Current through Register Vol. 49, No. 9, September, 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 StandardsA. 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.
