10A NCAC 06X .0206. ASSESSMENT AND REASSESSMENTS

(a)  The purpose of the initial assessment and regular reassessments is to determine each individual's or family's level of functioning and determine or confirm the need for In‑Home Aide Services.

(b)  The initial assessment and reassessments must be conducted by an appropriate professional, which means a social worker, registered nurse, registered dietitian or certified nutritionist, physical therapist and occupational therapist.  The initial assessment and reassessments are prerequisites to providing In‑Home Aide Services.

(c)  An initial assessment is not a prerequisite when the health, safety, or well‑being of an individual or family is at risk.  In these instances the initial assessment must be completed within five working days of the onset of services.

(d)  The initial assessment and reassessment must be conducted in the individual's or family's home and must address the mental, social, environmental, economic, and physical health status of the individual or family, as well as an individual's ability to perform activities of daily living (ADL's) and instrumental activities of daily living (IADL's).

(e)  The initial assessment and reassessments must be signed and dated by the professional responsible for assuring the completion of the initial assessment and reassessments.

(f)  An initial assessment must be completed prior to the professional's development of an In‑Home Aide Service Plan.

(g)  A full reassessment must be completed at least every 12 months or earlier if the appropriate professional, as specified in Paragraph (b) of this Rule, determines that the family's or individual's needs have increased or decreased due to changes in one or more of the functional areas listed in Paragraph (d) of this Rule.

(h)  A review of the individual's or family's situation must be completed by an appropriate professional as specified in Paragraph (b) of this Rule at least quarterly.  When Level II or III - Personal Care tasks are provided to a client, the quarterly review must be conducted in the client's home.  If a reassessment is conducted, it meets the requirements for a quarterly review.

(i)  If the individual or family needs Home Management tasks at Level I or II, the initial assessment and reassessments must be completed by an appropriate professional, as specified in Paragraph (b) of this Rule.  If a professional other than a social worker is conducting the initial assessment or reassessment at Level I or II, and the individual's or family's social needs appear more extensive than the assessor is able to adequately evaluate, then a social worker must be consulted for further input.  If the individual or family needs Home Management tasks at Level III or IV, the initial assessment and reassessments must be completed by a social worker.

(j)  If the individual or family needs Personal Care tasks at Level III, a registered nurse must complete the physical health status and the ADL portions of the initial assessment and reassessments.  For Level II Personal Care tasks, if a social worker or registered dietitian is conducting the initial assessment or reassessment and the individual's or family's personal care needs appear more extensive than the assessor is able to adequately evaluate, then an appropriate health professional must be consulted for further input.

(k)  Consultation with a registered nurse is required for Level II clients receiving Personal Care tasks if the client's personal care needs have increased due to changes in a medically related problem to determine the appropriate level of In-Home Aide Services.

 

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

Eff. December 1, 1991;

Amended Eff. September 1, 1993.