The following service categories and unit measures must be used to document the amount of service provided: 

Home Attendant / Personal Care:  Provides assistance to persons who are having difficulty or are unable to perform one or more of the following activities: preparing meals; shopping for food, prescriptions or household goods; bathing and personal care; housework; bill paying; writing letters; medication compliance; and/or navigating the medical care system. 

One unit equals one hour of Home Attendant / Personal Care services.

SPECIFICATIONS: 

1.            Required Services for Home Attendants and Personal Care Attendants:

1.1             Standby assistance with dressing, bathing, personal hygiene, grooming, toileting, transferring, and ambulating. Licensed Certified Nursing Assistants or certified Personal Care Aides may provide direct assistance. 

1.2             Prepare meals if home-delivered meals are unavailable or insufficient to meet client needs. This might include planning menus, cooking, and assistance with eating, if necessary. 

1.3             Reinforce the importance of taking the proper dosage of medication and remind client to take self-administered medications.

 2.            Additional Required Services for Home Care Attendants: 

2.1             General cleaning:  vacuum, mop, sweep, clean bathroom, clean kitchen, empty trash, dust, change linens, water plants and do laundry. 

2.2             Shop for groceries, prescriptions and/or household goods; pick up mail.

2.3             Assistance with correspondence. 

2.4             Assistance in filling out checks or obtaining money orders to pay bills and transporting client to pay bills.  

2.4.a.   Prior to accepting a client for this service, an attempt will be made to locate family or friends who can perform this service. 

2.4.b.   The program will perform this service only if: 

·                     Family or appropriate friends are unwilling or unable to assist client. 

·                     Family/friends have exploited or abused client. 

·                     The client needs help but not to the degree that intervention is necessary by the tribal representative payee service, if the client is Native American, or the county representative payee service, if available. 

2.4.c.    Assistance will be limited to filling out documents for the client’s signature and/or transporting the client to pay bills. 

3.            Optional Services for Home Care Attendants: 

3.1             Heavy cleaning:  Provide heavy cleaning (prior to the start of regular Home Attendant service) if the home is unsanitary or severely neglected. Funding for this one-time service is limited to $300. Programs may establish a cost-sharing agreement with the client to pay for this service. 

3.2             Transportation: The program must maintain current proof of driver’s licenses and vehicle insurance for all attendants involved in transporting clients. 

4.            Optional Services for Personal Care Attendants:  

4.1             Serve as client’s advocate within the health care system to ensure that proper and adequate medical care is obtained.

4.2             Transportation: The program must maintain current proof of driver’s licenses and vehicle insurance for all attendants involved in transporting clients.

5.            Safety:  

5.1             The grantee cannot assign Home Attendants / Personal Care Attendants to work in conditions that jeopardize their health and/or safety. 

6.            Assessment/Certification: 

6.1             Client Assessment: A client assessment must be completed prior to the start of service. The assessment must document the condition of the client based on the Assessment Criteria contained in Appendix A.  

6.2             Care Plan:  A Care Plan must be established for each client based on the needs identified in the assessment. See Care Plan Criteria contained in Appendix B. A signed copy of the Care Plan must be provided to the client. A new Care Plan must be established whenever changes are made to the plan and a copy of the new plan must be provided to the client. 

6.3             Reassessment:  A reassessment is required whenever there is a substantial change in a client’s physical condition, support system, or home environment. At a minimum, clients must be reassessed annually through an in-home visit. The reassessment must be based on the assessment criteria contained in Appendix A. Reassessment documentation must be recorded separately from the original assessment documentation. 

7.            Documentation Requirements: 

7.1             Home Attendant / Personal Care Attendant Progress Notes:  Service must be provided in accordance with the established care plan. The Home Attendant / Personal Care Attendant Progress Notes must be completed after each service visit and must contain the following documentation: 

7.1.a.    Housekeeping, personal care tasks, transportation information, bill paying services, and medical care advocacy provided to the client, including any services provided in addition to those specified in the Care Plan. 

7.1.b.   Attendant’s time of arrival and departure. 

7.1.c.    Signatures of the client and attendant. 

7.1.d.   A list of authorized care plan services not provided to the client and a brief explanation of why they were not provided.  

7.1.e.   Client signatures are to be obtained only after services have been provided. 

7.2             Verification System for Shopping:  A procedure must be established that allows Home Care Attendants and clients to verify the amount of money given to the attendant, cost of items purchased, and change returned to the client. Documentation of the transaction must be included in the Home Attendant / Personal Care Attendant Progress Notes. 

7.3             Verification System for Bill Paying:  A procedure must be established that allows the attendant’s supervisor to review bill paying procedures and verify that bills are being paid in an accurate and timely manner. Documentation of all transactions must be included in the Home Health Attendant / Personal Care Attendant Progress Notes. 

8.            Training: 

8.1             Home Attendants / Personal Care Attendants assigned to provide bathing assistance must receive training, which includes hands-on standby experience, prior to provision of service. Training must be provided under the supervision of a qualified health professional. (Home Attendants / Personal Care Attendants licensed as Certified Nurse Assistants or certified as Personal Care Aides are exempt from the training requirement.)  

8.1.a.   Documentation of training must include:  dates of training; name of Home Attendant / Personal Care Attendant receiving training; name, title, and agency of trainer; list of topics covered during the training; and copies of training material. 

9.            Quality Improvement: 

9.1             A quality assurance visit or phone call must be provided to each client at three-month intervals following each assessment or reassessment. The quality assurance check conducted six months after each assessment or reassessment must be in person. 

9.1.a.   The purpose of the quality assurance check is to: verify that the Care Plan is being followed, assess client satisfaction with the service, and amend the Care Plan, as necessary, to ensure that the client receives the services needed.

10.         Client Contact Time Frames: 

10.1      The following is a summary of the client contact time frames for assessments, reassessments, and quality assurance: 

Þ    Begin Date - Initial Assessment 

Þ    3 Months - Quality Assurance Visit or Phone Call 

Þ    6 Months - Quality Assurance Visit 

Þ    9 Months - Quality Assurance Visit or Phone Call 

Þ    12 Months - Reassessment