(e) Some and total assistance as referenced in subdivisions (f) and (g) of this section is defined as follows:

1. (1) some assistance means that a task or function is performed and completed by the client with assistance from another individual; and
2. (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. (1) making and changing beds;
2. (2) dusting and vacuuming the rooms which the client uses;
3. (3) light cleaning of the kitchen, bedroom and bathroom;
4. (4) dishwashing;
5. (5) listing needed supplies;
6. (6) shopping for the client if no other arrangements are possible;
7. (7) the client's laundering including necessary ironing and mending;
8. (8) meal preparation, including simple modified diets;
9. (9) payment of bills and other essential errands; and
10. (10) escort to appointments and community activities may also be included under EISEP.

(g) Personal Care Level II services include only:

1. (1) some or total assistance with the tasks listed in subdivision (f) of this section; and

2. (2) some or total assistance with:

   1. (i) bathing of client in the bed, tub or shower;
   2. (ii) dressing;
   3. (iii) grooming, including care of hair, shaving, and ordinary care of nails, teeth and mouth;
   4. (iv) toileting, including assisting the client on and off the bedpan, commode or toilet;
   5. (v) walking, beyond that provided by durable medical equipment, within and outside the home;
   6. (vi) transferring from bed to chair or wheelchair;
   7. (vii) preparation of meals in accordance with modified diets, including low sugar, low fat, low salt and low residue diets;
   8. (viii) feeding;
   9. (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;
   10. (x) routine skin care;
   11. (xi) using medical supplies and equipment such as walkers and wheelchairs; and
   12. (xii) changing simple dressings.

(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.

1. (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. (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. (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.

(k) Requirements for criminal background checks.

(o) Except under consumer directed in-home services, each person providing Personal Care Level I services shall:

1. (1) be instructed, prior to delivering any in-home services, on how to work with the elderly;

2. (2) receive an orientation, prior to delivering any in-home services to:

   1. (i) the housekeeping/chore tasks which the worker may perform;
   2. (ii) the policies and procedures of the provider agency; and
   3. (iii) the rights of clients as set forth in section 6654.16(ai) of this Part;
3. (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.

(q) Under consumer directed in-home services, responsibilities for training, which includes orientation and instruction, are as follows:

1. (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. (2) the fiscal intermediary is responsible for training the consumer or the consumer representative and the in-home services worker on the following:

   1. (i) the roles and responsibilities of the fiscal intermediary; and
   2. (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.

(s) Except under consumer directed in-home services, each in-home services worker shall:

1. (1) have or be designated a supervisor who shall:

   1. (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
   2. (ii) have received an orientation from the area agency on EISEP's design, objectives, local administration, standards, policies and procedures;

2. (2) 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:

   1. (i) demonstration and instruction to the worker and the client concerning specific tasks to be performed;
   2. (ii) orientation to the client and worker; and
   3. (iii) clarification of the roles and responsibilities of the worker, the client and the supervisor in relation to the service plan;

3. (3) receive regular supervision by the designated supervisor in each client's home at least every six months during which the supervisor shall:

   1. (i) evaluate the skills and performance of the in-home services worker;
   2. (ii) provide to the in-home services worker information, consultation, instruction, and demonstration as needed;
   3. (iii) determine the extent to which client needs are appropriately and adequately being met;
   4. (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
   5. (v) provide the client and his or her authorized representative an opportunity to discuss in privacy with the supervisor the service being provided;
4. (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. (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.

(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. (1) containing:

   1. (i) current and past care plan summaries;
   2. (ii) a copy of the current and past authorizations for service;
   3. (iii) a list of names and dates of workers who provide the in-home services;
   4. (iv) dated verifications of service provision, signed by the client or his or her authorized representative;
   5. (v) accident or incident reports;

   6. (vi) on-going narrative notes of a substantive nature that include but are not limited to:

      1. (a) observations;
      2. (b) problems;
      3. (c) plans of action;
      4. (d) records of telephone contacts; and
      5. (e) records of in-home supervisory visits;
2. (2) updated in a timely manner; and
3. (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. (1) containing at a minimum:

   1. (i) consumer or consumer representative contact information;
   2. (ii) current and past authorization for services, during the fiscal intermediary's tenure;
   3. (iii) name and other pertinent information of the consumer representative, if applicable;
   4. (iv) name(s) and contact information of in-home services worker(s);
   5. (v) name and contact information of back-up in-home services worker(s);
   6. (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;
   7. (vii) documentation of training provided by the fiscal intermediary to the consumer or consumer representative; and
   8. (viii) copies of any consumer specific reports requested by the area agency, case manager, consumer or consumer representative;
2. (2) updated in a timely manner; and
3. (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. (1) containing at a minimum:

   1. (i) enrollment form(s) for an in-home services worker;
   2. (ii) contact information;
   3. (iii) documentation of meeting eligibility requirements to be an in-home services worker as referenced in section 6654.15(d)(7) of this Part;
   4. (iv) documentation of compliance with subdivision (l) of this section;
   5. (v) documentation of compliance with subdivision (k) of this section, if applicable;
   6. (vi) copies of any agreements signed by the in-home services worker;
   7. (vii) required payroll and other benefits documents;
   8. (viii) copy of time sheets or electronic time keeping records;
   9. (ix) documentation of any training requests to the fiscal intermediary by the consumer or consumer representative for the in-home services worker; and
   10. (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. (2) updated in a timely manner; and
3. (3) maintained for six years from the end of the State fiscal year in which the consumer last received services.