PURPOSE:   

To promote quality of service, the Aging and Disability Services Division (ADSD) has established service specifications that contain general guidelines. ADSD will use these service specifications as the basis for assessing program performance. The service specifications that each grantee must follow consist of GENERAL REQUIREMENTS, according to the funding source, and SERVICE-SPECIFIC REQUIREMENTS established for each funded service.

SERVICE DEFINITION: 

This service provides homemaker and personal care assistance to seniors who are unable to perform self-care.

SERVICE CATEGORIES AND UNIT MEASURES: 

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

Homemaker:  Provides assistance to persons having difficulty with one or more of the following activities:  preparing meals, shopping for food or prescriptions, bathing or doing housework.

Chore: Provides assistance such as heavy housework, yard work or sidewalk maintenance (optional service). 

One unit equals one hour of Homemaker and/or Chore assistance. 

SPECIFICATIONS: 

1.         Required Services: 

1.1       General Cleaning:  vacuum, mop, sweep, clean bathroom(s), clean kitchen, empty trash, dust, change linens, do laundry

1.2       Shop for groceries and prescriptions

1.3       Pick up mail 

2.         Optional Services:

2.1       Stand-by assistance with bathing 

            2.2       Heavy cleaning and related services 

2.2.a   Heavy cleaning: Provide heavy cleaning if the home is unsanitary or severely neglected. ADSD funding for this service is limited to $300. 

2.2.b   Related Services:  Provide other services deemed necessary to assure good client health and safety. Safety services, such as duct cleaning, pest control and the provision of assistive equipment, smoke detectors, specialized toilet seats, large numbered phones, etc., may not exceed $200. Minor repairs/modification jobs, including the installation of grab bars or door locks, are limited to $200. 

2.2.c   There will be a financial limit of $700 per client per year. Programs may establish a cost sharing agreement with the client to pay for this service.  

2.3       Prepare meals if home-delivered meals are unavailable or insufficient to meet client needs. This might include preparation of meals for clients on special diets and preparation of meals in addition to those provided by a nutrition program. 

2.4       Homemakers may transport clients. The program must maintain current proof of drivers' licenses and vehicle insurance for all homemakers involved in transporting clients. 

3.            Assessment/Certification: 

3.1       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 B. An intake form and assessment must be completed on the person, age sixty (60) or older, who is requesting the service. 

3.2       Care Plan:  A Care Plan must be established for each client based on the needs identified in the assessment. The Care Plan Criteria contained in Appendix A are to be used to establish service tasks and frequency of service. 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. 

3.3       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 B. Reassessment documentation must be recorded separate from the original assessment documentation. 

4.         Documentation Requirements: 

4.1       Homemaker Activity Record:  Service must be provided in accordance with the established Care Plan. A Homemaker Activity Record must be completed after each service visit and must contain the following documentation:   

4.1.a   Name of client and date of service;  

4.2.a   Housekeeping and personal care tasks provided to the client, including any services provided in addition to those specified in the Care Plan;  

4.3.a   Homemaker’s time of arrival and departure;  

4.4.a   Signatures of client (or client’s representative) and homemaker; and 

4.5.a   A list of authorized Care Plan services not provided to the client and a brief explanation why they were not provided.  

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

4.2       Verification System for Shopping:  A procedure must be established which allows homemakers and clients to verify the amount of money given to the homemaker, cost of items purchased, and change returned to the client. Documentation of the transaction must be included on the Homemaker Activity Record. 

5.         Training: 

5.1       Homemakers assigned to provide bathing assistance must receive training, which includes hands-on experience, prior to provision of service. Training must be provided under the supervision of a qualified health professional. (Homemakers licensed as Certified Nurse Assistants are exempt from the training requirement). Documentation of training must include:  dates of training; name of homemakers that received training; name, title, and agency of trainer; list of topics covered; and copies of training material. 

6.         Quality Improvement: 

6.1       A quality assurance visit or phone call must be provided to each client at three-month intervals (as outlined in 7.1) following each assessment or reassessment. The quality assurance check conducted six months after each assessment or reassessment must be in person. 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. 

7.         Client Contact Time Frames: 

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

7.1.a   Begin Date - Initial Assessment 

7.1.b   3 Months - Quality Assurance Visit or Phone Call 

7.1.c   6 Months - Quality Assurance Visit 

7.1.d   9 Months - Quality Assurance Visit or Phone Call 

7.1.e   12 Months - Reassessment
 

APPENDIX A

  CARE PLAN CRITERIA  

Care Plans must be established based on the following maximum and minimum frequencies for each service task. Homemaker service cannot exceed three hours per visit.

Other Required Documentation:

·         The number of service hours to be provided each visit

·         The length of time services are authorized (maximum period is 12 months)

·         The signature of the agency representative and date

·         Signature of the client or client’s representative and date