File No. 33027
This rule was published in the November 1, 2009, issue (Vol. 2009, No. 21) of the Utah State Bulletin.
Human Services, Aging and Adult Services
Rule R510-401
Utah Caregiver Support Program
Notice of Proposed Rule
(Repeal and Reenact)
DAR File No.: 33027
Filed: 10/06/2009 02:48:57 PM
RULE ANALYSIS
Purpose of the rule or reason for the change:
The Caregiver rule has not been updated for several years and requires a number of changes to comply with updated federal requirements and improved processes. The rule has been completely updated and reorganized.
Summary of the rule or change:
While the content of the rule is not dramatically different, service levels, allowable costs and other limits to the program have been updated to reflect updates. Rather than major content changes, the structure of the rule has been changed and has been regrouped and reorganized making a regular marked-up copy difficult to follow. Updates have been made with regard to to services to grandparents, ages of potential clients, coordination with other services, and general updates.
State statutory or constitutional authorization for this rule:
- Section 62A-3-104
Anticipated cost or savings to:
the state budget:
The rule is being changed to reflect current practices which are already budgeted and will have no cost increase or savings as a result.
local governments:
The rule is being changed to reflect current practices which are already budgeted and will have no cost increase or savings as a result.
small businesses:
The rule is being changed to reflect current practices which are already budgeted and will have no cost increase or savings as a result.
persons other than small businesses, businesses, or local governmental entities:
The rule is being changed to reflect current practices which are already budgeted and will have no cost increase or savings as a result.
Compliance costs for affected persons:
None--The change brings the rule into compliance with current procedures and does not have a cost for compliance.
Comments by the department head on the fiscal impact the rule may have on businesses:
No fiscal impact on the program.
Lisa-Michele Church, Executive Director
The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:
Human ServicesAging and Adult Services
120 N 200 W
SALT LAKE CITY, UT 84103-1500
Direct questions regarding this rule to:
- Nels Holmgren at the above address, by phone at 801-538-3921, by FAX at 801-538-4395, or by Internet E-mail at [email protected]
Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:
12/01/2009
This rule may become effective on:
12/08/2009
Authorized by:
Nels Holmgren, Director
RULE TEXT
R510. Human Services, Aging and Adult Services.
[R510-401. Utah Caregiver Support Program (UCSP).
R510-401-1. Utah Caregiver Support Program Purpose.
The Utah Caregiver Support Program is created under
authority of the Older Americans Act of 1965 as amended in 2000
(PL 89-73) Part E - National Family Caregiver Support Program
(NFCSP).
The purpose of the program is to provide support services
including information and assistance, counseling, support groups,
respite and other home and community-based services to family
caregivers of frail older individuals. The program also
recognizes the needs of grandparents who are caregivers of
grandchildren and other older individuals who are relative
caregivers of children who are 18 years of age and under.
Operation of the program is a joint responsibility of the
State Division of Aging and Adult Services and local Area
Agencies on Aging (AAA). Funds are distributed by formula
(R510-100-1) to local AAAs.
R510-401-2. Definitions.
(1) "Adult" means an individual who is 18 years of
age or older.
(2) "Agency or Area Agency on Aging (AAA)" means
the agency designated by the Division of Aging and Adult Services
(DAAS) to coordinate and provide services for a defined
geographical area.
(3) "Agency Director" means the director of the
Agency.
(4) "Caregiver or Family Caregiver" means an adult
family member, or another adult individual, who is an informal
provider of in-home and community care to an older individual who
is:
(a) 60 years of age or older; or is a
(b) caregiver 60 years of age or older who is caring for
persons with mental retardation or related developmental
disabilities; or is a
(c) grandparent or older individual who is a relative
caregiver of a child not more than 18 years of age.
This definition excludes agency and privately-paid
supportive service providers.
(5) "Care Receiver" means an adult 60 years of age
or older who receives assistance from, or is dependent upon,
another for care and is:
(a) unable to perform at least two activities of daily
living without substantial human assistance, including verbal
reminding, physical cueing, or supervision; or
(b) due to a cognitive or other mental impairment, requires
substantial supervision.
(6) "Companion Services" means non-medical, basic
supervisory services which are provided to the eligible care
receiver in his home on a short-term, intermittent basis.
Companion Services provide respite to a caregiver who is caring
for eligible care receivers who do not require any personal care
assistance, medical assistance, or housekeeping services during
the time when companion services are provided.
(7) "Child" means an individual who is not more
than 18 years of age.
(8) "Counseling, Support Groups, or Caregiver
Training" means provision of advice, guidance, and education
about options and methods of caregiving to provide support to
caregivers in an individual or group setting.
(9) "Director" means the director of the Division
of Aging and Adult Services (DAAS), Utah Department of Human
Services).
(10) "Division" means the Division of Aging and
Adult Services (DAAS), Utah Department of Human Services.
(11) "Formal Resources" means an entity or
individual that provides services for a fee or
reimbursement.
(12) "Grandparent or Older Individual who is a Relative
Caregiver" means a grandparent or step-grandparent of a
child, or a relative of a child by blood or marriage, who is 60
years of age or older and:
(a) lives with the child;
(b) is the primary caregiver of the child because the
biological or adoptive parents are unable or unwilling to serve
as the primary caregiver of the child; and,
(c) has a legal relationship to the child, such as legal
custody or guardianship, or is raising the child
informally.
(13) "Informal Resources" means family, friends,
neighbors, community organizations or others who offer resources
and support and are not assigned by formal agencies or
organizations, irrespective of any payment received.
(14) "Multifaceted Systems" means a variety of
systems of support for the caregiver including but not limited to
those described in the required five service categories of the
(NFCSP), Title IIIE of the Older Americans Act, as amended in
2000.
(15) "National Family Caregiver Support Program or
NFCSP" is the federal program enacted as P. L. 106-501,
Title IIIE of the Older Americans Act, P. L. 89-73, 42 USC
Section 3001 et seq., as amended in 2000.
(16) "Relief" means ease from or lessening of
discomfort, anxiety, fear, stress, or burden.
(17) "Respite or Respite Care" is temporary,
substitute supports or living arrangements to provide a brief
period of relief or rest for caregivers as outlined in the
service plan developed by a case manager following a formal
assessment. It can be in the form of in-home respite, adult day
care respite, or institutional respite for an overnight stay on
an intermittent, occasional, or emergency basis. Respite can be
provided for a caregiver for no more than 12 consecutive months
from the date of enrollment and shall not exceed the annual
service expenditure limit per client, as established by the
Division in consultation the Area Agencies on Aging annually. If
either condition is met, the caregiver must come off of the
program and then may reapply on the anniversary of the start of
services. Temporary respite may not be provided by the twenty
percent (20%) maximum supplemental services funds.
(18) "Service Plan" means a written plan which
contains a description of the needs of the caregiver, the care
recipient, and the services and goals necessary to meet those
needs.
(19) "Supplemental Services" means other services
to complement the care of caregivers, on a limited basis as
determined by a case manager through the assessment process and
included in a service plan. Supplemental services shall serve to
maximize the support of caregivers and shall be flexible,
adaptable, and responsive to the needs of the individual
caregiver or care receiver wherever they reside in the State of
Utah. Services provided under supplemental services shall not
fall into other categories defined in the UCSP or the
NFCSP.
Expenditures for Supplemental Services are not included in
the annual established service expenditure limit for
Respite.
Necessity for Supplemental Services shall be specified in
the service plan goals. Reimbursement shall include the purchase
and/or rental, installation, removal, replacement, or repair of
approved items or services for the twelve months that the
caregiver is on the program. The case manager will document in
the caregiver file all funding resources explored and reasons
alternative funding cannot be accessed. Items or services
exceeding $250 per purchase must be prior approved by the Agency
Director based on a formal written request by the case manager or
designee documenting the determination of need and estimated
cost. The original approved waiver request will be placed and
maintained by the Agency in the caregiver file.
(a) "Supplies or Equipment" means durable and
non-durable goods purchased and/or rented under supplemental
services to provide support and assistance to caregivers in their
caregiving responsibilities. Reimbursement shall include the
purchase of supplies, and the purchase, and/or rental,
installation, removal, replacement or repair of approved
equipment.
(b) "Modifications or durable adaptive aids and
devices" purchased as supplemental services shall be
one-time purchases to provide support and assistance to
caregivers in their caregiving responsibilities. Minor
modifications of homes shall facilitate the ability of older
individuals to remain at home or provide for the safety of the
care receiver. Adaptive aids and devices shall assist the
caregivers helping care receivers to perform normal living
activities, and shall include the cost of any necessary
installation fitting, adjustment, repair, and training. Adaptive
aids and devices may be fabricated by a professional if the care
receiver needs specialized aids and devices.
(c) "Legal, Financial, or Placement Services"
purchased as supplemental services shall provide support and
assistance to caregivers in their caregiving responsibilities.
Services will provide the caregiver with legal, financial, and
placement advice, counseling, and representation by an attorney,
certified financial advisor, or other person acting under the
supervision of an attorney, certified financial advisor, or
placement professional.
(d) "Miscellaneous" services shall provide support
and assistance to caregivers in their caregiving
responsibilities. Miscellaneous services will facilitate the
ability to provide services to caregivers that arise from unusual
circumstances and shall assist the caregiver in performing their
caregiving responsibilities.
(20) "Waiver" means an intentional release in
writing by the Agency Director or designee, as authorized in the
rules, from a program limitation included in these rules.
R510-401-3. Eligibility for Services.
(1) Services listed in Section R510-401-5 are available to
caregivers, grandparents and older individuals who are relative
caregivers.
(2) Respite care and Supplemental Services are available to
caregivers who are:
(a) caregivers of adults 60 years of age or older
(b) caregivers 60 years of age or older caring for persons
with mental retardation or related developmental disabilities; or
are
(c) grandparents or older individuals who are a relative
caregiver of a child not more than 18 years of age.
(3) To provide respite and Supplemental Services to
caregivers of adults 60 years of age or older, the care receiver
must be:
(a) Functionally impaired because the individual is unable
to perform at least two activities of daily living without
substantial human assistance, including verbal reminding,
physical cueing or supervision; or
(b) Due to a cognitive or other mental impairment, requires
substantial supervision because the individual behaves in a
manner that poses a serious health or safety hazard to the
individual or to another individual.
(c) The caregiver must demonstrate a medium-to-high risk
score according to the DAAS Approved Demographic Intake and
Screening tool and complete the DAAS-approved Assessment and
DAAS-approved Burden score.
(4) In the event that there is insufficient funds to bring
an individual on the program the Agency shall maintain a list of
potential applicants. All potential applicants will be served in
turn by using the DAAS-approved Demographic Intake and Risk
Screening tool, and a Caregiver Burden score to determine
eligibility for services.
R510-401-4. Responsibilities of the
Division.
(1) Pursuant to UCA 62A-3-104, the Division shall:
(a) establish a funding formula for the distribution of the
funds as approved by the Board;
(b) monitor, and at the request of the Area Agency on Aging,
consult and assist in UCSP;
(c) provide training opportunities;
(d) define minimal documentation and client assessment
standards; and
(e) approve or disapprove waivers and exceptions.
R510-401-5. Program Content.
(1) Each Area Agency on Aging shall provide a multifaceted
system of caregiver support services for caregivers and, if
funded, for grandparents or older individuals who are relative
caregivers to include:
(a) information to caregivers about available
services;
(b) individual, one-on-one assistance to caregivers in
gaining access to services in the form of information and
assistance or case management. Assistance may include but is not
limited to such activities as phone contact and home
visits;
(c) individual counseling, support groups, and caregiver
training to assist the caregivers in making decisions and solving
problems relating to their caregiving roles;
(d) respite care to enable caregivers to be temporarily
relieved from their caregiving responsibilities; and
(e) Supplemental Services, on a limited basis, to complement
the care provided by caregivers.
(2) The Area Agency on Aging shall use the DAAS-approved
Demographic Intake and Risk Screening form and assessment tool to
determine eligibility for respite and supplemental services and
said tools shall be kept in the client file.
(3) Prior to receiving respite or supplemental services the
Area Agency on Aging shall develop a written service plan
including goals and objectives for the caregiver, which shall be
kept in the client file.
(4) The Area Agency on Aging shall ensure the provision of
the full range of caregiver support services in the community by
coordinating its activities with the activities of other
community agencies and voluntary organizations providing
supportive services to family caregivers and, if funded,
grandparents or older individuals who are relative caregivers of
children.
(5) Older Americans Act information and services shall be
provided to family caregivers in a direct and helpful manner. In
cases where caregiver support programs already exist within the
community, coordination of these programs and the UCSP is
essential to maximize the dollars available for family caregivers
and avoid duplication of services.
(6) To assure coordination of caregiver services in the
planning and service area, the Area Agency on Aging shall convene
a minimum of one joint planning meeting annually with other local
providers who currently provide support services to family
caregivers. As practical, the Area Agency on Aging shall
coordinate the activities under this program with other community
agencies and voluntary organizations providing services to
caregivers.
(7) Funds allocated on an annual basis under the UCSP for
services provided by an Area Agency on Aging shall be expended as
follows:
(a) Information to caregivers about available services: the
Area Agency on Aging may not use less than three percent of the
funds allocated under the UCSP to provide these services.
(b) Assistance to caregivers in gaining access to the
services: the Area Agency on Aging may not use less than five
percent of the funds allocated under the UCSP to provide these
services.
(c) Individual counseling, organization of support groups,
and caregiver training to caregivers to assist the caregivers in
making decisions and solving problems relating to their
caregiving roles: The Area Agency on Aging may not use less than
five percent of the funds allocated under the UCSP to provide
these services.
(d) Respite care to enable caregivers to be temporarily
relieved from their caregiving responsibilities: The Area Agency
on Aging may not use less than five percent of the funds
allocated under the UCSP to provide these services.
(e) Supplemental Services, on a limited basis, to complement
the care provided by caregivers: The Area Agency on Aging may not
use more than twenty percent of the funds allocated under the
UCSP to provide these services.
(f) The Area Agency on Aging shall spend no more than ten
percent of funds on services provided to grandparents and other
individuals who are relative caregivers of children.
(8) If a customer discontinues Respite and/or Supplemental
Services before the end of the twelve-month period and before the
annual established service expenditure limit per client is
reached, the case shall be closed.
(a) If funds are available, the caregiver may be readmitted
to the program subsequent to the case clsoing but shall do so
within twelve months from the original date of enrollment.
(b) If no funds are available, the person will be placed at
the top of the list to be the first person to be admitted to the
program if the person still has time left on the program.
(c) If funds become available, but there is no time
remaining based on the original admission, then the caregiver
needs to reapply and be considered for admission to the program
with all other applicants.
R510-401-6. Caregiver Advisory Council.
(1) The Area Agency on Aging shall develop and maintain a
Caregiver Advisory Council.
(2) The Caregiver Advisory Council may be a subgroup of the
Area Agency on Aging Advisory Council providing they meet the
requirements set forth in the rule.
(a) The Caregiver Advisory Council may be comprised of no
less than five members, some of whom shall be caregivers.
(3) The Caregiver Advisory Council shall meet no less than
semiannually, and meetings shall be scheduled by each Area Agency
on Aging.
(4) The primary duty of the Caregiver Advisory Council shall
include but not be limited to conducting an annual caregiver
satisfaction survey for the caregiver program.
(5) The Caregiver Advisory Council shall advise the Area
Agency on Aging in determining service needs and developing
action plans. When there is a concern over the use of limited
resources for Respite Care and Supplemental Services, the Area
Agencies on Aging, in consultation with their Caregiver Advisory
Council, may further limit the amount of services provided to an
individual caregiver. This local policy decision shall be in
writing and shall be uniform for all caregivers for the current
fiscal year.
(6) The Area Agency on Aging shall be responsible for
developing orientations for Caregiver Advisory Councils on
caregiver issues and responding to community needs.
R510-401-7. Voluntary Contributions.
(1) Individuals receiving services from this program may be
encouraged to participate in voluntary contributions for
services, provided that the method of solicitation is
non-coercive.
(2) Voluntary contributions shall in no way be based on a
means test of an individual client's income.
(3) Each Area Agency on Aging shall implement procedures for
voluntary contributions in the UCSP, and shall comply, at a
minimum, with the following:
(a) provide each recipient with an opportunity to
voluntarily contribute to the cost of the services;
(b) clearly inform each recipient that there is no
obligation to contribute and that the contribution is purely
voluntary;
(c) protect the privacy and confidentiality of each
recipient with respect to the recipient's contribution or
lack of contribution; and
(d) establish appropriate procedures to safeguard and
account for voluntary contributions.
(4) Use all collected voluntary contributions to expand the
service for which such contributions were given.
(5) In no instance shall services be denied if individuals
do not participate in voluntary contributions.
(6) Area Agencies on Aging will consult with relevant
service providers and older individuals in their planning and
service area to determine the best method for accepting voluntary
contributions.
R510-401-8. Reporting.
(1) The Area Agency on Aging shall collect data and maintain
records relating to the UCSP in the format specified by the
Division.
(2) The Area Agency on Aging shall furnish the records to
the DAAS as specified.
(3) The Area Agency on Aging shall report to DAAS, as
specified, the activities and determinations of the Caregiver
Advisory Council.
R510-401-10. Waiver Requests for Respite and
Supplemental Services.
An Area Agency on Aging may request in writing a waiver for
Respite and Supplemental Services in order to enable the caregiver
to carry out their duties in assisting the care receiver. In
requesting a waiver, the Area Agency on Aging must demonstrate that
effort has been made to access other sources of services or funds.
The Agency Director may grant a waiver for Supplemental Services or
Respite on a case-by-case basis provided that such waiver is
consistent with the law. A copy of the approved waiver request must
be placed in the client file and a copy sent in writing to the
Division.]
R510-401. Utah Caregiver Support Program (UCSP).
R510-401-1. Utah Caregiver Support Program Purpose.
The Utah Caregiver Support Program is created under authority of the Older Americans Act of 1965 as amended in 2000 (PL 89-73) Part E - National Family Caregiver Support Program (NFCSP) and 2006 (PL 109-365) Subpart 1 - Caregiver Support Program.
The purpose of the program is to provide support services including information and assistance, counseling, support groups, respite and other home and community-based services to family caregivers of frail older individuals. The program also recognizes the needs of grandparents and other relatives (not biological or adoptive parents) 55 years of age and older providing care to children under the age of 18 years as well as to grandparents and other relatives (not biological or adoptive parents) 55 years of age and older providing care to adults, age 18 to 59 years, with disabilities. Adult family members (age 18 years of older) or other adult informal caregivers providing care to individuals of any age with Alzheimer's disease and related disorders are also served under this program|.
Operation of the program is a joint responsibility of the State Division of Aging and Adult Services and local Area Agencies on Aging (AAA). Funds are distributed by formula (R510-100-1) to local AAAs.
R510-401-2. Authority.
This Rule is authorized by 62A-3-104; 42 USC Section 3001.
R510-401-3. Definitions.
(1) "Adult" means an individual who is 18 years of age or older.
(2) "Agency or Area Agency on Aging (AAA)" means the agency designated by the Division of Aging and Adult Services (DAAS) to coordinate and provide services for a defined geographical area.
(3) "Agency Director" means the director of the Agency.
(4) "Caregiver or Family Caregiver" means an adult family member, or another adult individual, who is an informal provider of in-home and community care to an older individual who is:
(a) 60 years of age or older; or is a
(b) caregiver 60 years of age or older who is caring for persons with mental retardation or related developmental disabilities; or is an
(c) adult family member (age 18 years or older) or other adult informal caregiver providing care to individuals of any age with Alzheimer's disease and related disorders; or is a
(d) grandparent 55 years of age or older individual who is a relative caregiver (not biological or adoptive parents) of a child not more than 18 years of age ; or is a
(e) grandparent and other relatives (not biological or adoptive parents) 55 years of age and older providing care to adults, age 18 to 59 years, with disabilities.
(f) This definition excludes agency and privately-paid supportive service providers.
(5) "Care Receiver" means an adult 60 years of age or older who receives assistance from, or is dependent upon, another for care and is:
(a) unable to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing, or supervision; or
(b) due to a cognitive or other mental impairment, requires substantial supervision; or
(6) "Child" means an individual who is not more than 18 years of age or who is an individual with a disability.
(7) "Companion Services" means non-medical, basic supervisory services which are provided to the eligible care receiver in his home on a short-term, intermittent basis. Companion Services provide respite to a caregiver who is caring for eligible care receivers who do not require any personal care assistance, medical assistance, or housekeeping services during the time when companion services are provided.
(8) "Counseling, Support Groups, or Caregiver Training" means provision of advice, guidance, and education about options and methods of caregiving to provide support to caregivers in an individual or group setting.
(9) "Director" means the director of the Division of Aging and Adult Services (DAAS), Utah Department of Human Services).
(10) "Disability" means a disability attributable to mental or physical impairment, or a combination of mental and physical impairments, that results in substantial functional limitation in 1 or more of the following areas of major life activity:
(a) self care,
(b) receptive and expressive language,
(c) learning,
(d) mobility,
(e) self-direction,
(f) capacity for independent living,
(g) economic self-sufficiency,
(h) cognitive functions, and
(i) emotional adjustment.
(11) "Division" means the Division of Aging and Adult Services (DAAS), Utah Department of Human Services.
(12) "Formal Resources" means an entity or individual that provides services for a fee or reimbursement.
(13) "Grandparent or Older Individual who is a Relative Caregiver" means a grandparent or step- grandparent of a child, or a relative of a child by blood, marriage, or adoption who is 55 years of age or older and:
(a) lives with the child;
(b) is the primary caregiver of the child because the biological or adoptive parents are unable or unwilling to serve as the primary caregiver of the child; and,
(c) has a legal relationship to the child, such as legal custody or guardianship, or is raising the child informally.
(14) "Informal Resources" means family, friends, neighbors, community organizations or others who offer resources and support and are not assigned by formal agencies or organizations, irrespective of any payment received.
(15) "Multifaceted Systems" means a variety of systems of support for the caregiver including but not limited to those described in the required five service categories of the (NFCSP), Title III E of the Older Americans Act, as amended in 2000.
(16) "National Family Caregiver Support Program or NFCSP" is the federal program enacted as P. L. 106-501, Title IIIE of the Older Americans Act, P. L. 89-73, 42 USC Section 3001 et seq., as amended in 2000.
(17) "Relief means ease from or lessening of discomfort, anxiety, fear, stress, or burden.
(18) "Respite or Respite Care" is temporary, substitute supports or living arrangements to provide a brief period of relief or rest for caregivers as outlined in the service plan developed by a case manager following a formal assessment. It can be in the form of in-home respite, adult day care respite, or institutional respite for an overnight stay on an intermittent, occasional, or emergency basis. Respite can be provided for a caregiver for no more than 12 consecutive months from the date of enrollment and shall not exceed the annual service expenditure limit per client, as established by the Division in consultation the Area Agencies on Aging annually. If either condition is met, the caregiver must come off of the program and then may reapply on the anniversary of the start of services. Temporary respite may not be provided by the twenty percent (20%) maximum supplemental services funds.
(19) "Severe Disability" means a severe, chronic disability attributable to mental or physical impairment, or a combination of mental and physical impairments, that:
(a) is likely to continue indefinitely; and
(b) results in substantial functional limitation in 3 or more of the following major life activities:
(i) self care,
(ii) receptive and expressive language,
(iii) learning,
(iv) mobility,
(v) self-direction,
(vi) capacity for independent living, and
(vii) economic self-sufficiency.
(20) "Service Plan" means a written plan which contains a description of the needs of the caregiver, the care recipient, and the services and goals necessary to meet those needs.
(21) "Supplemental Services" means other services to complement the care of caregivers, on a limited basis as determined by a case manager through the assessment process and included in a service plan. Supplemental services shall serve to maximize the support of caregivers and shall be flexible, adaptable, and responsive to the needs of the individual caregiver or care receiver wherever they reside in the State of Utah. Services provided under supplemental services shall not fall into other categories defined in the UCSP or the NFCSP.
(a) Expenditures for Supplemental Services are not included in the annual established service expenditure limit for Respite.
(b) Necessity for Supplemental Services shall be specified in the service plan goals. Reimbursement shall include the purchase and/or rental, installation, removal, replacement, or repair of approved items or services for the twelve months that the caregiver is on the program. The case manager will document in the caregiver file all funding resources explored and reasons alternative funding cannot be accessed. Items or services exceeding $250 per purchase must be prior approved by the Agency Director, or designee, based on a formal written request by the case manager or designee documenting the determination of need and estimated cost. The original approved waiver request will be placed and maintained by the Agency in the caregiver file and a copy sent in writing to the Division.
(c) "Supplies or Equipment" means durable and non-durable goods purchased and/or rented under supplemental services to provide support and assistance to caregivers in their caregiving responsibilities. Reimbursement shall include the purchase of supplies, and the purchase, and/or rental.installation, removal, replacement or repair of approved equipment.
(d) "Modifications or durable adaptive aids and devices" purchased as supplemental services shall be one-time purchases to provide support and assistance to caregivers in their caregiving responsibilities. Minor modifications of homes shall facilitate the ability of older individuals to remain at home or provide for the safety of the care receiver. Adaptive aids and devices shall assist the caregivers helping care receivers to perform normal living activities, and shall include the cost of any necessary installation fitting, adjustment, repair, and training. Adaptive aids and devices may be fabricated by a professional if the care receiver needs specialized aids and devices.
(e) "Legal, Financial, or Placement Services" purchased as supplemental services shall provide support and assistance to caregivers in their caregiving responsibilities. Services will provide the caregiver with legal, financial, and placement advice, counseling, and representation by an attorney, certified financial advisor, or other person acting under the supervision of an attorney, certified financial advisor, or placement professional.
(f) "Miscellaneous" services shall provide support and assistance to caregivers in their caregiving responsibilities. Miscellaneous services will facilitate the ability to provide services to caregivers that arise from unusual circumstances and shall assist the caregiver in performing their caregiving responsibilities.
(22) "Waiver" means an intentional release in writing by the Agency Director or designee, as authorized in the rules, from a program limitation included in these rules.
R510-401-4. Eligibility for Services.
(1) Services listed in Section R510-4O6-5 are available to caregivers, grandparents and older individuals who are relative caregivers.
(2) Priority to receive services shall be given in the order below:
(a) caregivers who are older individuals with greatest social need, and older individuals with greatest economic need (with particular attention to low-income older individuals); and
(b) family caregivers who provide care for individuals with Alzheimer's disease and related disorders with neurological and organic brain dysfunction; and
(c) older individuals providing care to individuals with severe disabilities, including children with severe disabilities; and
(d) grandparents or older individuals who are relative caregivers who provide care for children with severe disabilities.
(3) Respite care and Supplemental Services are available to caregivers who are:
(a) caregivers of adults 60 years of age or older; or are
(b) adult family members (age 18 years or older) or other adult informal caregivers providing care to individuals of any age with Alzheimer's disease and related disorders; or are
(c) caregivers 60 years of age or older caring for persons with mental retardation or related developmental disabilities; or are
(d) grandparents or older individuals (not biological or adoptive parents) 55 years of age or older who are a relative caregiver of a child not more than 18 years of age. ; or are
(e) grandparents and other relatives (not biological or adoptive parents) 55 years of age and older providing care to adults, age 18 to 59 years, with disabilities.
(4) To provide Respite and Supplemental Services to eligible the care receiver must be:
(a) Functionally impaired because the individual is unable to perform at least two activities of daily living without substantial human assistance, including verbal reminding, physical cueing or supervision; or
(b) Due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to the individual or to another individual; or
(c) A child physically or mentally impaired because the individual is unable to perform at least two areas of major life activity.
(d) The caregiver must demonstrate a medium-to-high risk score according to the DAAS Approved Demographic Intake and Screening tool and complete the DAAS-approved Assessment and DAAS-approved Burden score.
(5) In the event that there is insufficient funds to bring an individual on the program the Agency shall maintain a list of potential applicants. All potential applicants will be served in turn by using the DAAS-approved Demographic Intake and Risk Screening tool, and a Caregiver Burden score to determine eligibility for services.
R510-401-5. Responsibilities of the Division.
(1) Pursuant to UCA 62A-3-1O4, the Division shall:
(a) establish a funding formula for the distribution of the funds as approved by the Board;
(b) monitor, and at the request of the Area Agency on Aging, consult and assist in UCSP;
(c) provide training opportunities;
(d) define minimal documentation and client assessment standards; and
(e) approve or disapprove waivers and exceptions.
R510-401-6. Program Content.
(1) Each Area Agency on Aging shall provide a multifaceted system of caregiver support services for caregivers and for grandparents or older individuals who are relative caregivers to include:
(a) information to caregivers about available services;
(b) individual, one-on-one assistance to caregivers in gaining access to services in the form of information and assistance or case management. Assistance may include but is not limited to such activities as phone contact and home visits;
(c) individual counseling, support groups, and caregiver training to assist the caregivers in making decisions and solving problems relating to their caregiving roles;
(d) respite care to enable caregivers to be temporarily relieved from their caregiving responsibilities; and
(e) Supplemental Services, on a limited basis, to complement the care provided by caregivers.
(2) The Area Agency on Aging shall use the DAAS-approved Demographic Intake and Risk Screening form and assessment tool to determine eligibility for respite and supplemental services and said tools shall be kept in the client file.
(3) Prior to receiving respite or supplemental services the Area Agency on Aging shall develop a written service plan including goals and objectives for the caregiver, which shall be kept in the client file.
(4) The Area Agency on Aging shall ensure the provision of the full range of caregiver support services in the community by coordinating its activities with the activities of other community agencies and voluntary organizations providing supportive services to family caregivers and grandparents or older individuals who are relative caregivers of children.
(5) Older Americans Act information and services shall be provided to family caregivers in a direct and helpful manner. In cases where caregiver support programs already exist within the community, coordination of these programs and the UCSP is essential to maximize the dollars available for family caregivers and avoid duplication of services.
(6) To assure coordination of caregiver services in the planning and service area, the Area Agency on Aging shall convene a minimum of one joint planning meeting annually with other local providers who currently provide support services to family caregivers. As practical, the Area Agency on Aging shall coordinate the activities under this program with other community agencies and voluntary organizations providing services to caregivers.
(7) Funds allocated on an annual basis under the UCSP for services provided by an Area Agency on Aging shall be expended as follows:
(a) Information to caregivers about available services: the Area Agency on Aging may not use less than three percent of the funds allocated under the UCSP to provide these services.
(b) Assistance to caregivers in gaining access to the services: the Area Agency on Aging may not use less than five percent of the funds allocated under the UCSP to provide these services.
(c) Individual counseling, organization of support groups, and caregiver training to caregivers to assist the caregivers in the areas of health, nutrition and financial literacy and in making decisions and solving problems relating to their caregiving roles. The Area Agency on Aging may not use less than five percent of the funds allocated under the UCSP to provide these services.
(d) Respite care to enable caregivers to be temporarily relieved from their caregiving responsibilities: The Area Agency on Aging may not use less than five percent of the funds allocated under the UCSP to provide these services.
(e) Supplemental Services, on a limited basis, to complement the care provided by caregivers: The Area Agency on Aging may not use more than twenty percent of the funds allocated under the UCSP to provide these services.
(f) The Area Agency on Aging shall spend no more than ten percent of funds on services provided to grandparents and other individuals who are relative caregivers of a child not more than 18 years of age.
(8) If a customer discontinues Respite and/or Supplemental Services before the end of the twelve- month period and before the annual established service expenditure limit per client is reached, the case shall be closed.
(a) If funds are available, the caregiver may be readmitted to the program subsequent to the case closing but shall do so within twelve months from the original date of enrollment.
(b) If no funds are available, the person will be placed at the top of the list to be the first person to be admitted to the program if the person still has time left on the program.
(c) If funds become available, but there is no time remaining based on the original admission, then the caregiver needs to reapply and be considered for admission to the program with all other applicants.
(9) The Area Agency on Aging shall make use of trained volunteers to expand the provision of available resources and, if possible, work in coordination with organizations that have experience in providing training, placement, and stipends for volunteers or participants (such as organizations carrying out Federal service programs administered by the Corporation for National and Community Service), in community settings.
R510-401-7. Caregiver Advisory Council.
(1) The Area Agency on Aging shall develop and maintain a Caregiver Advisory Council.
(2) The Caregiver Advisory Council may be a subgroup of the Area Agency on Aging Advisory Council providing they meet the requirements set forth in the rule.
(a) The Caregiver Advisory Council may be comprised of no less than five members, some of who shall be caregivers.
(3) The Caregiver Advisory Council shall meet no less than semiannually, and meetings shall be scheduled by each Area Agency on Aging.
(4) The primary duty of the Caregiver Advisory Council shall include but not be limited to conducting an annual caregiver satisfaction survey for the caregiver program.
(5) The Caregiver Advisory Council shall advise the Area Agency on Aging in determining service needs and developing action plans. When there is a concern over the use of limited resources for Respite Care and Supplemental Services, the Area Agencies on Aging, in consultation with their Caregiver Advisory Council, may further limit the amount of services provided to an individual caregiver. This local policy decision shall be in writing and shall be uniform for all caregivers for the current fiscal year.
R510-401-8. Voluntary Contributions.
(1) Individuals receiving services from this program may be encouraged to participate in voluntary contributions for services, provided that the method of solicitation is non-coercive.
(2) Voluntary contributions shall in no way be based on a means test of an individual client's income.
(3) Each Area Agency on Aging shall implement procedures for voluntary contributions in the UCSP, and shall comply, at a minimum, with the following:
(a) provide each recipient with an opportunity to voluntarily contribute to the cost of the services;
(b) clearly inform each recipient that there is no obligation to contribute and that the contribution is purely voluntary;
(c) protect the privacy and confidentiality of each recipient with respect to the recipient's contribution or lack of contribution; and
(d) establish appropriate procedures to safeguard and account for voluntary contributions.
(4) Use all collected voluntary contributions to expand the service for which such contributions were given.
(5) In no instance shall services be denied if individuals do not participate in voluntary contributions.
(6) Area Agencies on Aging will consult with relevant service providers and older individuals in their planning and service area to determine the best method for accepting voluntary contributions.
R510-401-9. Reporting.
(1) The Area Agency on Aging shall collect data and maintain records relating to the UCSP in the format specified by the Division.
(2) The Area Agency on Aging shall furnish the records to the DAAS as specified.
(3) The Area Agency on Aging shall report to DAAS, as specified, the activities and determinations of the Caregiver Advisory Council.
(4) The Area Agency on Aging shall report to DAAS any mechanisms used with caregivers regarding information about and access to various services so that the persons can better carry out their caregiver responsibilities.
R510-401-10. Waiver Requests for Respite and Supplemental Services.
(1) An Area Agency on Aging may request in writing a waiver for Respite and Supplemental Services in order to enable the caregiver to carry out their duties in assisting the care receiver. In requesting a waiver, the Area Agency on Aging must demonstrate that effort has been made to access other sources of services or funds. The Agency Director, or designee, may grant a waiver for Supplemental Services or Respite on a case-by-case basis provided that such waiver is consistent with the law. A copy of the approved waiver request must be placed in the client file and a copy sent in writing to the Division.
KEY: caregiver, care receiver, elderly, respite
Date of Enactment or Last Substantive Amendment: [February 23, 2006]2009
Notice of Continuation: June 22, 2005
Authorizing, and Implemented or Interpreted Law: 63A-3-104(4); 62A-3-104(5)
Additional Information
The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull-pdf/2009/b20091101.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.
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For questions regarding the content or application of this rule, please contact Nels Holmgren at the above address, by phone at 801-538-3921, by FAX at 801-538-4395, or by Internet E-mail at [email protected].