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Lake Cumberland Area Agency on Aging & Independent Living Policies and Procedure Manual

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SECTION XIX

TAXONOMY

SERVICE AND UNIT DEFINITIONS FOR KENTUCKY STATE PROGRAM

STATE OMBUDSMAN

Ombudsman (1 Activity) - Activities include: 1. identifying, investigating, and resolving complaints that are made by, or on behalf of, residents; 2. relate to action, inaction, or decisions that may adversely affect the health, safety, welfare, or rights of the residents; 3. Monitoring the development and implementation of federal and state policies and regulations related to long- term care facilities; and 4. Providing information.

Presentations (1 Activity) - Unduplicated would be the number of presentations held.

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SERVICE AND UNIT DEFINITIONS FOR

OLDERAMERICANS ACT SERVICES

TITLE III B CLUSTER I

Adult DayCare/Adult Day Health (1 Hour) - Personal care for dependent elders in a supervised, protective and congregate setting during some portion of a day. Services offered in conjunction with adult day care/adult day health typically include social and recreational activities, training, counseling, and services such as rehabilitation, medications assistance, and home health aide services for adult day health. [Requires an assessment, care plan and ongoing casemanagement]

Assessment (1 Hour) - See Assessment portion of Case Management definition.

Case Management (1 Hour) - Assistance either in the form of access or care coordination in circumstances where the older person and/or their caregivers are experiencing diminished functioning capacities, personal conditions or other characteristics which require the provision of services by formal service providers or family caregivers. 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.

Chore (1 Hour) - Providing assistance to persons having difficulty with one or more of the following instrumental activities of daily living: heavy housework, yard work or sidewalk maintenance.

Homemaker (1 Hour) - Providing assistance to persons having difficulty with one or more of the following instrumental activities of daily living: preparing meals, shopping for personal items, managing money, using the telephone or doing light housework. [Requires an assessment, care plan and ongoing case management]

Personal Care (1 Hour) - Providing personal assistance, stand-by assistance, supervision or cues for persons with the inability to perform one or more of the following activities of daily living: eating, dressing, bathing, toileting, transferring in and out of bed/chair and walking. [Requires an assessment, care plan and ongoing case management]

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TITLE III B CLUSTER II

Escort (Assisted Transportation) (1 One-Way Trip) – Assistance and transportation, including escort, to a person who has difficulties (physical or cognitive) using regular vehicular transportation.

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TITLE III B CLUSTER III (other services)

Advocacy (1 Hour) - Action taken on behalf of an older person to secure his/her rights or benefits. Includes receiving, investigating and working to resolve disputes or complaints. Does not include service provided by an attorney or person under the supervision of an attorney.

Cash & Counseling (1 Activity) This covers the range of services provided or paid for through allowance, vouchers, or cash which are provided to the client so that the client can obtain the supportive services which are needed. (Services purchased by vouchers are to be counted under Cash and Counseling)

Escort (Assisted Transportation) (1 One-Way Trip) – Assistance and transportation, including escort, to a person who has difficulties (physical or cognitive) using regular vehicular transportation.

Homemaker (1 Hour) Providing assistance to persons having difficulty with one or more of the following instrumental activities of daily living: preparing meals, shopping for personal items, managing money, using the telephone or doing light housework. [Requires an assessment, care plan and ongoing case management]

Respite (1 Hour) - Care provided to an eligible person by an approved caregiver for a designated time period because of absence or need for relief of those normally providing care. [Requires an assessment, care plan and ongoing case management]

Transportation (1 One-Way Trip) - Transportation from one location to another. Does not include any other activity.

Counseling (1 Hour) - Uses the casework mode of relating to a client (via interview, discussion, or lending a sympathetic ear) to advise and enable the older person and/or his/her family to resolve problems (concrete or emotional) or to relieve temporary stresses encountered by them. May be done on a one-to-one basis or on a group basis and may be conducted by paid, donated and/or volunteer staff. (For nutrition, see Nutrition Counseling Title III-C).

Education/Training (1 Hour) - Providing formal or informal opportunities for individuals to acquire knowledge, experience or skills. Includes individual or group events designed to increase awareness in such areas as nutrition, crime, or accident prevention; promote personal enrichment, for example, through continuing education; to increase or gain skills in a specific craft, trade, job, or occupation. Does not include wages or stipends. (For nutrition, see Nutrition Education Title III- C).

Employment Services (1 Hour) - Services to encourage the employment of older workers, including job and second career counseling and, where appropriate, job

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development, referral, and placement.

Friendly Visiting (1 Contact) - Going to see a client in order to comfort or help. [Requires an assessment (documentation of need) and care plan]

Health Promotion (1 Session) Services which include health screenings and assessments; organized physical fitness activities; evidence-based health promotion programs; medication management; home injury control services; and/or information, education, and prevention strategies for chronic disease and other health conditions that would reduce the length or quality of life of the person sixty (60) or older.

Example: health promotion includes programs relating to chronic disabling conditions (including osteoporosis and cardiovascular disease) prevention and reduction of effects, alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, physical fitness programs such as walking programs, exercise programs, and music, art, and dance-movement therapy, and assisting participants in understanding health insurance policies.

Note: See Title III D on page 10.

Examples of reporting additional items under Health Promotion: Coalition building: Units: count the number of contacts (organizations, agencies) made in conducting a coalition-building activity. Number served: estimate the number of 60+ who would benefit from the program/service. Advocacy related to health issues: Units: the number of contacts made in conducting the advocacy. Number served: estimate the number of 60+ who would benefit from the advocacy.

Home Health Aide (1 Hour) - Providing assistance to persons and/or families whose routines have been disrupted by long or short term illness, disability or other circumstance through paraprofessional aides who provide personal health care services including assisting in administering medications, teaching the client and/or caregiver in self-care techniques, observing, recording, and reporting on the client's status and any observed changes. [Requires an assessment, care plan and ongoing case management]

Home Repair (1 Activity) - Performance of tasks for minor home adaptations including additions to or modifications of the home environment to enable the elderly to maintain independent living in the home or to ensure health, safety, or facilitate mobility.

Information and Assistance (1 Contact) - A service for older individuals that (A) provides individuals with current information services available within the communities, (B) links individuals to the services and opportunities that are available; (C) to the maximum extent practicable establishes adequate follow-up procedures. Internet web site "hits" are to be counted only if information is requested and supplied. [Note: The service units for information and assistance and for outreach are individual, one-on-one contacts between a service provider and an elderly client or caregiver. An activity that involves contact with multiple current or potential clients or caregivers (e.g., publications, publicity campaigns, and other mass media activities) should not be counted as a unit of service. Such services might be termed

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public information and reported on the public information category. They may also be reported in "Section II.E. – Utilization and Expenditures Profiles, Other Services Profile (Optional).]

Legal Assistance (1 Hour) - Legal advice, counseling and representation by an attorney or other person acting under the supervision of an attorney.

Public Information (1 Activity) – Provision of information, assistance or outreach to a group of individuals. Involves contact with several current or potential client/caregivers.

Ombudsman (1 Activity) - Activities include: 1. identifying, investigating, and resolving complaints that are made by, or on behalf of, residents; 2. relate to action, inaction, or decisions that may adversely affect the health, safety, welfare, or rights of the residents; 3. Monitoring the development and implementation of federal and state policies and regulations related to long- term care facilities; and 4. Providing information.

Presentations (1 Activity) - Unduplicated would be the number of presentations held.

Outreach (1 Contact) - Interventions with individuals initiated by an agency or organization for the purpose of identifying potential clients (or their caregivers) and encouraging their use of existing services and benefits.

[Note: The service units for information and assistance and for outreach are individual, one-on- one contacts between a service provider and an elderly client or caregiver. An activity that involves contact with multiple current or potential clients or caregivers (e.g., publications, publicity campaigns, and other mass media activities) should not be counted as a unit of service. Such services might be termed public information and reported on the public information category. They may also be reported in "Section II.E. – Utilization and Expenditures Profiles, Other Services Profile (Optional).]

Recreation (1 Contact) - Provision of activities which foster the health or social well- being of individuals through social interaction and the satisfying use of leisure time.

Respite (1 Hour) - Care provided to an eligible person by an approved caregiver for a designated time period because of absence or need for relief of those normally providing care. [Requires an assessment, care plan and ongoing case management]

Telephone Reassurance (1 Contact) - Phoning in order to provide comfort or help. [Requires an assessment (documentation of need) and care plan]

Transportation (1 One-Way Trip) - Transportation from one location to another. Does not include any other activity.

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Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Travel time incurred in the delivery of services.

(c) Training, staff meeting.

(d) Projectmanagement.

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SERVICE AND UNIT DEFINITIONS FOR OLDERAMERICANS ACT SERVICES

TITLE III C-1 CONGREGATE MEALS (CLUSTER II)

Congregate Meals (1 Meal) - Provision, to an eligible client or other eligible participant at a nutrition site, senior center or some other congregate setting, a meal which: (a) complies with the Dietary Guidelines for Americans (published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture); (b) provides, if one meal is served, a minimum of 33 and 1/3 percent of the current daily Recommended Dietary Allowances (RDA) as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences; (c) provides, if two meals are served, together, a minimum of 66 and 2/3 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second meal shall be balanced and proportional in calories and nutrients; and (d) provides, if three meals are served, together, 100 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second and third meals shall be balanced and proportional in calories and nutrients.

Nutrition Counseling (1 session per participant) - Individualized guidance to individuals who are at nutritional risk because of their health or nutritional history, dietary intake, chronic illnesses, or medications use, or to caregivers. Counseling is provided one-on-one by a registered dietician, and addresses the options and methods for improving nutrition status.

Nutrition Education (1 session per participant) - A program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants, caregivers, or participants and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise. [Note: this is the only service of the 14 listed services in the SPR where the unit measure (one session) refers to either an individual or group service. In this case, for example, a group of people attending a session on nutrition issues for the elderly would count as one unit of "Nutrition Education".] [Nutrition education must occur at least once a month]

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Training, staff meeting.

(d)Projectmanagement.

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SERVICE AND UNIT DEFINITIONS FOR OLDERAMERICANS ACT SERVICES

TITLE III C-2 HOME DELIVERED MEALS (CLUSTER I)

Home Delivered Meals (1 Meal) - Provision, to an eligible client or other eligible participant at the client's place of residence, a meal which: (a) complies with the Dietary Guidelines for Americans (published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture); (b) provides, if one meal is served, a minimum of 33 and 1/3 percent of the current daily Recommended Dietary Allowances (RDA) as established by the Food and Nutrition Board of the National Research Council of the National Academy of Sciences; (c) provides, if two meals are served, together, a minimum of 66 and 2/3 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second meal shall be balanced and proportional in calories and nutrients; and, (d) provides, if three meals are served, together, 100 percent of the current daily RDA; although there is no requirement regarding the percentage of the current daily RDA which an individual meal must provide, a second and third meals shall be balanced and proportional in calories and nutrients. [Requires an assessment, care plan and ongoing case management]

Nutrition Counseling (1 session per participant) - Individualized guidance to individuals who are at nutritional risk because of their health or nutritional history, dietary intake, chronic illnesses, or medications use, or to caregivers. Counseling is provided one-on-one by a registered dietician, and addresses the options and methods for improving nutrition status.

Nutrition Education (1 session per participant) - A program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants, caregivers, or participants and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise. [Note: this is the only service of the 14 listed services in the SPR where the unit measure (one session) refers to either an individual or group service. In this case, for example, a group of people attending a session on nutrition issues for the elderly would count as one unit of "Nutrition Education".] [Nutrition education must occur at least once a month]

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Travel time incurred in the delivery of services.

(c) Training, staff meeting.

(d) Projectmanagement.

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THESE DEFINITIONS TO BE USED JULY 1, 2011

SERVICE AND UNIT DEFINITIONS FOR OLDERAMERICANS ACT SERVICES

TITLE III D PREVENTIVE HEALTH

Health Promotion shall include the provision of one or more of the following services: community-based health promotion, provider involvement, collaboration, advocacy related to health issues, substance abuse prevention, medication misuse, mental health promotion, injury risk reduction, and cardiovascular health promotion. Contact may be directly with or on behalf of the client in either group or individual activities. [Note: Subservices must be mapped to main service]

Definitions were taken from 42 U.S.C. Section 3002. Definitions and OAA as amended in 2006.

Information and Counseling (1 Contact)

Mental Health - Screening for the prevention of depression, coordination of community mental health services, provision of educational activities, and referral to psychiatric and psychological services.

• Information - concerning diagnosis, prevention, treatment, and rehabilitation concerning age-related diseases and chronic disabling conditions, including osteoporosis, cardiovascular diseases, diabetes, and Alzheimer’s disease and related disorders with neurological and organic brain dysfunction.

• Counseling – Counseling regarding social services and follow up health services based on any of the services described in 42 U.S.C. Section 3002(14)(A through K). Also includes gerontological counseling.

• Education – Educational programs on the availability, benefits, and appropriate use of preventive health services covered under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.).

Health Promotion (1 Session)

Evidence-Based Health Promotion - Programs related to the prevention and mitigation of the effects of chronic disease (including osteoporosis, hypertension, obesity, diabetes, and cardiovascular disease), alcohol and substance abuse reduction, smoking cessation, weight loss and control, stress management, falls prevention , physical activity, and improved nutrition.

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• Physical Fitness – Group exercise, and music therapy, art therapy, and dance-movement therapy, including programs for multigenerational participation that are provided by an institution of higher education and a local educational agency, as defined in Section 8801(1) of title 20 or a community-based organization.

Risk Assessment (1 Session)

Routing Health Screening –May include hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, bone density, and nutrition screening; nutrition counseling and education for individuals and their primary caregivers; and injury control screening of high-risk home environments and provision of educational programs on injury prevention (including fall and fracture prevention) in the home environment.

• Nutrition Counseling and Education – Services for individuals and their primary caregivers.

• Injury Control – Services include screening of high-risk home environments and provision of educational programs on injury prevention (including fall and fracture prevention) in the home environment.

MedicationManagement (1 Session)

Screening and Education - to prevent incorrect medication and adverse drug reactions.

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Travel time incurred in the delivery of services.

(c) Training, staff meeting.

(g) Projectmanagement.

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SERVICE AND UNIT DEFINITIONS FOR OLDERAMERICANS ACT SERVICES

TITLE III E NATIONAL FAMILY CAREGIVER SUPPORT PROGRAM

The term ‘‘child’’ means an individual who is not more than 18 years of age or an individual 19-59 years of age who has a severe disability. The term relates to a grandparent or other older relative who is a caregiver of a child.

The term "caregiver" means an adult family member or another individual, who is an "informal" provider of in-home and community care to an older individual. "Informal" means that the care is not provided as part of a public or private formal service program.

The term ‘‘grandparent or other older relative caregiver of a child’’ means a grandparent, step-grandparent or other relative of a child by blood or marriage 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, as such legal custody or guardianship, or is raising the child informally.

In providing services the State shall give priority to caregivers who are older individuals with greatest social need, and older individuals with greatest economic need (with particular attention to low-income older individuals); and to older individuals providing care to individuals with severe disabilities, including children with severe disabilities.

For family caregivers who provide care for individuals with Alzheimer’s disease and related disorders with neurological and organic brain dysfunction, the State shall give priority to caregivers who provide care for older individuals with such disease or disorder; and for grandparents or older individuals who are relative caregivers, the State shall give priority to caregivers who provide care for children with severe disabilities.

CAREGIVERS:

FCSP Access Assistance Caregiver (1 Contact) - A service that assists caregivers in obtaining access to the services and resources that are available within their communities. To the maximum extent practicable, it ensures that the individuals receive the services needed by establishing adequate follow-up procedures. [Note: Information and assistance to caregivers is an access service, i.e., a service that: (A) provides individuals with information on services available within the communities; (B)

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links individuals to the services and opportunities that are available within the communities; (C) to the maximum extent practicable, establishes adequate follow-up procedures. Internet web site "hits" are to be counted only if information is requested and supplied.

FCSP Individual Counseling Caregiver (1 session per participant) - Counseling to caregivers to assist them in making decisions and solving problems relating to their caregiver roles. This includes counseling to individuals, support groups, and caregiver training (of individual caregivers and families). [Note: Subservices must be mapped to main service]

FCSP Caregiver Training Caregiver (1 Session) - to assist the caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles.

FCSP Support Groups Caregiver (1 Session) - Services to assist the caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles.

FCSP Information Services Caregiver (1 Activity) - A service for caregivers that provides the public and individuals with information on resources and services available to the individuals within their communities. [Note: service units for information services are for activities directed to large audiences of current or potential caregivers such as disseminating publication, conducting media campaigns, and other similar activities.]

FCSP Respite Caregiver (1 Hour) - Services which offer temporary, substitute supports or living arrangements for care recipients in order to provide a brief period of relief or rest for caregivers. Respite Care includes: (1) In-home respite (personal care, homemaker and other in- home respite); (2) Respite provided by attendance of the care recipient at a senior center or other nonresidential program; (3) Institutional respite provided by placing the care recipient in an institutional setting such as a nursing home for a short period of time as a respite service to the caregiver; and (for grandparents caring for children) summer camps. If the specific service units purchased via a direct payment (cash or voucher) can be tracked or estimated, report those service unit hours. If not, a unit of service in a direct payment is one payment.

FCSP Supplemental Services Caregiver (1 Activity) - Services provided on a limited basis to complement the care provided by caregivers. Examples of supplemental services include, but are not limited to, home modifications, assistive technologies, emergency response systems, and incontinence supplies. (Services purchased by vouchers are to be counted under Cash and Counseling)

FCSP Cash & Counseling Caregiver (1 Activity) - This covers the range of services provided or paid for through allowance, vouchers, or cash which are provided to the client so that the client can obtain the supportive services which are needed. (Services

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purchased by vouchers are to be counted under Cash and Counseling)

Individual Counseling (1 session per participant) - Counseling to caregivers to assist them in making decisions and solving problems relating to their caregiver roles. This includes counseling to individuals, support groups, and caregiver training (of individual caregivers and families). [Note: Subservices must be mapped to main service]

Respite (1 Hour) - Services which offer temporary, substitute supports or living arrangements for care recipients in order to provide a brief period of relief or rest for caregivers. Respite Care includes: (1) In-home respite (personal care, homemaker and other in-home respite); (2) Respite provided by attendance of the care recipient at a senior center or other nonresidential program; (3) Institutional respite provided by placing the care recipient in an institutional setting such as a nursing home for a short period of time as a respite service to the caregiver; and (for grandparents caring for children) summer camps. If the specific service units purchased via a direct payment (cash or voucher) can be tracked or estimated, report those service unit hours. If not, a unit of service in a direct payment is one payment.

Supplemental Services (1 Activity) - Services provided on a limited basis to complement the care provided by caregivers. Examples of supplemental services include, but are not limited to, home modifications, assistive technologies, emergency response systems, and incontinence supplies.

GRANDPARENTS:

FCSP Access Assistance Grandparents (1 session per participant) - A service that assists grandparents in obtaining access to the services and resources that are available within their communities. To the maximum extent practicable, it ensures that the individuals receive the services needed by establishing adequate follow-up procedures. [Note: Information and assistance to grandparents is an access service, i.e., a service that: (A) provides individuals with information on services available within the communities; (B) links individuals to the services and opportunities that are available within the communities; (C) to the maximum extent practicable, establishes adequate follow-up procedures. Internet web site "hits" are to be counted only if information is requested and supplied.]

FCSP Individual Counseling Grandparents (1 Session) - Counseling to grandparents to assist them in making decisions and solving problems relating to their caregiver roles. This includes counseling to individuals, support groups, and caregiver training (of individual grandparents and families).

FCSP Caregiver Training Grandparents (1 Session) - to assist the caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles.

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FCSP Support Groups Grandparents (1 Session) - Services roles assist the caregivers in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles.

FCSP Information Services Grandparents (1 Activity) - A service for grandparents that provides the public and individuals with information on resources and services available to the individuals within their communities. [Note: service units for information services are for activities directed to large audiences of current or potential grandparents such as disseminating publication, conducting media campaigns, and other similar activities.]

FCSP Cash & Counseling Grandparents (1 Activity) This covers the range of services provided or paid for through allowance, vouchers, or cash which are provided to the client so that the client can obtain the supportive services which are needed. (Services purchased by vouchers are to be counted under Cash and Counseling)

Individual Counseling (1 session per participant) - Counseling to caregivers to assist them in making decisions and solving problems relating to their caregiver roles. This includes counseling to individuals, support groups, and caregiver training (of individual caregivers and families). [Note: Subservices must be mapped to main service]

Respite (1 Hour) - Services which offer temporary, substitute supports or living arrangements for care recipients in order to provide a brief period of relief or rest for caregivers. Respite Care includes: (1) In-home respite (personal care, homemaker and other in-home respite); (2) Respite provided by attendance of the care recipient at a senior center or other nonresidential program; (3) Institutional respite provided by placing the care recipient in an institutional setting such as a nursing home for a short period of time as a respite service to the caregiver; and (for grandparents caring for children) summer camps. If the specific service units purchased via a direct payment (cash or voucher) can be tracked or estimated, report those service unit hours. If not, a unit of service in a direct payment is one payment.

Supplemental Services (1 Activity) - Services provided on a limited basis to complement the care provided by caregivers. Examples of supplemental services include, but are not limited to, home modifications, assistive technologies, emergency response systems, and incontinence supplies.

FCSP Respite Grandparents (1 Hour) - Services which offer temporary, substitute supports or living arrangements for grandparents in order to provide a brief period of relief or rest for the grandparents. Respite Care includes: (1) In-home respite (personal care, homemaker and other in-home respite); (2) Respite provided by attendance of the care recipient at a senior center or other nonresidential program; (3) Institutional respite provided by placing the care recipient in an institutional setting such as a nursing home for a short period of time as a respite service to the caregiver; and (for grandparents caring for children) summer camps. If the specific service units purchased via a direct payment (cash or voucher) can be tracked or estimated, report those service unit hours. If not, a unit of service in a direct payment is one payment.

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FCSP Supplemental Service Grandparents (1 Activity) - Services provided on a limited basis to complement the care provided by grandparents. Examples of supplemental services include, but are not limited to, home modifications, assistive technologies, emergency response systems, and incontinence supplies. (Services purchased by vouchers are to be counted under Cash and Counseling)

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Travel time incurred in the delivery of services.

(c) Training, staff meeting.

(d) Project management.

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TITLE VII ELDER ABUSE and OMBUDSMAN PROGRAMS

(Ombudsman for Title III will be under part B Supportive Services)

Elder Abuse Prevention (1 Activity) - Prevention of Elder Abuse, Neglect, and Exploitation. Activities include: (1) Development and strengthen community activities to prevent and treat elder abuse, neglect, and exploitations; (2) Use a comprehensive approach to identify and assist older individuals subject to abuse, neglect and exploitation; (3) Coordinate with other state and local programs and services to protect vulnerable adults, particularly older individuals.

Ombudsman (1 Activity) - Activities include: 1. identifying, investigating, and resolving complaints that are made by, or on behalf of, residents; 2. relate to action, inaction, or decisions that may adversely affect the health, safety, welfare, or rights of the residents; 3. Monitoring the development and implementation of federal and state policies and regulations related to long- term care facilities; and 4. Providing information.

Presentations (1 Activity) - Unduplicated would be the number of presentations held.

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(d) Review, update or maintenance of resource or agency files.

(e) Travel time incurred in the delivery of services.

(f) Training, staff meeting.

(d) Project management.

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ADRC SERVICES

Information Referral and Awareness (1 Contact) The information, referral and awareness function of an ADRC is defined by the ADRCs ability to serve as a highly visible and trusted place where people of all ages, disabilities and income levels know they can turn to for objective information on the full range of long-term service and support options. It is also defined by its ability to promote awareness of the various options that are available in the community, especially among underserved, hard-to-reach and private paying populations, as well as options individuals can use to "plan ahead" for their long-term care. ADRCs should also have the capacity to help individuals be aware of their Medicare benefits and other state and federal programs by partnering with State Health Insurance Assistance Programs (SHIPs) and Benefit Outreach and Enrollment Centers where they exist. Finally, ADRCs should have the capacity to link consumers with needed services and supports – both public and private – through appropriate referrals to other agencies and organizations.

Options Counseling and Assistance (1 Contact) The options counseling and assistance function is defined by the ADRCs ability to provide counseling and decision support, including one-on-one assistance, to consumers and their family members and/or caregivers. The main purpose of options counseling and assistance is to help consumers assess and understand their needs, and to assist them in making informed decisions about appropriate long-term service and support choices – as well as their Medicare options – in the context of their personal needs, preferences, values and individual circumstances. Options counseling and assistance also entails helping consumers to develop service plans and arranging for the delivery of services and supports, including helping individuals to hire and supervise their direct care workers. Individuals and families who receive options counseling should be in better position to make service and support choices that optimally meet their needs and preferences, and be able to make better use their own personal and financial resources in the short term and over time.

Intake/Assessment (1 Hour) Assistance either in the form of access or care coordination in circumstance where the older person or persons with disabilities and/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 gathering personal information, assessing needs, developing care plans, authorizing services, arranging services, coordinating the provision of services among providers, follow-up and reassessment, as required.

Outreach (1 Contact) Interventions initiated by an agency or organization for the purpose of identifying potential clients (or their caregivers) and encouraging their use of existing services and benefits.

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STATE HEALTH INSURANCE ASSISTANCE PROGRAM (SHIP)

SHIP Counseling (1 Contact) - Counselor’s time with or on behalf of a client.

Presentations (1 Activity/Event) – A SHIP counselor/coordinator connects with an audience concerning any information. Can be an audience of their peers or for the purpose of outreach to beneficiaries.

Media Activity (1 Activity) – Connecting with Medicare beneficiaries through various media sources including but not limited to radio, newspaper, television and material/publications. Involves identifying the most appropriate ways to reach underserved populations with greatest need for education and information on Medicare issues.

Counselor Training (1 Hour) – Total number of counselor hours in initial training(s) and total number counselor hours in update trainings.

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Travel time incurred in the delivery of services.

(c) Training, staff meeting (other than direct SHIP training).

(d) Project management.

Lake Cumberland Area Agency on Aging & Independent Living Policies and Procedure Manual

Section XIX Taxonomy Page 20

THESE DEFINITIONS TO BE USED JULY 1, 2011

SERVICE AND UNIT DEFINITIONS FOR KENTUCKY STATE PROGRAM

ADULT DAY CARE

Adult Day Care (NonAlzheimers) (1/2 Hour) – Adult day care is a supportive and therapeutic social program of supervision and care provided to an eligible adult during a part of the day, but for less than twenty-four (24) hours; and for: assistance with self-administration of medication; personal care services; self-care training; social activities; and recreational opportunities.

Adult Day Care (Alzheimers) (1/2 Hour) - Supervision and care provided to an eligible adult during a part of the day, but for less than twenty-four (24) hours; and assistance with self- administration of medication; personal care services; self-care training; social activities; and recreational opportunities to Alzheimer’s clients.

Alzheimers Respite in Day Care (1/2 Hour) - Supervision and care provided to a client with Alzheimer's disease or related dementing disease in a center to enable the caregiver temporary relief from care giving duties.

Alzheimers Respite In Home (1/2 Hour) - Supervision and care provided to a client with Alzheimer's disease or related dementing disease in a client's home to enable the caregiver temporary relief from care giving duties.

Assessment (1/2 Hour) - Collection of information and evaluation about a person's situation and functioning which identifies needs and resources so that a comprehensive plan of care may be developed.

Case Management (1/2 Hour) - A process for ensuring that participants receive appropriate, comprehensive, and timely services to meet their needs as identified in the assessment process; planning; referring the participant to appropriate agencies and individuals in the informal care giving systems; monitoring; and advocacy through case work activities in order to achieve the best possible resolution of individual needs.

[Note: All services requires an assessment, care plan, and ongoing case management]

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Travel time incurred in the delivery of services.

(c) Training, staff meeting.

 

(d) Project management.

Lake Cumberland Area Agency on Aging & Independent Living Policies and Procedure Manual

Section XIX Taxonomy Page 21

SERVICE AND UNIT DEFINITIONS FOR KENTUCKY STATE PROGRAM

HOMECAREPROGRAM

Assessment (1/2 Hour) - The collection and evaluation of in-depth information about a person’s situation and functioning capacity including formal and informal resources (present and potential) for the purpose of identifying needs and developing a comprehensive plan of care.

Case Management (1/2 Hour) - The process of planning, referring, monitoring and advocating to assure that appropriate, comprehensive, timely and cost-effective services are provided to meet the client’s individual needs as identified in the assessment.

Chore (1/2 Hour) - The performance of heavy housecleaning, minor household repairs, yard tasks, and other activities needed to assist in the maintenance of a functionally impaired elderly person in his own home.

Escort (1/2 Hour) - The accompaniment of a person who requires such assistance for reasons of safety or protection to or from his physician, dentist, or other necessary services.

Homemaker (1/2 Hour) - General household activities, including but not limited to nonmedical personal care, shopping, meal preparation, and routine household care, provided by a trained homemaker when the person regularly responsible for these activities is temporarily absent or unable to manage the home and care for himself or others in the home..

Home Delivered Meals (1 Meal) - The provision of a nutritionally sound meal, that meets at least one-third (1/3) of the current daily recommended dietary allowance, to a functionally impaired elderly person who is homebound by reason of illness, incapacity, or disability.

Nutrition Counseling (1 session per participant) - Individualized guidance to individuals who are at nutritional risk because of their health or nutritional history, dietary intake, chronic illnesses, or medications use, or to caregivers. Counseling is provided one-on-one by a registered dietician, and addresses the options and methods for improving nutrition status.

Nutrition Education (1 session per participant) - A program to promote better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants, caregivers, or participants and caregivers in a group or individual setting overseen by a dietitian or individual of comparable expertise.

Lake Cumberland Area Agency on Aging & Independent Living Policies and Procedure Manual

Section XIX Taxonomy Page 21

Home Health Aide (1/2 Hour) - The performance of simple procedures, including but not limited to personal care, ambulation, exercises, household services essential to health care at home, assistance with medications that are ordinarily self-administered, reporting changes in the patient's condition and needs, and completing appropriate records.

Home Repair (1 Activity) - The provision of minor home adaptations, additions, or modifications to enable the elderly to live independently or safely or to facilitate mobility including, where appropriate, emergency summons systems.

Personal Care (1/2 Hour) - Services directed toward maintaining, strengthening or safeguarding the functioning of a person in the home; includes helping a person with the activities of daily living such as bathing, eating, dressing, grooming, transferring, and toileting.

Respite (1/2 Hour) - Care provided by an approved caregiver or agency for a designated time period because of absence or need for relief of a primary caregiver.

A unit is defined as 1/2 Hour of direct service, except for home-delivered meals, where one unitequalsameal.

[Note: All services require an assessment, care plan and ongoing case management]

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(a) Review, update or maintenance of resource or agency files.

(b) Travel time incurred in the delivery of services.

(c) Training, staff meeting.

 

(d) Project management.

Lake Cumberland Area Agency on Aging & Independent Living Policies and Procedure Manual

Section XIX Taxonomy

SERVICE AND UNIT DEFINITIONS FOR KENTUCKY STATE PROGRAM

KY FAMILY CAREGIVER PROGRAM

KY Grandparent Information (1 Contact) - A service for grandparents that provides the public and individuals with information on resources and services available to the individuals within their communities. [Note: service units for information services are for activities directed to large audiences of current or potential grandparents such as disseminating publication, conducting media campaigns, and other similar activities.]

KY Grandparent Assistance (1 Contact) - A service that assists grandparents in obtaining access to the services and resources that are available within their communities. To the maximum extent practicable, it ensures that the individuals receive the services needed by establishing adequate follow-up procedures. [Note: Information and assistance to grandparents is an access service, i.e., a service that: (A) provides individuals with information on services available within the communities; (B) links individuals to the services and opportunities that are available within the communities; (C) to the maximum extent practicable, establishes adequate follow-up procedures. Internet web site "hits" are to be counted only if information is requested and supplied.]

KY Grandparent Individual Counseling (1 Session) - Counseling to grandparents to assist them in making decisions and solving problems relating to their caregiver roles. This includes counseling to individuals.

KY Grandparent Support Group (1 Session) - Services to assist the grandparents in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles.

KY Grandparent Caregiver Training (1 Session) - to assist the grandparents in the areas of health, nutrition, and financial literacy, and in making decisions and solving problems relating to their caregiving roles.

KY Grandparent Supplemental Services (1 Activity) – Services provided to meet identified needs of grandparents raising grandchildren including the following (when using vouchers, each voucher is counted as one unit):

KY Grandparent Supplemental Services are for vouchers up to $500 per grandchild with a maximum of $1,500 per household, unless an exception request is approved. The exception request cannot go beyond $500 per grandchild.

Lake Cumberland Area Agency on Aging & Independent Living Policies and Procedure Manual

Section XIX Taxonomy

Respite (1 Activity) care provided by a caregiver or agency approved by a district for a designated time period; and to temporarily relieve a grandparent who serves as primary caregiver to a grandchild.

Legal Assistance (1 Activity) relates to the grandchild’s safety and stability and excludes unlawful activity.

Child Clothing and Personal Care Needs (1 Activity)

Educational Supplies/Assistance (1 Activity) - is documented by the grandchild’s school of attendance.

Medical and Dental (1 Activity) - Co pays and premiums are prohibited.

Furniture (1 Activity) - Bed or dresser to be used by the grandchild.

Other (1 Activity)

Note: The following activities facilitate the delivery of services but shall not be reported as units of service except where required for a specific service:

(e) Review, update or maintenance of resource or agency files.

(f) Travel time incurred in the delivery of services.

(g) Training, staff meeting.

 

(h) Project management.

Lake Cumberland Area Agency on Aging & Independent Living Policies and Procedure Manual

Section XIX Taxonomy

SERVICE AND UNIT DEFINITIONS FOR KENTUCKY STATE PROGRAM

PERSONAL CARE ATTENDANT PROGRAM

Subsidy (1 Hour) - A financial reimbursement provided by the cabinet for personal care services granted to any adult who has a severe physical disability, needs not less than fourteen (14) hours of personal care assistance to prevent or remove an adult from inappropriate placement in an institutional setting, and who qualifies under KRS 205.910.

Evaluation and Program Coordination (1 Hour) – Provide an evaluation by a team as defined in KRS 205.900(2) of an applicant or participant for personal care services to determine eligibility, reevaluate at least biennially to determine the continued needs, and report findings and recommendations to the Cabinet. A program coordinator shall assist with completion of the application process, maintain a waiting list, prescreen applicants, assist participants with training of attendants, provide training to participants, review results of the evaluation team, assist participants in developing a care plan, assist with developing work agreements, assist with recruitment of attendants, and maintaining and submitting all required reports.

LCADD Contact Info

Lake Cumberland Area Development District
P.O. Box 1570
(mailing address)
2384 Lakeway Dr.
(street address)
Russell Springs, KY 42642
Phone: 270-866-4200
Toll Free: 800-264-7093
TDD: 800-648-6056
Fax: 270-866-2044
info@lcadd.org

LCADD Calendar

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