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STATE OF NEVADA SERVICE
SPECIFICATIONS INFORMATION,
ASSISTANCE AND ADVOCACY Any
exception to these Service Specifications must be requested in advance in
writing and approved by the Administrator. SERVICE DEFINITION: This service provides information, assistance and advocacy
assistance to seniors in accessing needed services, medical appointment,
errands, social activities, program and benefits. The service includes indirect and direct representation of
clients to obtain needed services and benefits. This service also may provide
transportation services to seniors to enable access to a variety of activities. In addition, counseling
on Medicare, Medicaid, Long Term Care and related topics by programs funded
under the State Health Insurance Advisory Program (SHIP) program model may be
provided to anyone as requested. SERVICE CATEGORIES AND UNIT MEASURES: Information,
Assistance and Advocacy: A service for older individuals that A.
provides current information on opportunities and services available to
individuals within their communities; B.
assesses the problems and capacities of individuals; C.
advocates, as necessary, for their rights and interests; D.
links the individuals to the services and activities that are
available; E. may provide transportation
for seniors to medical appointments, errands and social activities; F. ensures that
individuals receive services needed to the maximum extent feasible by
establishing adequate follow-up procedures. G. counsels individuals on
Medicare, Medicaid, Long Term Care and related topics primarily through
telephone contacts on toll free lines but also by direct counseling at other
venues. One unit of service equals one information, assistance and advocacy contact by telephone, in person, or on behalf of an older individual. (Each advocacy case may involve several contacts with or for the individual.) SPECIFICATIONS: 1.
Required Services: 1.1
Provide assistance and representation to individuals who have difficulty
negotiating the service delivery system.
1.2 Provide
access to services and social activities. 2.
Service Prohibitions: 2.1 Staff shall not accept tips,
gifts, fees, loans or anything of value from clients. 2.2 Staff shall not operate as the
client's legal guardian or executor. 2.3 Staff shall not become involved
in the client's personal financial affairs or estate. 2.4 Staff shall not become involved
in issues related to a criminal matter. 2.5
Staff shall not investigate elder abuse but must refer suspected abuse to the
appropriate agency within 24 hours.
3.
Documentation Requirements with the exception of Medicare-related
programs: 3.1 Maintain an individual case
record that documents the following: 3.1.a.
a summary of the client's problem or need; 3.1.b.
an assessment of the client’s physical and mental ability and their
support system to determine whether they are able to advocate on their own
behalf in resolving their advocacy issue; 3.1.c.
a chronology and summary of actions taken to assist the client, including
information and referral provided; 3.1.d.
follow-up verification of services received by frail clients determined
unable to advocate on their own behalf, and 3.1.e.
a copy of all benefit applications completed on behalf of the client. 3.2
Staff providing transportation must have a valid Nevada driver's license and a
Department of Motor Vehicles' driving record report on file. If a driver will be
entering a client's home, the staff member must have a criminal background check
on file.
3.3
If a driver uses his/her own vehicle, the driver must have current automobile
insurance verification on file.
4.
Documentation Requirements for Medicare-related programs:
4.1 The
program will maintain the documentation required by the SHIP program. 5.
Operating Procedures: 5.1
The program will develop and Implement a written procedure for handling requests
for assistance in person or by phone.
6.
Training: 6.1.
Staff and volunteers who serve as advocates must complete 20 hours
of training on related topics: mediation, counseling elders and/or special
benefits. Training must be completed within 6 months of hire date. Documentation
of all training must include: training date; type of training; name, title and
agency of presenter; name of staff receiving training; and, when applicable,
copies of agenda and certificates of completion. 6.2
Staff and volunteers must receive 5 additional hours of relevant training each
grant year.
7.
Quality Assurance with the exception of
Medicare-related programs: 7.1
The program shall establish an annual method to determine consumer satisfaction
with service through questionnaires or some other means. The results of the
quality improvement review must document any program deficiencies and contain a
plan of correction.
8.
Quality Assurance for Medicare-related programs: 8.1 The program will use the method approved by the SHIP program.
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