least 30 days before any:

(a) change of location;

(b) change in the population served;

(d) additional license or OL DSPD certification category; or

(e) change that transfers 50% or more ownership or controlling interest to a new owner.

(4)(a) For a change that requires a new OL DSPD certificate, the provider may not serve any new client until OL issues a new OL DSPD certificate.

(b) Until a new OL DSPD certificate is issued, the previous OL DSPD certificate's status continues.

R501-23-7. Inspections and Investigations.

(1)(a) OL shall conduct a site inspection for each OL DSPD site certification.

(b) OL may conduct an announced or unannounced site investigation as needed to determine compliance with any rule or requirement.

(2) When OL finds noncompliance during a site inspection or investigation, OL shall issue a written notice and notify the provider of the date that the provider is required to come into compliance.

(3) The provider and any staff shall cooperate with OL and refrain from withholding or manipulating information or influencing or interfering with any specific response of staff or a client to any department personnel.

(4) The provider shall ensure department-authorized personnel have unrestricted access to:

(a) any unaltered on- and off-site provider or client records;

(b) each area of each site subject to OL DSPD certification; and

R501-23-8. Administration.

(1) The provider shall:

(a) be at least 18 years old; and

(b) know and comply with each applicable federal, state, and local law, ordinance, and rule.

(2) The provider:

(a) shall accommodate each client's needs;

(b) shall take reasonable measures to protect the safety of each client; and

(c) may not engage in or allow conduct that endangers a client or is aversive to the health, safety, or welfare of a client.

(3) The provider shall ensure compliance with each OL DSPD certification requirement, unless the department approves a deviation in writing.

(4) The provider shall disclose any community-based services and ensure that community-based services are provided safely and in consideration of emergencies, transportation, weather, and overall client needs for food, medicine, and any other assistance necessary for safe participation in the human services program..

R501-23-9. Background Checks.

(1) OBP shall conduct human services program background checks in accordance with Rule R501-14 and Section 26B-2-120.

(2) The provider shall designate an individual who is responsible for:

(a) ensuring each individual associated with the OL DSPD certification has an eligible background check determination before being unsupervised with a client;

(b) ensuring each individual providing services or residing at the site has an application submitted in DACS within 14 days of becoming associated with the licensee;

(c) documenting how each individual with direct access is directly supervised for the entirety of the individual's supervised employment term before receiving the eligible determination from OBP;

(d) initiating, monitoring, and maintaining background checks in DACS for each individual with direct access;

(e) maintaining compliance with Rule R501-14;

(f) managing communications with OBP and OL;

(g) monitoring DACS and taking necessary actions when eligibility status changes for anyone associated with the OL DSPD certification; and

(h) separating anyone in DACS within five calendar days when the individual:

(i) is no longer associated with the OL DSPD certification; or

(ii) has an ineligible determination status from OBP on a background check with no pending appeal.

R501-23-10. Physical Site, Safety, and Injury Prevention.

(1) The provider shall ensure that any appliance and electrical, HVAC, and plumbing system is maintained in operating order.

(2)(a) The provider shall maintain the site in a clean and safe manner that is free from any hazard, excrement, grime, infestation, trash, and anything that could pose a risk to a client's health and safety.

(b) The provider shall keep furnishings and finishes clean and in good repair.

(3) The provider shall ensure:

(a) any chemicals are stored in consideration of the safety and risk level of any client served;

(b) any set of three or more stairs is equipped with secured handrails;

(i) a way to provide privacy to the user;

(ii) a working tub or shower; and

(iii) toilet paper and soap;

(d) emergency numbers, including 911, are near the telephone or in an area clearly visible to anyone needing the information;

(e) no animal that has a history of dangerous, attacking, or aggressive behavior is accessible to a client;

(f) the proper handling, storage, and disposal of hazardous materials and bio-contaminants;

(g) the site's street address number is visible from the street;

(h) the water heater is maintained at a low setting and does not exceed 120 degrees Fahrenheit;

(i) there are at least two ways of egress on each level of the site;

(j) there is a working telephone on-site that is accessible to each client for any emergency call; and

(k) when there is any firearm on the premises, that each firearm is not loaded and is in a cabinet, safe, or area that is locked with a key, combination, or fingerprint lock, unless the firearm's use is in accordance with Title 53, Chapter 5, Part 7, Concealed Firearm Act.

(4) The residential support certification provider shall ensure:

(a) each client bedroom on the ground level has a minimum of one window that may be used as egress if there is a fire;

(b) each client bedroom that is not on the ground level has a minimum of two exits, at least one of which shall exit directly to outside of the building that may be used as egress if there is a fire;

(i) a working stove;

(ii) a working sink; and

(iii) a working refrigerator;

(d) there is at least one toilet and hand washing sink that each client can easily access without going through the private room of any other individual; and

(e) there is a working tub or shower for client access.

(5) The provider shall document any deviation from this section as a result of client choice in the person-centered support plan.

R501-23-11. Client Guidance and Interaction.

(1)(a) The provider shall ensure each client is treated with dignity and respect and not subjected to any form of abuse, neglect, or exploitation while in care.

(b) The provider shall follow the reporting requirements if the provider witnesses or suspects abuse, neglect, or exploitation in accordance with Section R380-80-4.

(2) The provider may not:

(a) confine a client in any area or space including a closet, locked room, or other enclosure;

(b) force or withhold food, medication, rest, or toileting;

(d) restrain a client's movement by binding, tying, or another form of restraint, unless used as an emergency intervention or with a documented human rights restriction;

(e) shout at or use any practice intended to intimidate or humiliate a client;

(f) use any form of corporal punishment that produces pain or discomfort such as biting, hitting, pinching, shaking, or spanking; or

(g) violate Rule R380-80.

R501-23-12. Emergency Preparedness and Response.

(1) The provider shall maintain a fully supplied first aid kit on site and in each vehicle used to transport a client.

(2) The provider shall have a working fire extinguisher type 2A:10B:C or of larger capacity on each level of the site.

(3) The provider shall ensure:

(a) there is a working carbon monoxide monitor on each level of the site; and

(b) there is a working smoke detector on each level of the site.

(4) If a critical incident occurs under the direct responsibility and supervision of the provider, the provider shall:

(a) initiate a report of the incident to the DSPD online provider system within one business day of the incident;

(b) ensure any incident of abuse, neglect, or exploitation of a client is made known to the Division of Child and Family Services for a minor client or Adult Protective Services for an adult client and law enforcement as appropriate;

(c) notify the parent or legal guardian of each involved client within a 24-hour period from the time of the incident; and

(d) notify each department entity involved with the client's care, payment, or provider contract immediately.

R501-23-13. Transportation.

(1) While transporting a client, the provider shall ensure that individual safety restraint devices are used in accordance with Section 41-6a-1803.

(2) The provider may not leave a client unattended in a vehicle.

R501-23-14. Penalties.

(1) Any action the department takes on a contract will result in an OL sanction against the provider's OL DSPD certification, including OL DSPD certification suspension or revocation.

(2) Any action taken by OL on an OL DSPD certification will result in a report to the Office of Service Review and the applicable department division.

KEY: licensing, human services, Division of Services for People with Disabilities, DSPD certified

Date of Last Change: June 11, 2025

Authorizing, and Implemented or Interpreted Law: 26B-1-202(1)