Current through Register Vol. 46, No. 12, March 20, 2024
(a) For
purposes of this section the words "client" and "consumer" are interchangeable
except where noted otherwise.
(b)
Each area agency receiving EISEP service funds shall ensure provision of both
Personal Care Level I (may appear as housekeeping/chore in other sections of
the regulations) and Personal Care Level II (may appear as homemaking/personal
care in other sections of the regulations) services as needed by EISEP
participants as determined in compliance with the assessment procedures
prescribed in section
6654.16 of
this Part.
(c) An in-home service
provided as a respite service as described in section
6654.18
of this Part shall be so documented in the client case record.
(d) An in-home services agency or area agency
directly providing the services shall have and ensure that all in-home services
workers are familiar with written procedures for responding to emergency
situations.
(e) Some and total
assistance as referenced in subdivisions (f) and (g) of this section is defined
as follows:
(1) some assistance means that a
task or function is performed and completed by the client with assistance from
another individual; and
(2) total
assistance means that a task or function is performed and completed for the
client.
(f) Personal
Care Level I services include some or total assistance with only the following
tasks on behalf of or to assist a client:
(1)
making and changing beds;
(2)
dusting and vacuuming the rooms which the client uses;
(3) light cleaning of the kitchen, bedroom
and bathroom;
(4)
dishwashing;
(5) listing needed
supplies;
(6) shopping for the
client if no other arrangements are possible;
(7) the client's laundering including
necessary ironing and mending;
(8)
meal preparation, including simple modified diets;
(9) payment of bills and other essential
errands; and
(10) escort to
appointments and community activities may also be included under
EISEP.
(g) Personal Care
Level II services include only:
(1) some or
total assistance with the tasks listed in subdivision (f) of this section;
and
(2) some or total assistance
with:
(i) bathing of client in the bed, tub
or shower;
(ii) dressing;
(iii) grooming, including care of hair,
shaving, and ordinary care of nails, teeth and mouth;
(iv) toileting, including assisting the
client on and off the bedpan, commode or toilet;
(v) walking, beyond that provided by durable
medical equipment, within and outside the home;
(vi) transferring from bed to chair or
wheelchair;
(vii) preparation of
meals in accordance with modified diets, including low sugar, low fat, low salt
and low residue diets;
(viii)
feeding;
(ix) administration of
medication by the client, including prompting client of time, identifying the
medication for the client, bringing the medication and any necessary supplies
or equipment to the client, opening the container for the client, positioning
the client for medication and administration, disposing of used supplies and
materials and storing the medication properly;
(x) routine skin care;
(xi) using medical supplies and equipment
such as walkers and wheelchairs; and
(xii) changing simple dressings.
(h) To the extent
feasible, the same worker should be assigned to a client whenever possible. An
in-home services agency or area agency directly providing the services shall
have a back-up system for worker substitution when the regular worker is not
available. Under consumer directed in-home services, the consumer or consumer
representative shall have a backup system for worker substitution when the
regular worker is not available.
(i) Except under consumer directed in-home
services, an in-home services worker shall be able to read and write;
understand and carry out directions and instructions; record messages and keep
simple records; and communicate with clients, their families and others
involved in caregiving. Under consumer directed in-home services, the consumer
or the consumer representative shall determine the abilities they will require
the in-home services worker to possess.
(j) An in-home services agency, area agency
directly providing the services or, under consumer directed in-home services,
the consumer or consumer representative shall ensure that in-home services
workers perform tasks as specified in a client's care plan and service
schedule.
(k) Requirements for
criminal background checks.
(1) An in-home
services agency that is a licensed home care services agency or a certified
home health agency providing in-home services shall comply with SDOH
requirements for a criminal history check to the extent required by 10 NYCRR
Part 402.
(2) Agencies providing
in-home services other than licensed home care services agencies or certified
home health agencies, including area agencies directly providing in-home
services, shall complete a criminal history check on all in-home services
workers and applicants.
(3) Under
consumer directed in-home services, the consumer or the consumer representative
must be informed by the case manager or fiscal intermediary as designated by
the area agency of the option(s) to require a prospective in-home services
worker to complete a criminal history check.
(l) An in-home services agency, area agency
directly providing the services or, under consumer directed in-home services,
the consumer or consumer representative in conjunction with the fiscal
intermediary shall comply with SDOH health requirements for in-home services
workers pursuant to 10 NYCRR section
766.11(c) and (d)
or any successor regulation.
(m)
Each in-home services worker shall receive an annual assessment of his or her
performance and effectiveness except under consumer directed in-home services
no such assessment is required.
(n)
The in-home services agency or area agency directly providing the services
shall have liability or other insurance coverage in an amount sufficient to
protect the area agency from any potential liability claims resulting from
acts, omissions, or negligence of in-home services agency or area agency
personnel. An area agency on aging sponsored by a county or other unit of
general purpose local government may satisfy the insurance coverage requirement
through self-insurance. The in-home services agency shall maintain such
insurance coverage while its contract with the area agency is in effect and the
area agency directly providing the services shall maintain such coverage while
it is providing the services.
(o)
Except under consumer directed in-home services, each person providing Personal
Care Level I services shall:
(1) be
instructed, prior to delivering any in-home services, on how to work with the
elderly;
(2) receive an
orientation, prior to delivering any in-home services to:
(i) the housekeeping/chore tasks which the
worker may perform;
(ii) the
policies and procedures of the provider agency; and
(iii) the rights of clients as set forth in
section
6654.16(ai)
of this Part;
(3) receive
on-the-job training as needed to instruct the Personal Care Level I worker in a
particular skill or technique or to assist in resolving problems in individual
care situations.
(p)
Except under consumer directed in-home services, each person performing
Personal Care Level II services shall participate successfully in a training
program that meets the requirements described in 18 NYCRR section
505.14(e)(1)-(4) and
(7); or meets the training requirements as
described in 10 NYCRR section
700.2(b)(14)(i) or
(ii).
(q) Under consumer directed in-home services,
responsibilities for training, which includes orientation and instruction, are
as follows:
(1) the consumer or consumer
representative is responsible for determining the need for, and providing
and/or arranging for any training of the in-home services worker pertaining to
the performance of tasks in the consumer's care plan;
(2) the fiscal intermediary is responsible
for training the consumer or the consumer representative and the in-home
services worker on the following:
(i) the
roles and responsibilities of the fiscal intermediary; and
(ii) the respective roles and
responsibilities of the consumer or the consumer representative and the in-home
services worker as they relate to the roles and responsibilities of the fiscal
intermediary.
(r) At the request of the consumer or
consumer representative additional training may be provided. If such training
is available, the case manager or fiscal intermediary as designated by the area
agency will inform the consumer or consumer representative what additional
training is available to the consumer or consumer representative and the
in-home services worker, and the entity(ies) responsible for providing
it.
(s) Except under consumer
directed in-home services, each in-home services worker shall:
(1) have or be designated a supervisor who
shall:
(i) be a registered professional nurse
who is licensed and currently certified to practice as a registered
professional nurse in New York State, meets the health requirements specified
in subdivision (l) of this section and either has at least two years
satisfactory recent home health care experience or has a combination of
education and experience equivalent to at least two years of satisfactory
experience with at least one year of home health care experience, or acts under
the direction of a registered professional nurse who has at least two years
satisfactory recent home health care experience or has a combination of
education and experience equivalent to at least two years of satisfactory
experience with at least one year of home health care experience; or possess a
bachelors degree with a major in social work, psychology, counseling or related
field and one year of experience in the health or social services field; or
have five years of related experience; and
(ii) have received an orientation from the
area agency on EISEP's design, objectives, local administration, standards,
policies and procedures;
(2) unless impracticable, receive the first
supervisory visit in the home of each client to whom he or she is regularly
assigned within five working days of the first time he or she is to provide
services to the client. If the visit does not take place the first time the
worker is to provide services to the client, the supervisor shall contact the
client by phone or letter, prior to service delivery, to inform the client of
who the worker will be. The first in-home supervisory visit shall include:
(i) demonstration and instruction to the
worker and the client concerning specific tasks to be performed;
(ii) orientation to the client and worker;
and
(iii) clarification of the roles
and responsibilities of the worker, the client and the supervisor in relation
to the service plan.
(3)
receive regular supervision by the designated supervisor in each client's home
at least every six months during which the supervisor shall:
(i) evaluate the skills and performance of
the in-home services worker;
(ii)
provide to the in-home services worker information, consultation, instruction,
and demonstration as needed;
(iii)
determine the extent to which client needs are appropriately and adequately
being met;
(iv) follow up, as
specified by the case management agency, with the client's case manager to
report the findings of the supervisory visit; and
(v) provide the client and his or her
authorized representative an opportunity to discuss in privacy with the
supervisor the service being provided;
(4) receive administrative supervision on a
regular basis.
(t) Under
consumer directed in-home services, the consumer or consumer representative
shall supervise the in-home services worker.
(1) Supervision shall include, but is not
limited to, assuring that each in-home services worker competently and safely
performs services that are within the worker's scope of services and that are
included in the consumer's care plan.
(u) Records of an in-home services agency,
area agency directly providing the services or the fiscal intermediary under
consumer directed in-home services are subject to review only by the client,
his or her authorized representative, case manager, case manager supervisor,
area agency, the office, other authorized staff, and authorized program or
fiscal monitoring agents.
(v) An
in-home services agency or area agency directly providing the services shall
maintain a case record for each client receiving in-home services:
(1) containing:
(i) current and past care plan
summaries;
(ii) a copy of the
current and past authorizations for service;
(iii) a list of names and dates of workers
who provide the in-home services;
(iv) dated verifications of service
provision, signed by the client or his or her authorized
representative;
(v) accident or
incident reports;
(vi) on-going
narrative notes of a substantive nature that include but are not limited to:
(a) observations;
(b) problems;
(c) plans of action;
(d) records of telephone contacts;
and
(e) records of in-home
supervisory visits;
(2) updated in a timely manner; and
(3) maintained for six years from the end of
the State fiscal year in which the client last received
services.
(w) Under
consumer directed in-home services, the fiscal intermediary shall maintain a
record for each consumer receiving in-home services for whom it serves as the
fiscal intermediary:
(1) containing at a
minimum:
(i) consumer or consumer
representative contact information;
(ii) current and past authorization for
services, during the fiscal intermediary's tenure;
(iii) name and other pertinent information of
the consumer representative, if applicable;
(iv) name(s) and contact information of
in-home services worker(s);
(v)
name and contact information of back-up in-home services worker(s);
(vi) a log of contacts between the fiscal
intermediary and the case manager and between the fiscal intermediary and the
consumer or consumer representative that includes date, who contact was with,
summary of contact and follow up;
(vii) documentation of training provided by
the fiscal intermediary to the consumer or consumer representative;
and
(viii) copies of any consumer
specific reports requested by the area agency, case manager, consumer or
consumer representative;
(2) updated in a timely manner; and
(3) maintained for six years from the end of
the State fiscal year in which the consumer last received
services.
(x) Under
consumer directed in-home services, the fiscal intermediary shall maintain a
record for each in-home services worker:
(1)
containing at a minimum:
(i) enrollment
form(s) for an in-home services worker;
(ii) contact information;
(iii) documentation of meeting eligibility
requirements to be an in-home services worker as referenced in section
6654.15(d)(7)
of this Part;
(iv) documentation of
compliance with subdivision (l) of this section;
(v) documentation of compliance with
subdivision (k) of this section, if applicable;
(vi) copies of any agreements signed by the
in-home services worker;
(vii)
required payroll and other benefits documents;
(viii) copy of time sheets or electronic time
keeping records;
(ix) documentation
of any training requests to the fiscal intermediary by the consumer or consumer
representative for the in-home services worker; and
(x) a log of contacts between the fiscal
intermediary and the in-home services worker that includes date, who contact
was with, summary of contact and follow up;
(2) updated in a timely manner; and
(3) maintained for six years from the end of
the State fiscal year in which the consumer last received
services.
(y) An in-home
services agency or area agency directly providing the services shall maintain a
personnel record for each in-home services worker containing evidence of
compliance with this section. No reimbursement shall be available for services
provided by individuals who are not trained and supervised in accordance with
this section.
