Office for the Aging

 

STANDARD DEFINITIONS OF SERVICE

Adult Day Services (Social Adult Day and Adult Day Health)

  • SERVICE DEFINITION
    • There are two types of adult day services (ADS) - social adult day services (SADS), which do not include a medical component in the program and are regulated by the NYS Office for the Aging when funded with aging funds, and adult day health care (ADH), which includes a medical component and is regulated by the NYS Department of Health.
    • Social Adult Day Services
      A structured, comprehensive program which provides functionally impaired individuals with socialization, supervision and monitoring, personal care and nutrition in a protective setting during any part of the day, but for less than a 24-hour period. Additional services may include and are not limited to maintenance and enhancement of daily living skills, transportation, caregiver assistance and case coordination and assistance.
    • Adult Day Health Care
      Health care services and activities provided to a group of registrants with functional impairments to maintain their health status and enable them to remain in the community. Programs are located at a licensed residential health care facility or an extension site. Programs are approved by the NYS Department of Health. (Note: regulations prohibit the use of EISEP funding for adult day health care.)

  • UNIT OF SERVICE
    • One hour of service
  • FUNDING SOURCES
    • Title III-B, Title III-E, EISEP (Only for SADS), CSE, Other

Assisted Transportation

  • SERVICE DEFINITION
    • Assistance and transportation, including escort, to a person who has difficulties (physical or cognitive) using regular vehicular transportation.
  • UNIT OF SERVICE
    • Each one-way trip
  • FUNDING SOURCES
    • Title III-B, Title IIIC-1, Title III-E, EISEP, CSE, CSI, SNAP, Other

Caregiver Services

  • SERVICE DEFINITION
    • Services included are support groups for caregivers, caregiver counseling on issues to help caregivers in making decisions and solving problems related to their care giving roles and training workshops for caregivers. For state funded CRC's it also includes lending libraries. These are services designed to support caregivers and help sustain their efforts to provide care.
  • UNIT OF SERVICE
    • Each participant of a group or individual session receives one unit of service.
  • FUNDING SOURCES
    • Title III-B, Title III-E, Title III-D, CSE, CSI, Other

Case Management

  • SERVICE DEFINITION
    • A comprehensive process that helps older persons with diminished functioning capacity, and/or their caregivers, gain access to and coordinate appropriate services, benefits and entitlements. Case management consists of assessment and reassessment, care planning, arranging for services, follow-up and monitoring at least every two months and discharge. These activities must be provided by or under the direction of the designated case manager or case manager supervisor.
      Note: please see CAARS instructions regarding the acceptability of reporting assessments for those seeking/receiving home delivered meals as the only community based long term care service they will receive.
      Case Management activities for clients receiving community-based long term care services:
      • A comprehensive MDS-compliant assessment is the collection of information about a person's situation and functioning, and that of his/her caregivers, which allows identification of the person's specific strengths and needs in the major functional areas.
      • A care plan is a formal agreement between the client and case manager and, if appropriate, the client's caregivers regarding client strengths and problems, goals and the services to be pursued in support of goals.
      • Implementation of the care plan (arranging and authorizing services) includes contacting service providers, conducting case conferences and negotiating with providers for the delivery of needed services to the client as stated in the care plan.
      • Follow-up and monitoring which provides for contact every two months with the client and is ongoing and regular with the service providers to ensure that service delivery is meeting the client's needs and being delivered at the appropriate levels and quality.
      • Reassessment is the formal re-examination of the client's situation and functioning and that of his/her caregivers to identify changes which occurred since the initial assessment/last reassessment and to measure progress toward goals outlined in the care plan. It is done at least annually and more frequently if needed. Changes are made to the care plan as necessary.
      • Discharge is the termination of case management services. Reasons for discharge may include the client requesting discharge, the attainment of goals described in the care plan, the client needing a type of service other than case management or ineligibility for the service. Case managers may also be functioning in the role of a support coordinator or consultant to informal caregivers. In this role, the case manager may be acting as a teacher, networker, counselor and/or family guide.
  • UNIT OF SERVICE
    • One hour of service including travel time.
  • FUNDING SOURCES
    • Title III-B, Title III-D, Title III-E, CSE, EISEP, SNAP , Other

Congregate Meal

  • SERVICE DEFINITION
    • A hot or other appropriate meal which meets nutritional requirements and is served to an eligible participant in a group setting.
  • UNIT OF SERVICE
    • Each meal served. Meals served to individuals through means-tested programs such as Medicaid Title XIX waiver meals are excluded from the NSIP meals count.
  • FUNDING SOURCES
    • Title IIIC-1, Title III-E, EISEP, CSE, SNAP, Other

Consumer Directed In Home Services

  • SERVICE DEFINITION
    • A service that provides assistance with the tasks that are the same or similar to those included in the definitions of Personal Care Level I and Personal Care Level II, and which is managed by the consumer, or a representative selected by the consumer. This includes such activities as recruitment, selection, training, supervision and dismissal of the in-home services worker.
  • UNIT OF SERVICE
    • One hour of service
  • FUNDING SOURCES
    • EISEP, CSE, Other

Health Promotion

  • SERVICE DEFINITION
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    • Services and activities that foster good health and quality of life, increase awareness and understanding of healthy lifestyles, promote chronic disease prevention and management and promote physical and mental health. These include but are not limited to:
      • Medication management to prevent incorrect medication and adverse drug reactions (required)
      • Routine health screenings such as vision, diabetes, bone density and nutrition
      • Evidence-based health promotion programs
      • Medicare preventive services such as education programs on the availability, benefits, and appropriate use of preventive health services
      • Preventive nutrition services such as nutrition counseling and education
      • Physical fitness programs
      • Home injury control services such as screening home environments and education programs on injury and falls prevention at home
      • Mental Health services such as screening for depression, provision of educational activities

  • UNIT OF SERVICE
    • One unit = Each participant or attendee of a group session, class or event One unit = Each distribution of a health related topic in a newsletter, newspaper, radio or TV show
  • FUNDING SOURCES
    • Title III-B, Title III-D, Title III-E, EISEP, CSE, CSI, Other

Home Delivered Meal

  • SERVICE DEFINITION
    • A hot or other appropriate meal which meets nutritional requirements and is provided to an eligible person for home consumption.
  • UNIT OF SERVICE
    • Each meal served. Meals served to individuals through means-tested programs such as Medicaid Title XIX waiver meals are excluded from the NSIP meals count.
  • FUNDING SOURCES
    • Title III-E, Title IIIC-2, EISEP, CSE, SNAP, Other

Home Health Aide Service

  • SERVICE DEFINITION
    • The provision of health care tasks, personal hygiene services, housekeeping tasks and other related support services essential to the client's health including:
      1. Assisting with tasks listed under Personal Care Level II services;
      2. Performing simple measurements and tests to routinely monitor the patient's medical condition;
      3. Preparing meals in accordance with modified diets or complex modified diets;
      4. Performing a maintenance exercise program;
      5. Using medical equipment, supplies and devices;
      6. Changing dressings to stabilize surface wounds;
      7. Caring for an ostomy after the ostomy has achieved its normal function;
      8. Providing special skin care; and
      9. Administering of medication.
  • UNIT OF SERVICE
    • One hour of service excluding travel time.
  • FUNDING SOURCES
    • Title III-B, Title III-E, CSE, Other

Information and Assistance

  • SERVICE DEFINITION
    • A service that:
      1. provides individuals with information on services available through the AAA and within the communities;
      2. assists individuals by linking them to the services and opportunities that are available within the communities;
      3. to the maximum extent practicable, establishes adequate follow-up procedures. Internet web "hits" are to be counted only if information is requested and supplied.
  • UNIT OF SERVICE
    • One contact
  • FUNDING SOURCES
    • Title III-B, Title IIIC-1, Title IIIC-2, Title III-D, Title III-E, HIICAP, WRAP, PoE, CSE, CSI, SNAP, Other

In-Home Contact and Support

  • SERVICE DEFINITION
    • Services and activities designed to provide support to older people who are isolated because of physical and/or cognitive limitations. These services are not defined separately elsewhere in the standard definitions and may include but are not limited to:
      • Shopping Assistance - Shopping on behalf of an older person
      • Friendly Visiting - A scheduled visit to an older person to provide socialization, recreation and the opportunity to observe and report the person's condition and circumstances.
      • Telephone Reassurance (including automated systems) - Regularly scheduled telephone contact with an older person with follow-up as necessary and appropriate.
      • Supervision - Services provided in the home to monitor, guide and oversee the older person's actions and activities. Supervision services funded by EISEP or III-E as respite for a client's informal caregivers "paid supervision."
      • Other services - Provided in the home to support the person including house cleaning, laundry service, bill paying/other essential errands.
  • UNIT OF SERVICE
    • One contact
  • FUNDING SOURCES
    • Title III-B, Title IIIC-1, Title IIIC-2, Title III-E, EISEP, CSE, SNAP, Other

Legal Assistance

  • SERVICE DEFINITION
    • Provision of legal advice, counseling and representation by an attorney or other person acting under the supervision of an attorney.
  • UNIT OF SERVICE
    • One hour of service
  • FUNDING SOURCES
    • Title III-B, Title III-E, CSE, Other

Long Term Care Ombudsman

  • SERVICE DEFINITION
    • Services provided by duly authorized patient advocates on behalf of people residing in long term care facilities and their families. Primary activities include identifying, investigating and resolving complaints, concerning resident care, quality of life and residents' rights. Identification of adverse issues and conditions affecting residents, promoting the development of resident and family councils, and ensuring residents have regular and timely access to ombudsman advocacy services.
  • UNIT OF SERVICE
    • No unit or people served reporting required for the client data systems. This information is reported under the Ombudsman Reporting System. All clients identifying information is confidential and subject to disclosure according to requirements under the OAA. Report expenditures only using the CAARS quarterly on line system.
  • FUNDING SOURCES
    • Title III-B, Other

Nutrition Counseling

  • SERVICE DEFINITION
    • Individualized guidance to individuals who are at nutritional risk because of their health or nutrition history, dietary intake, chronic illnesses, or medications use. Counseling is provided one-on-one by a nutrition professional, who evaluates the person's nutritional needs, develops and implements a nutrition counseling plan, evaluates the client's outcome, maintains documentation and distributes appropriate literature. It is recommended that initial counseling be provided face-to-face at a congregate site, in the home or in an office setting. Follow up nutrition counseling may be provided face-to-face at a congregate site, in the home, office setting or by telephone. A nutrition professional is defined as a Registered Dietitian (RD), a Registered Dietitian-Eligible who must successfully complete the exam within 18 months (RDE), or a NYS Certified Dietitian/Nutritionist (CDN). Certified Diabetic Educators (CDE) is appropriate only for nutrition counseling with older individuals with diabetes. Nutrition counseling services are available to an older individual and/or her/his caregiver upon referral and/or request.
  • UNIT OF SERVICE
    • One hour of service (time with individual and travel time).
  • FUNDING SOURCES
    • Title IIIC-1, Title IIIC-2, Title III-D, Title III-E, EISEP, CSE, CSI, SNAP, Other

Nutrition Education

  • SERVICE DEFINITION
    • A planned program to promote better nutrition, physical fitness and health through information and instruction on nutrition and related consumer topics of general interest. The program is provided by or under the direction of a Registered Dietitian (RD), Registered Dietitian-Eligible (RDE), NYS Certified Dietitian-Nutritionist (CDN), or a Dietetic Technician-Registered (DTR). Information and instruction may occur in group settings and/or through distribution of materials to individuals. A minimum of 6 group or class presentations must be provided at each congregate meal site annually. Nutrition information or handouts are provided to congregate and home delivered meal participants at least monthly.
  • UNIT OF SERVICE
    • Each participant of a group or individual session receives one unit of service. Each distribution of handouts to congregate and/or homebound participants (not counted if handouts are part of a presentation or are left on display to be picked up by participants). = One unit per participant Each article prepared and printed in a newsletter or newspaper; each radio or television presentation= One unit
  • FUNDING SOURCES
    • Title IIIC-1, Title IIIC-2, Title III-D, Title III-E, CSE, CSI, SNAP, Other

Outreach

  • SERVICE DEFINITION
    • Activities initiated by the AAA or its subcontractors for the purpose of identifying potential clients (or their care givers) and encouraging their use of existing services and benefits. This includes face-to-face or telephone contact between a worker and an individual.
  • UNIT OF SERVICE
    • Each contact
  • FUNDING SOURCES
    • Title III-B, Title IIIC-1, Title IIIC-2, Title III-E, CSE, CSI, SNAP, Other

Personal Care Level I

  • SERVICE DEFINITION
    • A service that includes some or total assistance with the following tasks on behalf of or to assist a person commensurate with the person's limitations in IADLs:
      • Making and changing beds
      • Dusting and vacuuming the rooms which the person uses
      • Light cleaning of the kitchen, bedroom and bathroom
      • Dishwashing
      • Listing needed supplies
      • Shopping for the person
      • The person's laundering, including necessary ironing and mending
      • Preparing meals, including simple modified diets
      • Paying bills and other essential errands
      • Escorting to appointments and community activities
  • UNIT OF SERVICE
    • One hour of service
  • FUNDING SOURCES
    • Title III-B, Title III-E, EISEP, CSE, Other

Personal Care Level II

  • SERVICE DEFINITION
    • A service that includes assistance with the following tasks on behalf of or to assist a client commensurate with the person's limitations in ADLs or limitations in both ADLs and IADLs:
      Some or total assistance with:
      • All the tasks listed under Personal Care Level I
      • Bathing of the person in the bed, tub or shower
      • Dressing
      • Grooming, including care of hair, shaving and ordinary care of nails, teeth and mouth
      • Some assistance with:
        • Toileting, including assisting the person on and off the bedpan, commode or toilet
        • Walking, beyond that provided by durable medical equipment, within the home and outside the home
        • Transferring from bed to chair or wheelchair
        • Preparation of meals in accordance with modified diets, including low sugar, low fat, low salt and low residue diet
        • Feeding
        • Administration of medication by the client, including prompting the 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 the medication and administration, disposing of used supplies and materials and storing the medication properly
        • Providing routine skin care
        • Using medical supplies and equipment such as walkers and wheelchairs
        • Changing simple dressings
  • UNIT OF SERVICE
    • One hour of service
  • FUNDING SOURCES
    • Title III-B, Title III-E, EISEP, CSE, Other

Personal Emergency Response System

  • SERVICE DEFINITION
    • A service which utilizes an electronic device to alert appropriate people of the need for immediate assistance in the event of an emergency situation in an older person's home.
  • UNIT OF SERVICE
    • One unit for each month or part of a calendar month that the device is in the person's home.
  • FUNDING SOURCES
    • Title III-B, Title III-E, EISEP, CSE, Other

Senior Center, Recreation and Education

  • SERVICE DEFINITION
    • Activities organized and scheduled through the AAA or its subcontractors which involve older persons in courses, workshops, other learning activities and satisfying use of free time.
  • UNIT OF SERVICE
    • One group session
  • FUNDING SOURCES
    • Title III-B, Title IIIC 1, Title III-D, CSE, CSI, SNAP, Other

Transportation

  • SERVICE DEFINITION
    • Transportation from one location to another. Does not include any other activity.
  • UNIT OF SERVICE
    • One unit for each one way trip per person
  • FUNDING SOURCES
    • Title III-B, Title IIIC-1, Title III-E, EISEP, CSE, CSI, SNAP, Other