	Home Care and Support Services: Home Health Aide Services, Personal Care Aide Services, and Homemaker Services

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

HCS 6: Coordinated Home Management, Activities of Daily Living, and Health Services

Delivery of coordinated services ensures a safe, healthy, stable living environment.

HCS 6.01

Sufficient community resources are drawn upon, and are reviewed with sufficient frequency, to provide a flexible approach and best possible “package” of services for each individual or family and their changing needs.

Interpretation: A service “package” refers to the number and combination of different services, and volume of care. This perspective acknowledges that users of services are a diverse group who need a variety of services of varying combinations and frequencies.

Research Note: A state study of composition and predictors of use of home care services delivered through Medicaid waiver programs to poor and frail elder people in two large urban counties found that factors such as cognitive impairment, household composition, and such program guidelines as cost sharing vary according to types of services used. Suggested reasons for variations in service use, having practical significance for quality improvement or program evaluation efforts, included: differences in opinion of assessment teams as to benefits of services, or attitudes about service entitlement, and differences in professional training. Standardized training for assessment teams, and more precise guidelines for ordering services given client need, to reduce interpretation and unwanted variation, were considered useful.

HCS 6.02

Services provided directly or by a cooperating provider can include:

housekeeping tasks and home management activities and education;
companionship;
chores, safe food handling and storage, and nutritious meal preparation;
assistance with personal care;
monitoring of overall health and well-being including observing, reporting, and documenting changes in bodily function;
assistance with self-administered medications;
assistance with simple, prescribed rehabilitative exercises;
simple wound care;
assistance or prompting with activities of daily living;
assistance with ambulation and transfer; and
assistance with participation in community activities.

Interpretation: When an organization provides some and not all of the services and support typically required to maintain a person in their home and community, the organization demonstrates that it alerts providers to any identified unmet needs.

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	PURPOSE: Individuals who receive Home Care and Support Services obtain a maximum level of independence, functioning, and health, and extend the time it is possible to live safely at home and in the community.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.


	IMPAIRMENT A loss or abnormality in physiological, psychological, or mental structure or functioning, such as paralysis of a limb, mental retardation, or blindness.


	QUALITY In this context, the extent to which contemporary and generally recognized standards for professional practice are met and exceeded, and desirable service outcomes achieved.


	EVALUATION The review and assessment of organizational operations, programs and services.


	ASSESSMENT An evaluation, which utilizes professional expertise and skills in the collection and analysis of data to understand and describe the nature of service needs of an individual, family, or group. Assessment, as in needs assessment, is also used to determine priorities of program planning and service development for the organization as a whole. See also DIAGNOSIS.


	ENTITLEMENT A state or condition of being entitled, or a right to benefits specified by law or contract. In the United States, "entitlements" generally refer to government programs that provide financial assistance and healthcare services to members of specified groups, such as the elderly or persons with disabilities.


	TRAINING Instruction so as to make fit, qualified, or proficient in a skill or body of knowledge.


	CLIENT See service recipient.


	MANAGEMENT See ADMINISTRATION


	MONITORING An evaluation involving a periodic review of consumer services, organizational activities, or conduct. Specifically, monitoring is an activity of case coordination, whereas more broadly, monitoring is an evaluation technique used in overall quality assurance.


	MEDICATION A prescribed or over-the-counter drug that is injected, taken orally, applied topically, or otherwise administered.