910 KAR 1:170. Supportive services for the elderly.
RELATES TO: KRS 205.201, 205.203, 205.455-205.465, 910 KAR 1:180, 42 U.S.C. 3001 et seq.
STATUTORY AUTHORITY: KRS 194A.050, 205.204(2)
NECESSITY, FUNCTION, AND CONFORMITY: 42 USC 3001 et seq., the Older Americans Act of 1965, as amended, authorizes grants to states to provide assistance in the development of new or improved programs for older persons. KRS 194A.050 authorizes the Cabinet for Health Services to adopt regulations as necessary to implement programs mandated by federal law, or to qualify for the receipt of federal funds. KRS 205.204 designates the Cabinet for Health Services as the state agency to administer the Older Americans Act in Kentucky. The function of this administrative regulation is to set forth the standards of operation for the Supportive Services Program in Kentucky, in compliance with the statutory requirement of KRS 13A.221 that requires a separate administrative regulation for each topic of general subject matter.
Section 1. Definitions. (1) "Access" means information and referral services, outreach service and transportation service.
(2) "Adequate proportion" means no less than sixty-five (65) percent of the federal funding allocated by the Older Americans Act of 1965, as amended, excluding administrative funds.
(3) "Agency" means the area agency on aging, an entity designated by the state to administer, at the local level, the programs funded by the Older Americans Act of 1965, as amended.
(4) "In-home services" means the following supportive services:
(a) Homemaker and home health aide;
(b) Visiting and telephone reassurance;
(c) Chore maintenance;
(d) In-home respite; and
(e) Home repair.
(5) "Legal assistance" means:
(a) Legal advice and representation by an attorney;
(b) Counseling or other appropriate assistance by a paralegal or law student under the supervision of an attorney; or
(c) Counseling or representation by a nonlawyer, where permitted by law, to older individuals with economic or social needs.
(6) "OAA" means the Older Americans Act of 1965, as amended.
(7) "Office" means the Office of Aging Services, Cabinet for Health Services.
(8) "Supportive service provider" means an entity that provides supportive services funded by the OAA, under an approved area plan.
(9) "Unit of service" means:
(a) One-half (1/2) hour of direct contact with or on behalf of the participant;
(b) One (1) contact for the information and referral service;
(c) One (1) call for the telephone reassurance service;
(d) One (1) mile for the transportation service; and
(e) For federal reporting purposes, the following:
1. One (1) visit for the friendly visiting service;
2. One (1) session for the health promotion and recreation services;
3. One (1) contact for the outreach service; and
4. One (1) one-way trip for the transportation service.
Section 2. Eligibility. (1) Participants receiving supportive services funded by the OAA shall be sixty (60) years of age or older.
(2) Agencies shall establish systems for prioritizing applicants to ensure services are targeted to those in greatest need.
(3) Means tests shall not be allowed to determine eligibility.
Section 3. Service Provider Responsibilities. (1) Services shall be provided in accordance with the approved agency plan which shall ensure an adequate proportion is planned and expended to fund access, in-home and legal assistance services.
(2) Eligibility of each participant shall be established and personnel who approve services shall be designated.
(3) Volunteers and paid staff with the same written job description and responsibilities shall meet comparable requirements for training and skills.
(4) Services shall be provided under the supervision of qualified personnel.
(5) Services shall be accessible to participants by telephone, home visit, center location or person-to-person contact.
(6) Center services shall be available on a regularly scheduled basis. Major permanent changes shall have prior approval of the agency and be publicized to participants.
(7) Staff training shall be as follows:
(a) New staff shall receive an orientation;
(b) New staff shall be trained prior to assuming responsibilities or shall receive on-the-job training from qualified agency staff;
(c) Existing staff shall receive training on job-related topics at a minimum of once per year.
(8) Staff shall not accept personal gratuities from participants or vendors.
(9) Staff shall not, without prior approval of the supervisor, pay bills or cash checks for participants.
(10) Designated staff, who are trained and skilled in assessing and dealing with the needs of the elderly and in the delivery of each service, shall be provided.
(11) There shall be a staff person, qualified by training and experience, responsible for administering each service and supervising assigned staff.
(12) The following activities shall not be reported as units of service except where required for a specific service:
(a) Review, update or maintenance of resource or agency files;
(b) Travel time incurred in the delivery of services;
(c) Training sessions or staff meetings; or
(d) Project management.
(13) A record documenting participant identification data, requests for service, eligibility for services provided and follow-up shall be maintained for each participant.
(14) A procedure shall be utilized annually for the evaluation of unmet need, the results to be made available to the agency.
(15) The legal assistance provider shall:
(a) Specify how it intends to target services for the needs of low-income minority individuals;
(b) Attempt to provide services to the population of low-income minority individuals in at least the same proportion as the population bears to the older population as a whole;
(c) Provide individual legal casework, legal referral, and legal education to the elderly and training for attorneys in areas of law relevant to the elderly;
(d) Contact institutionalized elderly and inform and educate these individuals about the legal assistance services available;
(e) Specify how it intends to coordinate its efforts with the efforts of the Long-term Care Ombudsman Office;
(f) Meet at least annually with the local ombudsman program;
(g) Submit a written quarterly activities report to the agency, documenting the legal activities and services provided to participants as follows:
1. Aggregate data as requested by the agency shall be provided on the quarterly program performance report, herein incorporated by reference; and
2. Information protected by the attorney-client privilege shall not be divulged.
Section 4. Support Services. Services funded by the OAA and administered by the area agencies on aging shall be provided as follows:
(1) Advocacy shall be action taken on behalf of an older person or group of older persons to secure rights or benefits. Advocacy services shall:
(a) Include receiving, investigating, and working to resolve disputes or complaints;
(b) Not include services provided by an attorney or person under the supervision of an attorney;
(c) Arrange annual public hearings within each area development district to:
1. Provide public information;
2. Identify areas of concern; and
3. Develop plans to address concerns;
(d) Keep the public informed of available services through other means identified in the area plan; and
(e) Include assessments as to whether or not provided services are reaching the population most in need.
(2) Counseling services shall be either singly or in a group and provided in a private, confidential setting to:
(a) Interview, discuss and actively listen to participants to advise and enable participants and families to resolve problems;
(b) Relieve temporary stress encountered by participants and families.
(3) Education services shall:
(a) Provide formal or informal opportunities for individuals or groups to acquire knowledge, experience or skills and increase awareness;
(b) Be presented by persons qualified by education or experience, on topics relevant to participant need and interest as identified through staff and participant input;
(c) Use donated resources for the provision of services if possible; and
(d) Maintain records which include topics, presenters, location and number of participants.
(4) Employment services shall include:
(a) Provision of consultation, job development and other services designed to assist participants in securing paid employment:
1. Information to participants concerning available employment;
2. Counseling which may include advise on taking tests, preparing a resume, attitude during an interview, and how to locate potential employers; and
3. Educating prospective employers;
(b) Referrals to prospective employers;
(c) Transportation assistance to participants involved in job search activities; and
(d) Follow-up activities on participants seeking paid employment.
(5) Friendly visiting services shall be planned visits to socially or geographically isolated participants:
(a) To express interest in his welfare by providing companionship and continuing contact with the community;
(b) Provided by trained staff or trained volunteers who have a staff person identified as supervisor;
(c) With consideration given for participant preference regarding the person providing service, schedule of times for, and length of service; and
(d) Using volunteers to provide the service if possible.
(6) Health promotion services shall develop programs designed to maintain or improve the health and well-being of older persons, including health screening, health promotion and other related activities. Services shall include:
(a) Assisting participants in securing and utilizing the available health services for attaining and maintaining a favorable condition of health;
(b) Education on the need for health care;
(c) Assistance to participants to help them understand health insurance policies; and
(d) Wellness activities like walking programs, exercise programs and other group activities.
(7) Information and referral services shall:
(a) Provide information in response to an inquiry regarding opportunities and services available;
(b) Assist in accessing opportunities and services;
(c) Follow-up to determine whether services were received and identified needs were met; and
(d) Utilize current records of appropriate community resources, including local procedures for assessing participant needs and for making referrals to appropriate agencies.
(8) Legal assistance services shall:
(a) Be available for institutionalized older persons and other elderly persons otherwise entitled to legal assistance;
(b) Not be denied because of a person's failure to disclose information about income or resources; and
(c) Assure providers maintain records to include individual client services and group activities, covering topics, presenters, locations and numbers of participants.
(9) Outreach services shall:
(a) Locate or reestablish contact initiated by providers, to identify participants in need of services;
(b) Provide information;
(c) Encourage the use of existing services;
(d) Be provided in the total geographic area served by the agency, in accordance with a plan to identify the elderly in the area, with priority given to low income minority; and
(e) Be provided by a worker with current knowledge of services available to the elderly, in accordance with an established procedure for worker assistance to the participant in accessing appropriate services, including follow-up to assure needs have been met.
(10) Recreation services shall provide activities which foster the health or social well-being of individuals through social interaction and the satisfying use of leisure time:
(a) By a person who is knowledgeable and skilled in the recreational activities provided, including a volunteer under the supervision of the center director; and
(b) With consideration for the physical and mental conditions and activity preferences of the participants.
(11) Telephone reassurance services shall:
(a) Provide regular telephone contact to or from isolated individuals:
1. To determine if they are safe and well;
2. To determine if they require special assistance; or
3. To provide psychological reassurance;
(b) Include a prearranged schedule for contacting the participant, and:
1. A plan of action for each participant to be implemented in the event of a nonanswered call;
2. The participant's preference regarding the person providing service; and
3. A record of calls and length of calls.
(12) Transportation services shall:
(a) Carry older persons to or from community resources to access or receive needed services;
(b) Comply with federal, state, and local regulations to ensure a safe journey from the point of departure to destination; and
(c) Use vehicles safe and accessible to older persons and properly insured to protect the participants in accordance with state laws.
(13) Provision of the following supportive services shall be governed by 910 KAR 1:180, homecare program for the elderly:
(b) Case management;
(e) Home health aide;
(f) Homemaker, home management and homemaker, personal care;
(g) Home repair; and
Section 5. Material Incorporated by Reference. (1) The form necessary for the implementation of the supportive services for the elderly program shall be herein incorporated by reference.
(2) Material incorporated by reference may be inspected and copied at the Office of Aging Services, CHR Building, 5th Floor, 275 East Main Street, Frankfort, Kentucky 40621. Office hours are 8 a.m. to 4:30 p.m. (18 Ky.R. 1745; Am. 2275; eff. 1-10-92; Recodified from 905 KAR 8:170, 10-30-98; Recodified from 923 KAR 1:170, 7-8-99.)