Long
Term - Personal Care Services
Who is eligible?
Medicaid recipients
who are either 65 years of age or older, OR 21 years of age or older with
disabilities (Disabled is defined as meeting the eligibility criteria
established by the Social Security Administration for disability benefits.)
These individuals
must also:
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Meet the requirements for nursing facility level of care, AND
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·
Be able to direct his/her care independently or through a responsible
representative, AND
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Meet one of the following criteria:
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Be in a nursing facility and be able to be discharged if community-based
services were available; OR
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Be likely to require nursing facility admission within the next
120 days; OR
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Have a primary care-giver who has a disability or is over the age
of 70; OR
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·
Face a substantial possibility of deterioration in mental or physical
condition or functioning if either home and community-based services
or nursing facility services are not provided in less than 120 days.
What
are personal care services?
Personal care services
are those services that provide assistance with activities of daily living
and instrumental activities of daily living. They may be either the actual
performance of the personal care task for the individual or supervision
and prompting so the individual performs the task by him/herself. They
include tasks such as:
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eating;· bathing;· dressing;· grooming;
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transferring (getting in/out of the tub, from a bed to a chair);
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reminding the recipient to take medication;
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ambulation;
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toileting;
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light housekeeping;
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food preparation and storage;
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grocery shopping;
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laundry;
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assisting with scheduling medical appointments when necessary;
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accompanying the recipient to medical appointments when necessary
due to the recipient’s frail condition;
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assisting the recipient to access transportation.
What
is not covered under personal care services?
Personal care services
ARE NOT to be used for:
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specialized nursing procedures (i.e., insertion of feeding tube,
indwelling catheter, tracheostomy care, injections)
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skilled nursing services
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medication administration
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rehabilitative services
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specialized aide procedures (i.e., measuring/recording vital signs,
specimen collection, special skin care, etc.)
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cleaning areas of home not occupied by recipien
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food preparation or laundry for anyone other than the recipient
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companionship
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supervision
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respite of the primary care giver
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