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STATE OF NEVADA
DIVISION FOR AGING SERVICES
SERVICE
SPECIFICATIONS
HOME
SERVICES AND
VEHICLE MODIFICATIONS
(Revised
1/06)
Any
exception to these Service Specifications must be requested in advance in
writing and approved by the Administrator.
This service can provide one or more of the following home
services: home safety evaluations, home safety training, home and/or vehicle
accommodation/modifications, activities of daily living aides or
equipment, home maintenance, home repair assistance or home chore services to
people 60 years and older, who are at risk of injury and/or decreased ability to
remain in their residences.
The following service categories and unit measures
established by the Division for Aging Services must
be used to document the amount of service provided:
Home
Safety Evaluations:
An assessment of the primary residence to evaluate how the client is able
to perform activities of daily living (ADL) within the environment will be
performed. Based on the evaluation, a determination and recommendations are made
that would improve the safety, accessibility and/or the quality of life for the
client and his/her caregiver.
Optional: A
licensed occupational therapist (OT) or physical therapist (PT) may complete
the evaluation.
Home Safety Training: The client and family/caregivers are taught techniques
that enhance safe activities, conserve energy, and enhance quality of life for
both the caregiver and receiver.
Home
Accommodation/Modifications: Minor
or major home modifications /accommodations to any section of the client or
family’s residence or property to improve safety, accessibility or the quality
of life. Home modifications may include but are not limited to: installing hand
rails, grab bars, vision panels in doors, leverage door handles or faucets,
adhesive strips, carpeting or kick plates, building ramps, modifying or
replacing doors, modifying sinks or cabinets to accommodate wheelchairs,
removing thresholds, closing open risers on stairs and amplifying telephone
rings and door bells.
Home Aides/Equipment/Supplies:
An authorized person or agency (i.e., an OT, PT, a trained installer
or a durable medical equipment agency) shall provide aides and/or equipment to
enhance safe activities. In addition, personal care products may be provided by
the funded agency.
Home Maintenance:
Minor or major maintenance to the existing home or property to improve
safety, accessibility or the quality of life of the senior. Home maintenance may
include but is not limited to changing batteries in smoke detectors and changing
air conditioner filters; resetting water softeners, changing sprinkler heads,
replacing appliances such as air conditioners, garbage disposals, washers and
dryers.
Home Repair:
Minor or major repair to the existing home or property to improve safety,
accessibility or quality of life for the senior. This can include but is not
limited to repairing stairs, roofs, railings, replacing parts on appliances
and/or repairing electrical items.
Home chore services: Minor or major chores, which include but are not limited to
yard maintenance, wood cutting/chopping, pest control, window washing, heavy
duty cleaning and snow removal that improve safety, accessibility or the quality
of life of the senior.
Vehicle Accommodation/Modification:
Any vehicle modification that facilitates accommodation, improves safety,
accessibility, mobility and quality of life of the senior.
Vehicle modifications may include, but are not limited to: wheelchair
ramps or lifts, gear modifications, special mirrors, safety equipment, etc.
It does not include repairs to get a vehicle into working condition.
Vehicle modifications expenditures may not exceed $5,000 without prior
authorization from the Division.
One unit equals completion of a home accommodation/modification, a home
Aide or equipment, a home maintenance or a home repair and or any other
intervention that is part of the home service plan.
One unit equals completion of one hour of home safety evaluation, home
safety training or home chore service.
One unit equals completion of one modification to a
vehicle.
1.
Required Services
1.1
Identify clients by an evaluation of the
client’s home and/or vehicle when requests for services are received or when a
referral is received from another agency.
1.1.a
Standardized forms and method of communication between team
members, clients and referring agencies are developed to ensure the client
receives assistance that is appropriate.
1.1.b
Develop a standardized safety evaluation form that is
comprehensive and detailed, which is to include a recommendation list to be
reviewed with the client and client’s (or caregiver’s) signature agreeing to
the recommendations.
1.2
Home accommodations/modifications and home
repairs must have the required permits and be approved by a building inspector
(s) when applicable.
1.2.a
Standardized forms and method of communication between team
members, clients and referring agencies are developed to ensure the client
receives assistance that is appropriate.
1.2.b
Develop a standardized safety evaluation form that is
comprehensive and detailed, which is to include a recommendation list to be
reviewed with the client and client’s (or caregiver’s) signature agreeing to
the recommendations.
1.3
Requests for vehicle modifications must include the following
documentation:
1.3.a
A copy of a current driver’s license
for the driver of the vehicle,
1.3.b
Proof of insurance for the vehicle to
be modified,
1.3.c
A copy of the vehicle
registration,
1.3.d
If the vehicle has more that 40,000 miles on the odometer, a mechanic’s
statement of inspection which states that the vehicle’s power train, brakes,
steering, and safety features (lights, wipers, windows, locks, seatbelts, and
tires) are in good working condition,
1.3.e
The vehicle must belong to a member of the applicant’s household. A
vehicle on which a lift will be mounted must have sufficient weight and
suspension strength to safely carry the lift and mobility device.
2.
Service Prohibitions
2.1
Staff, volunteers or contractors shall not accept tips, gifts or loans
from clients.
2.2
Staff, volunteers or contractors shall not smoke in client’s
homes.
2.3
Staff, volunteers or contractors shall not bring family members, other
people or pets to the client’s home without client’s permission and grantee
approval.
3.1
The grantee cannot assign staff, volunteers or contractors to work in
conditions that jeopardize their safety.
3.2
A qualified professional will supervise volunteers.
3.3
Prior to providing services, staff, professionals and volunteers are
required to have a fingerprint search conducted by the Nevada Highway Patrol
Criminal Information Services. The search will include a review of the records
contained in the Nevada Criminal History Repository.
3.3.a
Professionals are exempt from this requirement if they are licensed and
bonded.
3.3.b
Volunteers are exempt from this requirement if they receive direct
supervision from a bonded and licensed professional.
4.
Operating Procedures:
4.1
Referrals: Agencies making
referrals shall fax or mail the referring information forms. (1.Client
information, and 2. Financial Waiver). In the event the referral form is
incomplete, the Home Services Coordinator will complete forms by contacting the
client, family and/or primary physician.
4.2
A home and/or safety evaluation shall be completed prior to the start of
service. The safety evaluation shall document the condition of the client’s
primary residence and/or vehicle and
property and identify needed services. A safety evaluation shall be completed
and a plan developed for each person over the age of sixty (60) residing in
the household.
4.2.a
When two or more agency partners collaborate with the same client, one
agency will be designated to complete a home safety evaluation that can be used
by all parties. A vehicle safety
evaluation may be completed by an agency other than the one designated to
complete a home evaluation.
Based on the evaluation
recommendations, a Home Services and/or Vehicle Modification Plan is made that
would improve the safety, accessibility and or the quality of life for the
client and his/her caregiver. These recommendations become part of the Home
and/or Vehicle Safety Plan.
Preferred but Optional:
A licensed occupational or physical therapist performs the evaluation of
the primary residence and/or vehicle, and determines how the client is
performing activities of daily living (ADL) within that environment.
4.2.b
The person responsible for completing the home and/or vehicle service
shall review recommendations of the evaluator and shall assess the dwelling
and/or vehicle to determine the feasibility and appropriateness of the service
as part of the Home Services and/or Vehicle Modification Plan. Any major changes
in either Plan must be coordinated with the
evaluator. The
final Home Services and/or Vehicle Modification Plan shall be approved
and signed by client or caregiver.
4.2.c
The cost of the home safety service and/or vehicle modification such as
materials or installation shall be detailed in the Home Services and/or
Vehicle Modification Plan. Availability of insurance to defray costs
should be explored. The client or their family shall be given the opportunity to
contribute to the cost of the home safety service and/or vehicle
modification.
Participation in the program will
not be denied because the client is unable to contribute.
4.2.d
Verification of satisfactory completion:
The grantee will verify in writing that the Home Services and/or Vehicle
Modification Plan is complete. Client satisfaction shall be determined by a
follow up telephone call or visit within 6 weeks of completion of service.
4.2.d.1
If additional services are identified the grantee will document the need
and determine if funds are available for completion of the service. If
additional services are provided another follow-up phone call or visit shall be
completed and documented.
4.2.d.2
A summary of the Home Services and/or Vehicle Modification Plan will be
sent to the referring agency and primary physician. This documentation should be
maintained in the client’s file for a three-year period for audit purposes.
5.
Documentation Requirements:
5.1
Home Services and/or Vehicle Modification Plan Activity Record:
Service must be provided in accordance with the established Plan. An
Activity Record must be completed after each service visit and must contain the
following documentation: a) name of
client and date of service, b) services provided to the client, including any
services provided in addition to those specified in the Plan, c) signatures of
client (or caregiver) and provider on completed Home Services
and/or Vehicle Modification Plan, and e) a list of authorized Home Safety and/or
Vehicle Modification Plan services not provided to the client and a brief
explanation of why they were not provided. Client signatures are to be obtained
only after services have been provided.
5.2
Independent Contractor Verification: If the client has home repairs and/or vehicle modifications
completed by an outside contractor, the following must occur:
5.2.a
The client must obtain three bids for projects that cost over
$2,000.
5.2.b
The contractor must be licensed and bonded.
5.2.c
A procedure must be established that allows the grantee to verify the
cost and the completion of the services provided.
If the work is covered by private insurance or the client plans to
contribute to the cost of the project, this should also be noted.
5.3
Quarterly Report: Grantee will prepare a Quarterly Service Summary
form that identifies the units of service provided and the number of clients
receiving services in the specific quarter. The Quarterly Service Summary must
be submitted to DAS by the 15th of the month following the end of each quarter.
Supporting information will be maintained for three years.
6.1
Grantees are required to establish a waiting list policy that will be
activated in the event that demand for service exceeds the program’s
capacity.
6.2
A waiting list is to be established only after all other measures for
improving the efficiency of the service delivery system have been examined and,
when feasible, implemented. Waiting list documentation must include, at a
minimum:
6.2.a
the client’s name, address, and telephone number;
6.2.b
the date the client was placed on the waiting list; and
6.2.c
the description of each client’s need for service.
Clients
with the greatest needs are to receive priority consideration. The program must
define in writing “greatest need.” The program must establish a
procedure for updating the continued service needs of clients placed on the
waiting list.
7.1
A visit or phone call must be made to each client no later than 6 weeks
after the service is provided. The purpose of the follow-up is to:
verify that the Home Services and/or Vehicle Modification Plan was
followed and the work was completed, assess the client’s satisfaction with the
service, and amend the Home Services and/or Vehicle Modification Plan if any
other service needs have been identified.
8.1
The following is a summary of steps for assessments, job completion,
quality assurance and reassessment:
8.1.a
Begin Date – Referral information is received
8.1.b
Complete initial Home Services and/or Vehicle Modification
Evaluation
8.1.c
Develop Home Services and/or Vehicle Modification Plan
8.1.d Obtain
Necessary Permitting (where applicable)
8.1.e
Develop Work Schedule
8.1.f
Complete Service
8.1.g
Follow up Visit or Phone Call within 6 weeks of completion
8.1.h
If applicable, schedule and complete additional work as needed
8.1.i
Client file is closed
