1. (a)

   1. (1) Eligibility. The client must meet the following criteria:

      1. (A) Be over sixty (60) years of age;
      2. (B) Be frail, i.e., have a physical or mental disability, including Alzheimer's disease or a related disorder with neurological or organic brain dysfunction, that restricts the ability of the individual to perform normal daily tasks or which threatens the capacity of the individual to live independently;
      3. (C) Be without significant social support systems, i.e., persons who are willing and able to perform required services for them;
      4. (D) Have an income at or below two hundred percent (200%) of SSI; and
      5. (E) Be in social need, i.e., need caused by noneconomic factors, i.e., physical and mental disabilities, language barriers, and cultural, social, and geographic isolation, including that caused by racial or ethnic status, which restrict an individual's ability to perform normal daily tasks or which threaten such individual's capacity to live independently.

   2. (2) Recipients of supplemental personal care must also:

      1. (A) Meet Medicaid Personal Care Program medical criteria; and
      2. (B) Have a physician's prescription for personal care services.

2. (b) Service definitions. As used in this subpart:

   1. (1) “Adult day care” means a group program designed to provide care and supervision to meet the needs of four (4) or more functionally impaired adults for periods of less than twenty-four (24) hours, but more than two (2) hours per day in a licensed facility;
   2. (2) “Chore” means household chores such as running errands, preparing food, simple household tasks, heavy cleaning, and yard and walk maintenance, which the older person is unable to handle on his or her own and which does not require the services of a trained homemaker or other specialist;

   3. (3)

      1. (A) “Emergency assistance” means provision of goods or payment of bills to meet or prevent an imminent emergency.
      2. (B) For example, purchase of basic necessities for someone whose home has been destroyed by fire, or payment to a utility company to prevent imminent shut off of electricity or gas service.
      3. (C) The limit is four hundred dollars ($400) per client;
   4. (4) “Health promotion” means education and services to an individual which increase awareness of good health and nutrition practices and encourage a more healthy lifestyle;

   5. (5)

      1. (A) “Home-delivered meals” means a hot, or other appropriate, meal that contains at least one-third (1/3) of the nutritional value of the recommended daily allowance.
      2. (B) The meal is delivered to the client's home.
      3. (C) Menus must be approved by the Division of Aging, Adult, and Behavioral Health Services of the Department of Human Services nutritionist;

   6. (6)

      1. (A) “Homemaker” means household management tasks such as menu planning, bill paying, checking account management, etc., and may include but cannot be limited to household chores.
      2. (B) “Homemaker” cannot include medically oriented personal care tasks.
      3. (C) The homemaker must be trained in household management tasks and be supervised by the provider agency to ensure that tasks are completed accurately and appropriately;

   7. (7)

      1. (A) “Personal care” means assisting a client with bathing, dressing, personal appearance, feeding, and toileting under the direction of a medical professional.
      2. (B) Personal care clients also receive:
3. (i)
4. (a) (a) Assessment: administering standard examinations, procedures, or tests for the purpose of gathering information about the client to determine need and/or eligibility for services.
5. (b) (b) Information collected may include health status, financial status, activities of daily living status, etc.
6. (c) (c) Prenursing home admission screening as well as routine health screening (blood pressure, hearing, vision, diabetes) activities are included.

7. (d) (d) If services are not begun during the twelve (12) months after an initial assessment is conducted or are interrupted/stopped for twelve (12) months or longer, another assessment must be done to start/resume service; and

   1. (ii)
8. (a) (a) Reassessment: review of the client's need for continuation, start up, if more than six (6) months but less than twelve (12) months since initial assessment was done, or change of personal care service.

9. (b) (b) For clients receiving personal care, reassessment must be done every six (6) months or more frequently if the client's condition changes requiring a change in the service plan;

   1. (8)

      1. (A) “Personal emergency response system” means a portable, in­home, twenty-four-hour electronic alarm system that enables an elderly, infirm, or homebound individual to secure immediate help in the event of a physical, emotional, or environmental emergency.
      2. (B) There is a one-time cost for installation;

   2. (9)

      1. (A) “Repair/modification/maintenance” means improving or maintaining the client's residence and home appliances.
      2. (B) “Repair/modification/maintenance” includes weatherization or other energy conservation measures, wheelchair ramps, safety features, etc.
      3. (C) The limit is four hundred dollars ($400) per client, and may be more than one (1) job.
      4. (D) The limit is four hundred dollars ($400) per client per home; and

   3. (10)

      1. (A) “Respite care” means service to relieve the family of a frail/vulnerable older adult from daily caregiving responsibilities.
      2. (B) It can be provided to meet an emergency need or to schedule relief periods in accordance with the regular caregiver's need for temporary relief from continuous caregiving.
      3. (C) The period of relief makes it possible for the elderly individual to continue living in the community and avoid permanent institutionalization.
      4. (D) It can be provided either in a person's home by employees of licensed agencies or in licensed facilities.

      5. (E)

         1. (i) There are two (2) types of this service:
10. (a) (a) Short-term respite: respite provided for a period of five (5) hours or less during the day; and

11. (b) (b) Long-term respite: respite provided for a period of more than five (5) hours during the day.

    1. (ii) Anything from five (5) to twenty-four (24) hours shall be billed on a day rate which equals the cost of five (5) hours of respite care at the hourly rate.

Codification Notes: “SSI” means Supplemental Security Income.