Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 19 - Aging and Adult Services › Rule 016.19.12-002 - Policy 226: Health Promotion, Wellness & Disease Prevention

Current through Register Vol. 49, No. 6, June, 2024
Section 226
			 Division of Aging and Adult Services Policy and Procedures Manual
226.000
Health Promotion, Wellness
			 & Disease
Prevention
Each Area Agency on Aging (AAA) and subcontractor shall provide
				for health promotion, wellness and disease prevention programs to older adults,
				particularly those who have the greatest economic and/or social need and/or are
				in the minority in their planning area.
Health promotion, wellness and disease prevention programs can
				include, but are not limited to exercise classes, physical activity,
				self-management classes, behavior modification classes, nutrition classes, and
				fall prevention classes.
Health promotion, wellness and disease prevention programs must
				conform to requirements of the State laws, the Older Americans Act (OAA) and
				accompanying federal regulations and policies and procedures of the Division of
				Aging and Adult Services (DAAS). The AAAs will develop procedures to assist
				subcontractors in meeting DAAS and AAA procedures as needed.
226.010
Purpose
To ensure that older adults, particularly those who have the
				greatest economic and/or social need and/or are in the minority, attain and
				maintain physical and mental well-being through regular programs of health
				promotion, wellness, and disease prevention.
226.011
Scope
These procedures apply to the state Area Agencies on Aging
				(AAA) and the subcontractors of health promotion, wellness, and disease
				prevention programs and define the process for providing health promotion,
				wellness and disease prevention programs.
226.012
General Authority
The Older Americans Act of 1965 as amended.
226.013
Definitions
Health Promotion and Disease Prevention:
A. Health risk
			 assessments
B. Routine health
			 screenings
C. Nutritional
			 counseling and education for individuals and their primary caregivers
D. Evidence-based health promotion programs,
			 including but not limited to programs related to the prevention and mitigation
			 of the effects of chronic disease (including osteoporosis, hypertension,
			 obesity, diabetes, cardiovascular disease), alcohol and substance abuse
			 reduction, smoking cessation, weight loss and control, stress management, fall
			 prevention, physical activity, and improved nutrition
E. Programs regarding physical fitness, group
			 exercise, music therapy, art therapy, and dance movement therapy, including
			 programs for multigenerational participation that are provided by:
1. An institution of higher
			 learning
2. A local educational
			 agency as defined in section 14101 of the elementary and Secondary Education
			 Act of 1965 ( 20 U.S.C.
			 8801 )
3. A community-based organization
F. Home injury control services,
			 including screening of high-risk home environments and provision of educational
			 programs on injury prevention (including fall and fracture prevention) in the
			 home environment
G. Medication
			 management screening and education to prevent incorrect medication and adverse
			 drug reactions
The term shall not include services for which payment may be
				made under titles XVIII and XIX of the Social Security Act (
				42U.S.C.
				1395 et seq., 1396 et seq.).
Wellness
: an active lifelong process
				of becoming aware of choices and making decisions toward a more balanced and
				fulfilling life.
A. Process:
			 individuals never arrive at a point where there is no possibility of
			 improvement.
B. Aware: individuals
			 are by nature continuously seeking more information about how they can
			 improve.
C. Choices: individuals
			 have considered a variety of options and have selected those that seem to be in
			 their best interest.
Evidence-Based Disease Prevention
				Program
: A process of planning, implementing, and evaluating
				programs adapted from tested models or interventions in order to address health
				issues in a social ecological context. In an evidence-based disease prevention
				program, the proposed intervention is based on rigorously conducted research
				with published results.
Greatest Economic Need
: The need
				resulting from an income level at or below poverty levels set by the Bureau of
				Census.
Greatest Social Need
: The need caused
				by non-economic factors which include physical and mental disabilities, limited
				English proficiency (LEP), cultural, social, or geographical isolation which
				restrict an individual's ability to perform normal daily tasks or threaten his
				or her capacity to live independently.
226.020
Service Definition for Health
			 Promotion, Wellness &
Disease Prevention
The facilitation of a client's involvement in activities to
				promote health and well-being, to reduce isolation, and to keep the client in
				the community. This may be accomplished through, but are not limited to,
				physical fitness activities, health screenings, nutrition education, and
				evidence-based disease prevention programs such as: chronic disease self
				management, falls prevention, behavior modification, and others.
226.021
Unit
			 Definition
One unit is equal to one activity session of related service
				provision.
226.022
Goal of Service
The purpose of Health Promotion, Wellness, and Disease
				Prevention programs for older adults is to:
A. Maintain or enhance health and
			 well-being
B. Maintain or enhance
			 self-sufficiency and personal independence
C. Prevent isolation and disengagement due to
			 chronic disease or illness
D.
			 Increase physical and mental activity
E. Empower the client to manage their
			 physical conditions
F. Offer
			 activities that enhance all dimensions of wellness
G. Provide the tools for making healthier
			 life decisions
226.030
Minimum of Standards
A. Each
			 provider of Health Promotion, Wellness or Disease Prevention Programs must meet
			 the following minimum standards:
1. A person
			 qualified by work related training or experience must be designated to
			 supervise the program
2.
			 Satisfactory procedures must be established to schedule and provide health
			 promotion, wellness and disease prevention activities for older adults with
			 adequate operating procedures to assure proper management and
			 accountability.
3. There must be
			 adequate working space, staff, supplies, equipment, and operating
			 procedures
4. Adequate records must
			 be maintained to record and evaluate service provisions, fiscal management, and
			 provide a basis for required reports
5. Satisfactory procedures must be
			 established to protect confidentiality of records which include names and
			 personal information, and to obtain and record the individual's informed
			 consent prior to the release of personal information
6. Satisfactory procedures must be
			 established to objectively resolve service complaints and evaluate the quality
			 of services delivered, including services provided to persons with
			 disabilities
7. Health Promotion,
			 Wellness and Disease Prevention programs are to be provided, which are:
a. Varied to appeal to participants with
			 differing levels of ability
b.
			 Designed to increase the participant's knowledge of health related
			 issues
c. Designed to empower older
			 adults in making healthier life decisions
d. Designed to address the various dimensions
			 of wellness
e. Designed to maintain
			 or increase the participant's physical fitness
f. Designed to maintain or increase the client's ability to
			 participate in the daily activities of living
B. Each AAA and /or provider must offer
			 Evidence-Based Health Promotion/Disease Prevention programs.
1. Each Evidence-Based Program must be
			 approved by DAAS
2. The program is
			 to be implemented by a community-based organization (i.e., a non-medical
			 setting), yet partnering with healthcare/clinical settings is
			 appropriate
3. The community-based
			 organization implementing the program must be able to deliver part, if not all,
			 of the intervention - meaning the community-based organization cannot be
			 limited to doing outreach/screening.
4. Each Evidence-Based Program must meet the
			 following requirements:
a. Program leaders
			 must have required program specific certification
b. Program leaders must participate in
			 program specific continuous and/or re-certification training
c. Maintain program specific
			 fidelity
d. Keep and record all
			 program specific required data
5. Assess all programs at least annually,
			 including:
a. Process Evaluation - program,
			 program leader, participant satisfaction
b. Outcome Evaluation - including, but not
			 limited to, benefits, type of evidence generated, program goals, gained
			 knowledge, before and after participant changes
C. DAAS will assess Health Promotion programs
			 as required by OAA and DAAS policy and will provide technical assistance as
			 requested.
226.040
Eligibility
A. Persons
			 receiving billable services must be age 60 or older
B. Persons receiving billable services may be
			 primary caregivers under age 60
C.
			 Other persons (under 60) may receive non-billable services at the discretion of
			 the AAA
226.050
Service Activities
A. Client intake
			 and casework appropriate to maintain client in the program
B. Collection of required data for
			 evidence-based programs
226.051
Access to Service
The client may enter the service system at any point through
				appropriate referral or drop-in.
226.052
Delivery
			 Characteristics
Each client shall have a client record to indicate an
				application for service, documentation of service rendered and authorization
				release where appropriate.
226.060
Staffing
There shall be a supervisor on duty for assistance to assigned
				staff. The staff shall be qualified to provide assistance and guidance in
				health promotion, wellness, and disease prevention activities. There shall be
				an annual evaluation of the staff by the supervisor in charge of personnel. The
				staff shall participate in on-going training as scheduled and training records
				will be maintained. All workers must be able to carry out directions and
				instructions, able to maintain program fidelity, and keep
				records.