Module 2: Home- and Community- Based Services Aging Services of Minnesota Older Adult Services Orientation Manual © Aging Services of Minnesota 2014 1

© Aging Services of Minnesota 2014 1

Module 2:

Home- and Community- Based ServicesAging Services of Minnesota

Older Adult Services Orientation Manual


Home and Community Settings

Private homes

Townhomes

Senior patio homes

Multifamily senior rental housing


Services Offered

Services offered in home and community settings are diverse, catering to varying levels of care

Informal Community Supports

Home Management

ServicesRespite Care Adult Day

Services

Home Care Services

Medicare Home Health Care

ServicesHospice


Community Supports Informal Caregivers

Caregivers can include a friend, spouse, or other family member

Essential role – providing 75% of all care to older adults

Services range from basic companionship to complex medical tasks

46% of informal caregivers

provide medical/nursing

services to older adults


Community Supports Other Services

• Block nurse program

• Faith community nursing

• Volunteer companions

• Volunteer transportation


Home Management Services

Services of a non-technical nature that emphasize the daily needs of individual users

Requires registration with the Minnesota Department of Health

Housekeeping

Shopping

Meal preparation


Respite Care

Provides informal caregivers (such as a spouse or family member) a temporary relief from caregiving

Duration can range from hours to weeks

Respite care can be provided in:•the home, •care centers,•housing with services, or•adult day center


Adult Day Services

Services provided in a group setting

Services may include activities and socialization, meals, baths, health care services, and social services by staff in a licensed setting.

Most adult day service centers operate 10 to 12 hours per day

On average participants attend for 3 to 6 hours several days a week


Home Care

Home care agencies must be licensed by the Minnesota Department of Health.

• They can provide personal care, health care, and home management services.

Services are provided in any home setting including Housing with Services establishments


Home Care LicensingHistorical classes of home care licenses

Class A professional home

care agency license

• May provide all home care services, at least one of which is nursing, physical therapy, speech therapy, occupational therapy, nutritional services, medical social services, home health aide tasks, or the provision of medical supplies and equipment when accompanied by the provision of a home care service

• Class A agencies may be Medicare-certified

Class B paraprofessional

agency license

• Personal care services, homemaker services, and home management tasks in a persons’ home

Class F home care

provider license

• Nursing, personal care and home management services provided in a person’s home or registered HWS establishment


Home Care Licensing Minnesota Home Care Law

Minnesota Department of Health recommended home care provider licensing regulation changes to 2012 Legislature

Legislature passed changes into law

Transition period started July 1, 2013

2012 2013

Transition period continues

2014

Full implementation by July 2015

All providers must be licensed under the new law

2015

Key change: Streamlined 4 license distinctions into 2 (basic or comprehensive) based on the level of services being provided


Home Care Provider Basic

Assistive tasks provided by trained, unlicensed personnel that include:

• Assisting with dressing, self-feeding, oral hygiene, hair care, grooming, toileting, and bathing

• Standby assistance

• Verbal or visual reminders to take regularly scheduled medication

• Verbal or visual reminders to the client to perform regularly scheduled treatments and exercises

• Preparing modified diets ordered by a licensed health professional

• Assisting with laundry, housekeeping, meal preparation, shopping, or other household chores and services


Home Care ProviderComprehensive

Home care services that may include any of the basic home care services and one or more of the following:

• Services of an advanced practice nurse, registered nurse, licensed practical nurse, physical therapist, respiratory therapist, occupational therapist, speech-language pathologist, dietitian or nutritionist, or social worker

• Tasks delegated by a registered nurse, a licensed health professional to trained, unlicensed staff

• Medication management services

• Hands-on assistance with transfers and mobility

• Assisting clients with eating when the clients have complicating eating problems


Home Care Licensing LawTimeline of Key Dates

Change of ownership applications required to pay an application fee

• $2,100 for a provider operating at the Basic Level fee or

• $4,200 for a provider operating at the Comprehensive Level

New providers applying for licensure will apply for Basic or Comprehensive license, pay the new fees, and abide by new licensing laws (will be inspected by Minnesota Department of Health within 14 months)

All providers licensed by Minnesota Department of Health prior to January 1, 2014, will transition to the new set of requirements upon their regular license renewal date


Home Health Care

Home health care differs from home care in that it:

Requires Medicare certification from the Centers for Medicare and Medicaid Services (must also be licensed under Minnesota state statutes)

1

Home health care provides seniors and people with disabilities with short-term skilled nursing, rehabilitative, and therapeutic home health care services

2

Is the only level of home care reimbursable by Medicare 3


Home Health CareEligibility

Adults over age 65 are eligible to receive Home Health Care if services are:

• Provided by a Medicare certified home health care agency

• Under the care of a doctor

• Require a skilled level of care provided by a nurse or physical therapist

• Short-term or intermittent

• Provided while homebound (as defined by Centers for Medicare and Medicaid Services)


Home Health CareServices Provided

Examples of services a Medicare-certified home health care agency may provide include:

• Physical therapy

• Skilled assessments and teaching

• Occupational or speech therapy

• Wound care

• Pain management

• Home health aide services

• Medical social services


Hospice Care

Hospice defined:• Family-oriented; designed to meet spiritual, emotional,

and physical needs during the end of life• Supportive and palliative care provided but does not

provide treatment to underlying conditions

Hospice requirements:• Hospice providers must be licensed under Minnesota

state statues• Medicare Eligibility – when a physician gives a prognosis

of six months or less to live


Hospice CareServices Provided

Services provided include:• Bereavement and emotional support for family• Counseling• Dietary and other counseling• Home health aide and homemaker services• Medical social services• Medical supplies and equipment• Nursing services• Outpatient drugs for symptom and pain control• Physical, occupational, and speech therapy• Physician services• Short-term inpatient care• Spiritual care


Acknowledgements

This resource was made possible by funding from the Ronald Patterson Governance Fund

of the Aging Services of Minnesota Foundation

Developed by Health Dimensions Group, Minneapolis, MN

Documents

Module 2: Home- and Community- Based Services Aging Services of Minnesota Older Adult Services Orientation Manual © Aging Services of Minnesota 2014 1