Kentucky Administrative Regulations › Title 910 - CABINET FOR HEALTH AND FAMILY SERVICES - OFFICE OF AGING SERVICES › Chapter 1 - Aging Services › Section 910 KAR 1:180 - Homecare program for the elderly

Current through Register Vol. 51, No. 1, July 1, 2024
RELATES TO:
				KRS
				13B.010-13B.170,
				194A.700(1),
				(7),
				205.010(6),
				205.201,
				205.203,
				205.455-465,
				209.030(2),
				(3), 42 U.S.C. Chapter 35
NECESSITY, FUNCTION, AND CONFORMITY: 42 U.S.C. Chapter 35
				authorizes grants to states to provide assistance in the development of new or
				improved programs for older persons.
				KRS
				194A.050(1) authorizes the
				secretary to promulgate administrative regulations necessary to implement
				programs mandated by federal law, or to qualify for the receipt of federal
				funds. KRS
				205.204 designates the cabinet as the state
				agency to administer 42 U.S.C. Chapter 35 in Kentucky and promulgate
				administrative regulations for this purpose. This administrative regulation
				establishes the standards of operation for a homecare program for elderly
				persons in Kentucky.
Section 1.
			 Definitions.
(1) "Activities of daily living"
			 is defined by KRS
			 194A.700(1).
(2) "Area plan" means the plan that:
(a) Is submitted by a district for the
			 approval of the department; and
(b)
			 Releases funds under contract for the delivery of services within the planning
			 and service area.
(3)
			 "Assessment" means the collection and evaluation of information about a
			 person's situation and functioning to determine the applicant's or recipient's
			 service level and development of a plan of care utilizing a holistic,
			 person-[]centered approach by a qualified case manager.
(4) "Case management" means a process,
			 coordinated by a case manager, for linking a client to appropriate,
			 comprehensive, and timely home or community based services as identified in the
			 plan of care by:
(a) Planning;
(b) Referring;
(c) Monitoring;
(d) Advocating; and
(e) Following the timeline of the assessment
			 agency to obtain:
1. Service level;
			 and
2. Development of the plan of
			 care.
(5) "Case
			 management supervisor" means an individual:
(a) Meeting the requirements of Section
			 5(1)(a) of this administrative regulation; and
(b) Who has four (4) years or more experience
			 as a case manager.
(6)
			 "Case manager" means the individual employee responsible for:
(a) Coordinating services and supports from
			 all agencies involved in providing services required by the plan of
			 care;
(b) Completing the initial
			 assessment, plan of care, and annual reassessment;
(c) Ensuring all service providers have a
			 working knowledge of the plan of care; and
(d) Ensuring services are delivered as
			 required.
(7) "Case
			 record" means the collection of information, documents, demographics, and
			 required information maintained in the Aging Services tracking data
			 system.
(8) "Department" means the
			 Department for Aging and Independent Living.
(9) "District" is defined by
			 KRS
			 205.455(4).
(10) "Extraordinary out-of-pocket expenses"
			 means medical expenses not covered by insurance including:
(a) Copays;
(b) Deductibles;
(c) Prescriptions;
(d) Premiums for medical insurance;
			 or
(e) Other medical, dental, or
			 vision cost incurred as a result of medically necessary treatments or
			 procedures.
(11)
			 "Homecare services" means services that:
(a)
			 Are:
1. Provided to an eligible individual who
			 is a "functionally impaired elderly person" as defined by
			 KRS
			 205.455(7); and
2. Directed to the individual established in
			 subparagraph 1 of this paragraph toward:
a.
			 Prevention of unnecessary institutionalization; and
b. Maintenance in the least restrictive
			 environment, excluding residential facilities;
			 and
(b)
			 Include:
1. "Chore services" as defined by
			 KRS
			 205.455(1);
2. "Core services" as defined by
			 KRS
			 205.455(2);
3. "Escort services" as defined by
			 KRS
			 205.455(5);
4. "Home-delivered meals" as defined by
			 KRS
			 205.455(8);
5. "Home-health aide services" as defined by
			 KRS
			 205.455(9);
6. "Homemaker services" as defined by
			 KRS
			 205.455(10);
7. "Home repair services" as defined by
			 KRS
			 205.455(11);
8. "Personal care services" as defined by
			 subsection (16) of this section; and
9. "Respite services" as defined by
			 KRS
			 205.455(12).
(12) "Informal supports" means any care
			 provided to an individual that is not provided as part of a public or private
			 formal service program.
(13)
			 "Instrumental activities of daily living" is defined by
			 KRS
			 194A.700(7).
(14) "Natural Supports" means a non-paid
			 person or community resource who can provide, or has historically provided,
			 assistance to the consumer or, due to the familial relationship, would be
			 expected to provide assistance if capable.
(15) "Personal care services" means
			 assistance with activities of daily living.
(16) "Person-centered planning" means a
			 process:
(a) For selecting and organizing the
			 services and supports that an older adult or person with a disability might
			 need to live in the community and is directed by the person who receives the
			 support; and
(b) That is directed
			 by the person who receives the support.
(17) "Reassessment" means reevaluation of the
			 situation and functioning of a client.
(18) "Service level" means the minimum
			 contact required through face-to-face visits and telephone calls by the case
			 manager or social service assistant.
(19) "Social service assistant" means an
			 individual who:
(a) Has at least a high school
			 diploma or equivalent;
(b) Works
			 under the direction of the case manager supervisor;
(c) Assists the case manager with record
			 keeping, filing, data entry, and phone calls;
(d) Helps determine what type of assistance
			 their clients need;
(e) Assists the
			 client in getting services to carry out the plan of care;
(f) Coordinates services provided to the
			 client;
(g) Assists clients in
			 applying for other services or benefits for which they may qualify;
			 and
(h) Monitors clients to ensure
			 services are provided appropriately.