Chapter 14. In-Home Aide Services

“Abuse” means the sustaining of any physical injury of an IHAS client receiving service as a result of:

“Administration” means the Social Services Administration of the Department of Human Services.

“Case manager” means an individual designated by the local department or other social service agency to:

“Client” means an eligible individual receiving In-Home Aide Services.

“Exploitation” means any action which involves the misuse of an IHAS client's funds, property, or person.

“Functional disability” means difficulty in performing activities of daily living because of:

“Institutionalization” means placement in a hospital, psychiatric hospital, or nursing home.

“Local department” means the Department of Social Services in one of the 23 counties or Baltimore City or the Montgomery County Department of Health and Human Services, where the applicant resides or will reside.

“Neglect” means the willful deprivation of an IHAS client of adequate food, clothing, essential medical treatment, or habilitative therapy, shelter, or supervision.

“Self-neglect” means the inability of an IHAS client to perform activities of daily living or to provide the IHAS client with the services:

Is receiving case management in a social service program from the local department, or from a social service agency through an arrangement with the administration, and requires the service as a part of a treatment plan to:

Is unable to obtain the necessary paraprofessional services from another resource;

Is willing to accept IHAS; and

Agrees to pay any fee required in a fee schedule published by the administration.

The director of a local department or the designee may waive a fee for service for applicants or clients who require services as part of a treatment plan to prevent or remedy abuse, neglect, self-neglect, or exploitation.

The local department shall document in the case record every 90 days the continued need for the waiver.

Local departments shall accept and process requests for In-Home Aide Service by, or on behalf of, any individual or family.

The local department shall assign requests for IHAS that do not come from a case manager in the local department or other social services agency to a case manager in the local department.

An assessment of the individual's functional capacity, if required;

A medical evaluation by the individual's physician, if required;

A ranking scale scored according to Regulation .10F of this chapter;

A copy of the service plan which the IHAS is required to complete;

Income documentation;

Documentation of eligibility; and

An application for IHAS signed by the individual or individual's representative.

The goals to be met;

Tasks to be performed;

Amount and the length of service to be provided including a personal care plan prepared by a registered nurse or physician if personal care is required;

The specific results expected from the provision of aide services; and

The date service is expected to begin.

Assigning a local department staff member;

Purchasing the services from a private for-profit or nonprofit agency that has contracted with the Administration to provide the service; or

Purchasing the services from a self-employed individual.

Meal planning and preparation;

Personal care services which include:

Cleaning the eligible individual's bedroom, bath, kitchen, and personal laundry;

Providing transportation to health and shopping facilities as well as other community resources required by the service plan.

Teaching meal planning and meal preparation; and

Providing therapeutic aide services that include emotional support, introducing the client to neighborhood resources, and reinforcing appropriate self-care and caretaking behaviors, and teaching budgeting and home management.

The local department may make arrangements for the provision of additional types of in-home aide services including heavy chore services to the eligible individual.

If the case manager documents in the case record that intensive aide service, that is, more than 20 hours of aide service per week, is necessary to prevent imminent nursing home placement, or abuse, neglect, or self-neglect, and funds or staff are or become available, the local department shall provide the number of hours and days of care, including evening and weekend care, necessary to prevent nursing home placement, or abuse, neglect, or self-neglect, subject to the limitations in Regulation .07B of this chapter.

A family with children shall receive intensive aide service, that is more than 20 hours of aide service per week, if funds or staff are or become available, and if the:

Regardless of the method by which service is delivered, the local department shall require the service provider to complete a report to the IHAS supervisor on the client's current situation as often as necessary, and not less than monthly, to record any change in the client's situation. The report is required if the client prevents the aide from performing the tasks agreed to in the plan for aide services or the aide:

The IHAS supervisor shall keep the report in the case record in the local department, and shall forward a copy of the report to the case manager.

If there is a change in the client's status which the IHAS supervisor determines may affect the case management plan or the plan for aide service, the supervisor shall inform the case manager within 2 working days.

The IHAS supervisor shall send a current report on the client's situation to the case manager with a request that the client be reassessed, and a medical reevaluation and revised personal care plan be prepared if indicated.

The IHAS supervisor, with the case manager, shall develop a new or revised plan for aide services within 5 working days of receipt of the reassessment and personal care plan.

While the client is absent from the home; or

If the client requests termination.

Notify the case manager when the client is not at home; and

Notify the case manager if the client has requested termination, and include a copy of the aide's status report.

If the IHAS supervisor determines that there is an immediate threat to the aide's health, safety, or welfare from environmental hazards, or from a client, a member of the client's household, or someone regularly present during times of service, the local department may immediately suspend services on an emergency basis.

If services are suspended on an emergency basis, the notice provisions of Regulation .09B of this chapter do not apply. The local department shall send by certified mail written notice of the suspension to the client stating:

Objectives of service have been reached and the IHAS supervisor and case manager agree that service is no longer needed;

The family, client, or case manager is able to secure the necessary service from an alternative source;

The case manager evaluates the client as no longer in need of IHAS;

The client is deceased;

The client moves to the jurisdiction of another local department;

The client is hospitalized, placed in a long-term care facility, or is receiving community-based waiver program services;

The client is no longer eligible;

The limit in Regulation .07A of this chapter has been reached;

The case manager, with the IHAS supervisor, determines that the service has not been effective in achieving the specific changes in the client's condition or family's situation which were expected to result from providing services;

If an individual on the waiting list has a ranking score of seven or above, the local department shall:

If the resources of the local department are insufficient to serve the existing clients, the local department shall terminate the client with the lowest ranking score below seven on the IHAS Ranking Scale, and continue terminating until the remaining clients can be served with the resources available;

The service is suspended for 4 weeks;

The client requests termination;

The client declines IHAS service; or

The client has prevented the IHAS aide from performing tasks agreed upon in the care plan for aide service.

All emergency action hearing requests shall be filed with the local department within 30 days of the certified mailing of the notice of the local department's action, and shall state the name and address of the client, and the effective date of the action appealed.

The local department shall notify the Office of Administrative Hearings immediately upon receipt of an emergency action hearing request. Oral notification shall be followed by written notification within 24 hours.

A hearing shall be conducted within 7 days of the filing date of the hearing request.

A decision by the administrative law judge shall be rendered within 7 days after the conclusion of the hearing.

IHAS is necessary in order to prevent eviction, or correct environmental conditions which are unsafe or detrimental to the applicant's or the client's health. — 1

Applicant's or client's income is equal to or below the amount for the appropriate family size in a fee schedule published by the administration. — 1

The wage earner would lose job income or job if aide service is not provided. — 1

The applicant or client has suffered a personal or financial loss within the last 6 months which affects the individual's emotional or social functioning. — 1

A community resource is not available and willing to assist the applicant or client with the problem which is causing the need for aide service, or the applicant or the client is socially and psychologically isolated. — 1

The applicant or client is not currently receiving in-home aide service from any other agency, or aide service is being discontinued. — 1

An applicant can be discharged from institutional or child foster care only if aide service is provided — 3

The applicant or client or an individual cared for by the applicant or client is in danger of immediate institutionalization or child foster care if aide services are not provided. — 3

The request for service is related to care of children between:

The client, or individual cared for by the client, is in danger of abuse or neglect by the client or other individual:

The applicant or client has a physical, psychiatric, or cognitive disability, and needs assistance in order to perform activities of daily living: