10A NCAC 06X .0203. DESCRIPTION OF IN‑HOME AIDE SERVICE LEVELS FOR ADULTS

As used in this Subchapter, the following descriptions of In‑Home Aide Service levels shall apply for adults:

(1)           Level I ‑ Home Management.  In‑Home Aide Services at this level are intended to provide support to individuals and their families who require assistance with basic home management tasks, such as housekeeping, cooking, shopping, and bill paying.  Clients to be served include those who are self‑directing, medically stable, and who have at least one instrumental activity of daily living (IADL) impairment.  Personal care tasks may not be performed at this level.

(2)           Level II ‑ Home Management and Personal Care.  In‑Home Aide Services at this level are intended to provide support to individuals and their families who require assistance with basic activities of daily living and home management tasks.  Both the home management and assistance with personal care tasks can be provided to the client when his capacities are diminishing or when the client is striving to maintain or improve his own functioning.  Clients to be served include those who are medically stable and partially dependent in carrying out one or two activities of daily living (ADL) due to physical or mental impairments, or both; or who have maintenance needs or rehabilitative potential, or both.  In addition to their personal care needs, clients may also require assistance with IADL activities to improve IADL functioning or to learn independent living skills; or they may have two to four IADL needs requiring additional support to maintain or achieve overall functioning.

(3)           Level II ‑ Home Management Only.  In‑Home Aide Services at this level are intended to provide support to individuals and their families who require assistance with home management tasks and do not require assistance with personal care.  Provision of home management tasks focuses more on strengthening and developing the individual's own skills rather than on doing these tasks for him.  Clients to be served include those who need assistance to remain in their own homes; or who need assistance to maintain, strengthen, and safeguard their functioning because of physical or emotional illness or handicap.

(4)           Level III ‑ Home Management.  In‑Home Aide Services at this level are intended to provide intensive education and support to individuals and their families in carrying out home management tasks and improving family functioning skills.  Provision of the service primarily focuses on individualized work with a client and his family in teaching and demonstrating skills and tasks and reinforcing improved client and family accomplishments.  It also involves direct care and support in crisis situations.  Clients to be served generally have moderate to severe limitations in cognitive or psycho‑social functioning, but have potential for partial or total independence in IADL or home management functioning, or both.  Some clients may have more than four IADL impairments.

(5)           Level III ‑ Personal Care.  In‑Home Aide Services at this level are intended to provide substantial ADL support to individuals who require assistance with health or personal care tasks, or both.  Provision of these tasks involves extensive "hands on" care and potential assistance with a wide range of health related conditions.  Clients to be served include those who are medically stable with significant ADL impairments (three or more) resulting from a chronic condition; or who are medically stable with significant ADL impairments, but have rehabilitative potential; or who are medically unstable due to recent illness, complications of a chronic condition, or a deteriorating condition with variable ADL and IADL needs.

(6)           Level IV ‑ Home Management.  In‑Home Aide Services at this level are intended to provide a wide range of educational and supportive services to individuals and their families who are in crisis or who require long term assistance with complex home management tasks and family functioning skills.  Provision of the service involves quick and creative response to individual and family crisis situations identified by the case manager; it also focuses on appropriate learning sessions with small groups of persons from different families who have similar needs.  Clients to be served include those who have serious limitations in cognitive or psycho‑social functioning, or both, but who have the potential for major or complete independence in IADL functioning and who have little or no ADL impairment.

 

History Note:        Authority G.S. 143B‑153;

December 1, 1991.