Washington Administrative Code › Title 388 - Social and Health Services, Department of › AGING AND ADULT SERVICES › Chapter 388-106 - Long-term care services › MAC AND TSOA SERVICES › Section 388-106-1900 - What definitions apply to MAC and TSOA services?

Current through Register Vol. 24-14, July 15, 2024
The following definitions apply to MAC and TSOA
					 services:
"Care plan"
means the plan developed by the
					 department in GetCare that summarizes the services described in WAC
					 388-106-1915 that you chose to
					 receive.
"Care receiver"
means an adult age 55 and over
					 who has been authorized for MAC or TSOA services.
"Caregiver"
means a spouse, relative, or
					 friend (age 18 and over) who has primary responsibility for the care or
					 supervision of an adult who meets eligibility criteria and does not receive
					 direct, public, or private payment such as a wage for the caregiving services
					 they provide.
"Caregiver assistance services"
are services
					 that take the place of those typically performed by an unpaid caregiver in
					 support of the care receiver's unmet needs for assistance with activities of
					 daily living (ADLs) and instrumental activities of daily living (IADLs).
"Caregiver phases"
means the phases a
					 caregiver experiences as the needs of the care receiver change, which in turn
					 changes the responsibilities and tasks of caregiving. The change in
					 responsibilities and tasks impacts the relationship between the caregiver and
					 the care receiver. There are five phases showing the change in relationship
					 roles from primarily family member to primarily caregiver. The five phases
					 are:
(1) Phase one - Acting as a
				  relative/friend almost all of the time;
(2) Phase two - Acting most often as a
				  relative/friend, but sometimes as a caretaker;
(3) Phase three - Acting equally as a
				  relative/friend and as a caregiver;
(4) Phase four - Acting most often as a
				  caregiver, but sometimes you are still a relative/friend; and
(5) Phase five - Acting as a caregiver almost
				  all of the time.
"Family caregiver"
means the same as
					 "caregiver."
"GetCare"
means a statewide web-based
					 information system that includes a client management component that includes
					 screening and assessment tools for use by area agencies on aging (AAA) and
					 other aging and disability network partners.
"GetCare assessment"
is a process during which
					 the department gathers information for an individual without a caregiver in the
					 following areas: Functional needs, diagnoses and conditions, behavior health
					 supports, oral health, and nutritional health to assist the individual with
					 choosing step three services.
"GetCare screening"
is a process during which
					 the department gathers information for an individual without a caregiver in
					 order to determine risk scores. The information covers the following areas:
					 Function needs, fall risk, availability of informal help, memory and
					 decision-making issues, and emotional well-being. The risk scores are used to
					 determine if the individual is referred for a full GetCare assessment.
"Health maintenance and therapies"
are
					 clinical or therapeutic services that assist the care receiver to remain in
					 their home or the caregiver to remain in their caregiving role and provide high
					 quality care. Services are provided for the purpose of preventing further
					 deterioration, improving, or maintaining current level of functioning.
"Identity discrepancy"
means a negative
					 psychological state that occurs when the activities and responsibilities that a
					 caregiver assumes with regard to the care receiver are inconsistent with the
					 care-giver's expectations or personal norms concerning these activities and
					 responsibilities.
"MAC"
means medicaid alternative care, which
					 is a federally funded program authorized under section 1115 of the Social
					 Security Act. It enables an array of person-centered services to be delivered
					 to unpaid caregivers caring for a medicaid eligible person who lives in a
					 private residence (such as their own home or a family member's home) and
					 chooses to receive community-based services.
"Medicaid transformation project"
refers to
					 the authority granted to the state by the federal government under section 1115
					 of the Social Security Act. This is a five year demonstration waiver to support
					 health care systems prepare for and implement health reform and provide new
					 targeted medicaid services to eligible individuals with significant needs. It
					 includes MAC and TSOA programs.
"Personal assistance services"
are supports
					 involving the labor of another person to help the care receiver complete
					 activities of daily living and instrumental activities of daily living that
					 they are unable to perform independently. Services may be provided in the care
					 receiver's home or to access community resources.
"RDAD"
means reducing disability in
					 Alzheimer's disease. This program is designed to improve the ability of the
					 person with memory problems to complete activities of daily living while also
					 helping caregivers provide assistance to the person.
"Service provider"
means an agency or
					 organization contracted with the department.
"Specialized medical equipment and supplies"
are goods and supplies needed by the care receiver that are not covered under
					 the medicaid state plan, medicare, or private insurance.
"TCARE"
means tailored caregiver assessment
					 and referral, which is an evidence-based caregiver coordination process
					 designed to assist department assessors who work with family caregivers to
					 support adults living with disabilities. TCARE is designed to tailor services
					 to the unique needs of each caregiver to help reduce stress, depression, and
					 burdens associated with caregiving. TCARE was developed by a research team at
					 the University of Wisconsin-Milwaukee led by Dr. Rhonda Montgomery in
					 collaboration with over 30 organizations serving family caregivers. The TCARE
					 process is licensed for use by Tailored Care Enterprises, Inc.
"TCARE assessment"
is a part of the TCARE
					 process during which the department assessors gather responses to all of the
					 TCARE screening questions and additional questions focused on both the
					 caregiver's experience and the care receiver's situation, such as memory
					 issues, behavioral needs, assistance needs with activities of daily living and
					 instrumental activities of daily living, and diagnoses/conditions.
"TCARE screening"
is a part of the TCARE
					 process during which the department gathers information from the caregiver to
					 determine scores and ranges for the caregiver's identity discrepancy, burdens,
					 uplifts, and depression. The ranges are used to determine if the caregiver is
					 referred for a full TCARE assessment.
"Training and education"
are services and
					 supports to help care-givers gain skills and knowledge to implement services
					 and supports needed by the care receiver to remain at home and skills needed by
					 the caregiver to remain in their role.
"TSOA"
means tailored supports for older
					 adults, which is a federally-funded program approved under section 1115 of the
					 Social Security Act. It enables the delivery of person-centered services
					 to:
(1) Caregivers who care for an
				  eligible person as defined in WAC
				  388-106-1910; and
(2) Eligible persons as defined in WAC
				  388-106-1910, without a
				  caregiver.