Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 19 - Aging and Adult Services › Rule 016.19.16-002 - Section 310- Arkansas Family Caregiver Support Program

Current through Register Vol. 49, No. 6, June, 2024
Section 310 Division of Aging and Adult
			 Services Policy and Procedures Manual
310.000
Arkansas Family Caregiver Support Program
Each Area Agency on Aging (AAA) shall establish vendor
				agreements and/or contracts with community-based organizations to provide
				multifaceted systems of support services, including counseling, support groups,
				respite, and other home and community- based services to families caring for
				their frail older members. The Arkansas Family Caregiver Support Program
				(AFCSP) also recognizes the needs of grandparents, who are caregivers of
				grandchildren, and to older persons, who are relative caregivers of children
				age 18 and younger. An AAA may provide such services
directly
by
				requesting a waiver from DAAS in accordance with DAAS Policy 201. The approval
				of such waiver will be at DAAS's sole discretion.
310.010
Purpose
The purpose of this policy is to establish administrative and
				service delivery standards for the Arkansas Family Caregiver Support
				Program.
310.011
Scope
This policy applies to all AAAs and their subcontractors who
				provide Family Caregiver Support Services.
310.012
General Authority
The authority for this Section is Sections 371, 372, 373, and
				374 of the Older Americans Act of 1965, as amended [
				P.L.
				106-501 ], Grants for State and Community Programs
				on Aging.
310.100
Definitions
Area Plan -
AAA's plan of operation which has been
				approved by the Division of Aging and Adult Service (DAAS).
Subcontractor -
An entity that is awarded a
				contract from an AAA to provide designated services under the Area Plan.
Elderly client -
An eligible (60 years of age or
				older) elderly individual who receives OAA services.
Child -
An individual who is not more than 18
				years of age or who is an individual with a disability.
Family Caregiver -
An adult family member or
				another individual, who is an informal provider of in-home and community care
				to an older individual.
Informal Provider -
Care is not provided as part
				of a public or private formal service program.
Grandparent or Older Individual who is a Relative
				Caregiver -
A grandparent or step-grandparent of a child or a relative
				of a child by blood, marriage, or adoption who is 55 years of age or older;
				and
A. Lives with the child;
B. Is the primary caregiver of the child
			 because the biological or adoptive parents are unable or unwilling to serve as
			 the primary caregiver of the child; and
C. Has a legal relationship to the child,
			 such as legal custody or guardianship, or is raising the child informally.
310.200
Procedural Requirements
310.201
Responsibilities of the
			 Division of Aging and Adult Services
A. Designate a coordinator to implement and
			 oversee program development of AFCSP statewide;
B. Develop and maintain consistent standards
			 and mechanisms for AFCSP to be implemented statewide. These standards and
			 mechanisms shall be used to assure the quality of services provided in
			 accordance with OAA, Administration on Community Living regulations and
			 policies, and the U.S. Department of Health and Human Services policies and
			 rules;
C. Collect, maintain, and
			 report information pertaining to AFCSP to the Assistant Secretary for Aging of
			 the Department of Health and Human Services;
D. Provide technical assistance as needed;
			 and
E. Assume quality assurance
			 responsibilities for all caregiver programs to ensure compliance with
			 standards, policies, and procedures of DAAS and OAA.
310.202
Responsibilities of Area Agency
			 on Aging
A. Assess the needs of
			 caregivers in the planned service area (PSA) to develop and submit an area plan
			 (or update) reflecting local needs to DAAS outlining the services to be
			 provided at least annually;
B.
			 Publicize AFCSP services to ensure that individuals throughout the PSA know
			 about the availability of the services;
C. Provide caregiver information and referral
			 as well as screen individuals for caregiver support services;
D. An assessment of need for each client
			 should be performed and maintained in a client file. An in-home assessment will
			 be completed on individuals whose screening indicates a need for respite or
			 supplemental services;
E. Arrange
			 for the provision of individually needed family caregiver services directly
			 and/or through local service providers;
F. Maintain current database of programs and
			 services, regardless of funding stream, which a person needing caregiver
			 support services can access;
G.
			 Organize new and coordinate with existing caregiver support groups;
H. Coordinate AFCSP with other programs and
			 service systems serving persons with disabilities;
I. Attend training planned by DAAS;
J. Ensure appropriate program/financial
			 reporting, billing, and budget reconciliation;
K. Negotiate contracts and provide quality
			 assurance program implementation;
L. Compile, maintain, and report waiting
			 lists of persons requesting caregiver services for which service is not
			 available;
M. Give priority for
			 services to older individuals with greatest social and economic need, with
			 particular attention to low-income older individuals, and older individuals
			 providing care and support to persons with mental retardation and related
			 developmental disabilities (as defined in 102 of the Developmental Disabilities
			 Assistance and Bill of Rights Act {
			 42 U.S.C.
			 6001 });
N. Give priority for services to family
			 caregivers who provide care for individuals with Alzheimer's disease and
			 related disorders with neurological and organic brain dysfunction, as well as
			 grandparents or older individuals who are relative caregivers of children with
			 severe disabilities;
O. AAAs are
			 strongly encouraged to seek the input of regional Alzheimer's chapter(s),
			 relevant and existing support groups, Cooperative Extension Service, and area
			 mental health and community-based organizations providing various forms of
			 assistance to family caregivers who provide informal in-home and community care
			 to older individuals and to grandparents raising grandchildren in maintaining
			 AFCSP in their region. Additionally, AAAs are encouraged to seek the input of
			 family caregivers providing care to older adults and grandparents raising
			 grandchildren on their service needs;
P. The area plan must include a service
			 budget for each category of service in the AAA's PSA;
Q. AAAs will establish and maintain an
			 adequate system for record keeping of persons served expenditures and waiting
			 lists by categories established by OAA and DAAS; and
R. An assessment of needs for each client
			 will be performed and maintained in a client file.
310.203
Responsibilities of Service
			 Providers
A. Each provider shall adhere
			 to DAAS policies and procedures for programs on aging and shall provide
			 services in accordance with AFCSP's policies and procedures;
B. Each provider shall comply with all the
			 provisions of the service descriptions as established by AAAs and
			 DAAS;
C. Attend training provided
			 by DAAS or AAAs;
D. Each provider
			 shall maintain financial records in accordance with standard accounting
			 procedures and comply with all applicable State and Federal
			 regulations;
E. Each provider shall
			 maintain and submit program data and statistics as required by AAAs;
			 and
F. Forms utilized by providers
			 shall include all information required by AAAs and DAAS.
310.204
Eligibility for Caregiver
			 Services
A. Family caregivers who are
			 adult family members or other individuals providing informal in-home and
			 community care to an older individual (60 years of age or older) who is "frail"
			 and determined to be functionally impaired because of:
1. An inability to perform at least two
			 activities of daily living without substantial human assistance, including
			 verbal reminding, physical cueing, or supervision; or
2. Due to cognitive or other mental
			 impairment, requires substantial supervision because the individual behaves in
			 a manner that poses a serious health or safety hazard to the individual or to
			 others.
B. In the case
			 of a family caregiver of an older individual, respite care and supplemental
			 services under AFCSP shall be provided only if the care recipient is
			 functionally impaired and meets either of the following conditions:
1. An inability to perform at least two
			 activities of daily living without substantial human assistance, including
			 verbal reminding, physical cueing, or supervision; or
2. Due to cognitive or other mental
			 impairment, requires substantial supervision because the individual behaves in
			 a manner that poses a serious health or safety hazard to the individual or to
			 others.
C. Services may
			 be provided by grandparents or older individuals who are a relative caregiver
			 of a child by blood, marriage, or adoption who is 55 years of age or older, and
			 who:
1. Lives with the child;
and
2. Is the primary
			 caregiver of the child because the biological or adoptive parents are unable or
			 unwilling to serve as the primary caregiver of the child;
and
3. Has a legal
			 relationship to the child, such as legal custody or guardianship, or is raising
			 the child informally.
310.205
Service Components of the
			 AFCSP
The five service categories for caregiver services are:
A.
Information
provided to
			 caregivers about available services, including public education and provisions
			 of information at health fairs and other similar designations as determined by
			 the State. Included in the definition of information is
			 "
outreach
", defined as interventions for the purpose of
			 identifying potential caregivers and encouraging their use of existing services
			 and benefits. Services are directed to large audiences of current or potential
			 caregivers such as disseminating publications, conducting media campaigns, and
			 other similar activities.
B.
Access/Assistance
given to caregivers in gaining access to
			 services by linking individuals to the opportunities and services available to
			 the maximum extent. The provider should ensure that the individual receives the
			 services needed and makes the opportunities available to the individuals by
			 establishing adequate follow-up procedures.
Case management
is
			 assistance either in the form of access or care coordination in circumstances
			 where the older person or their caregivers are experiencing diminished
			 functioning capacities, personal conditions, or other characteristics which
			 require the provision of services by formal service providers. Activities of
			 case management include assessing needs, developing care plans, authorizing
			 services, arranging services, coordinating the provision of services among
			 providers, follow-up and reassessment, as required.
C.
Counseling
includes
			 individual counseling, organization of support groups and caregiver training to
			 assist caregivers in the areas of health, nutrition, financial literacy, and
			 making decisions, as well as, solving problems relating to their caregiver
			 roles.
D.
Respite Care
provides temporary, substitute supports or living arrangements to
			 provide a brief period of rest for caregivers. It can be in the form of
			 in-home, adult day care, or institutional respite. The respite period may be an
			 overnight stay or may be taken on an intermittent, occasional or emergency
			 basis by the hour. Respite care services may include the following activities:
1. In-home services, including services
			 provided by volunteers or in-home service providers;
2. Adult day care services; or
3. Institutional respite care.
4. For grandparents caring for children -
			 this could include summer camps.
E.
Supplemental Services
are
			 provided on a limited basis, not to exceed 10% of the Title III-E Allocation,
			 to complement the care provided by caregivers. Supplemental Services includes
			 goods or services to assist the caregiver and/or the care recipient, as needed.
			 Examples include: blood pressure measuring instruments, insulin test kits,
			 dental work, eyeglasses (caregiver only),one time medications, homemaker,
			 chore, and personal care (Note: care recipient must not be Medicaid eligible).
			 Under the flexible AFCSP, these services or supports could be provided on a
			 limited basis for either the caregiver or care receiver.
Temporary -
No more than seven consecutive days
				nor more than fourteen days in a calendar year. A day is considered to be a
				24-hour time period. A client can have 336 hours a year of respite services
				(fourteen days) but not more than 168 hours of respite services for seven
				consecutive days.
Limited Basis
-Not more than once per week (or a
				total of 8 hours per week)
310.200
Respite Care
&
Supplemental Restriction
In order to be eligible for respite care and supplemental
				services (i.e., personal assistance), family caregivers must be providing
				in-home and community care to older individuals who meet the following
				definition of "frail" as outlined in subparagraph (A) (i) or (B) of section 102
				(28) of the Older Americans Act:
The term "frail" means that the older individual is
				determined to be functionally impaired because the individual -
a.
Is unable to perform at least two
			 activities of daily living without substantial human assistance, including
			 verbal reminding physical cueing or supervision,
or
b.
Due to a cognitive or other mental impairment, requires substantial
			 supervision because the individual behaves in a manner that poses a serious
			 health or safety hazard to the individual or to another individual.
NOTE:
This restriction does not
				apply to grandparents or older individuals who are relative caregivers of
				children not more than 18 years of age from receiving respite care and/or
				supplemental services.
310.206
Funding Requirements
A. No AAA may use more than ten percent (10%)
			 of its award to provide Title III-E services to grandparents and older
			 individuals who are relative caregivers of minors.
B. No AAA may budget and/or expend more than
			 twenty percent (20%) of its federal award to provide supplemental services.
			 Supplemental services are flexible enhancements to caregiver support programs
			 designed for the benefit of caregivers.
C. No AAA may use more than ten percent (10%)
			 of its award for administrative costs.
D. AAAs are not allowed to transfer funds
			 between Title III-E and any other Titles under the OAA.
E. The current Intrastate Funding Formula
			 will be used to distribute Title III, Part E funds.
F. The intent of the Title III-E maintenance
			 of effort provision in Section 374 is that States and AAAs
do not
use the funds available under Title III-E to supplement existing
			 services. Title III-E funds must be spent in addition to, and shall not
			 supplant, any Federal, State, or local funds expended by an AAA to fund
			 services described in these guidelines provided prior to the date of enactment
			 of Part E (effective November 12, 2000).
G. State Aging Services may be used to match
			 the Title III-E.
H.
All
OAA requirements, regarding program income, apply to Part E
			 services.
310.207
Reporting Requirements
AAAs and their providers must adhere to all OAA and DAAS
				reporting policies and procedures. See Reporting Policy
				208.