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SECTION 445: IN-HOME AIDE SERVICES: LEVEL I-HOME MANAGEMENT PROCEDURES

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REVISED: 09/17/10

I. SERVICE PROVISION

A. Social Worker for the Blind

1. The Social Worker for the Blind is responsible for Authorizing In-Home Level I-Home Management Services as needed by the consumer and as Agency funds permit. As Case Manager, the SWB may recommend appropriate In-Home Aides to the consumer but as employer, the consumer will make the decision about the aide he/she wants to employ, and complete IRS Form 2678: Employer Appointment of Agent (Form F-2). http://www.irs.gov/pub/irs-pdf/f2678.pdf             
The SWB will provide on-going support to the consumer and the aide through home visits, individual or group conferences dealing with job-related issues and/or telephone contacts with the consumer and the aide.

2. The SWB, along with the consumer and In-Home Aide, will negotiate the number of In-Home Level I-Home Management hours needed and which may be authorized. Maximum amount paid cannot exceed $999, even if the aide is employed by more than one consumer (including the employer’s share of the FICA, which is paid by DSB, as well as the employee’s share that is deducted from the employee’s gross wages) in any quarter.

3. The SWB will complete an authorization for the number of hours, rate of pay (current State minimum wage or the prevailing local wage for the services as on file in the controller’s office by letter and approved by the Chief), and submit to the supervisor for approval prior to the service being provided to the consumer. 

4. Contacts by Social Worker for the Blind

a. During the first calendar week that the aide is working with a consumer, the SWB will make a home visit or telephone call to the aide.
b. During the first month that the aide is working with a consumer, the SWB will make at least two on-site visits.
c. On-going quarterly visits: The SWB will conduct an on-site visit at least quarterly. At least some portion of these visits must occur when the aide is actually providing care to the consumer.

B. In-Home Aide

1. An In-Home Aide will be hired by the consumer to perform Level I - Home Management tasks which are necessary to enable the individual to remain and function effectively in his/her own home as long as possible. The aide is the employee of the consumer and not of DSB.

a. Who may be employed as an In-Home Aide?

(1) Non-relatives who are:

(a) 18 years of age or older, and
(b) Qualified to perform the tasks needed by the consumer.

(2) Relatives of the consumer (parent, spouse, child, or sibling) who are:

(a) 18 years of age or older, and
(b) Qualified to perform the tasks needed by the consumer, and
(c) Give up employment in order to perform the service. Documentation from the former employer that the employee gave up employment stating his/her reason as the need to care for the family member (DSB consumer).

b. Who may not be employed as an In-Home Services Aide:

(1) Any person less than 18 years of age.
(2) Persons not qualified to perform the tasks needed by the consumer.
(3) Unemployed relative (parent, child, spouse, or sibling of the consumer).

2. Is trained by Social Worker for the Blind or other qualified person(s).

3. Works in the consumer's own home.

4. Is assigned appropriate tasks by the consumer in accordance with terms of the Agreement for Level I - Home Management Services (DSB-7108).

5. Is supervised by the consumer.

6. Is discharged by the consumer if dismissal is necessary.

7. Will be paid the current State minimum wage or the prevailing local wage for the service as on file in the Department of Health and Human Services (DHHS) controller's office by letter and approved by the supervisor.

8. Receives his/her monthly paycheck electronically through the Division of Services for the Blind.

9. May be employed by more than one consumer.  *(Maximum amount paid cannot exceed $999, even if the aide is employed by more than one consumer (including the employer’s share of the FICA, which is paid by DSB, as well as the employee’s share that is deducted from the employee’s gross wages in any quarter).

10. Is covered under the usage and hour provisions of the N.C. Wage and Hour Act.

11. Is exempted from the Fair Labor Standards Act of 1938 as amended May 1974 (companionship services) Section 13 (a) (15).

12. Is not covered by Workman's Compensation.

13. Is not eligible for unemployment benefits, health benefits, etc.

14. The following forms will need to be completed by the In-home Aide prior to beginning work for the consumer:

(1) A Driving Record Check (Form-16)
(2) A Criminal Records Check Transmittal Form (Form-17)
(3) A Criminal Records Check Direct Care Employment Consent Form (Form-18)
(4) Form I-9: Employment Eligibility Verification (Form F-1)
(5) *Form W-9: Request for Taxpayer Identification Number.  (If a new In-Home Aide needs to be added as a vendor or if there is a change in their name or address, an IRS Form W-9: Request for Taxpayer Identification Number and Certification needs to be completed).  http://www.irs.gov/pub/irs-pdf/fw9.pdf?portlet=3    
(6) DSB Form 7108 Agreement for In-Home Aide Services (Form F-10)
(7) Payment Verification Form (Form F-19)

15. The SWB provides time logs (DSB-7309) to the In-Home Aide. The time log should be completed monthly by the aide, approved by the consumer and submitted to the Social Worker for the Blind for processing. 

C. Examples of Level I - Home Management Tasks

1. Clean/care for clothing: ironing, simple mending, laundering.

2. Do basic housekeeping tasks: sweeping, vacuuming, dusting, mopping, washing dishes.

3. Make minor repairs to house and furnishings.

4. Make unoccupied bed.

5. Recognize and report changes in consumer's health and environment.

6. Identify medications for consumer.

7. Prepare simple meals.

8. Shop for food from verbal or written instructions.

9. Observe and report symptoms of abuse, neglect, illness, etc., to proper professional.

Personal Care tasks may not be performed at this level.

Refer to appendix F for a listing of consumer indicators, appropriate tasks, and required competencies for Level I - Home Management. Consumer indicators established for this level provide a general idea of what the consumer's physical condition might be. These indicators and tasks are intended to assist the SWB with determining the appropriate level of care for the consumer.

D. Service Planning and Service Delivery

1. The needs assessment and quarterly reviews must be conducted in the consumer's own home and will address the psycho-social, environmental, economic, physical health, and instrumental activities of daily living (IADL's). The results will be documented on DSB-7103 (Independent Living Services Program Assessment and Plan) and case recording.

2. Re-determination of Eligibility

a. All consumers must undergo a re-determination of eligibility every twelve months or more often, if the consumer's situation warrants it. As with the needs assessment and quarterly reviews, the re-determination must be conducted in the consumer's own home.

This annual re-determination includes a full assessment of the consumer's needs as well as his/her response to services already provided and will verify the consumer's continuing eligibility based on vision status, need for the service and income.

b. The re-determination will be documented on DSB-7103 (Independent Living Services Program Assessment and Plan) and case recording.

c. Any changes in Level I - Home Management tasks will be documented, dated, and signed on the Service Plan and DSB-7108: Agreement Plan for In-Home Aide Services by designated individuals.

II. COMPETENCY REQUIREMENTS AND TRAINING REQUIREMENTS

A. All In-Home Aides assigned Level I - Home Management tasks must demonstrate competence in the specific tasks assigned to them before performing the tasks independently for the consumer. Aides must pass competency requirements for all Level I - Home Management tasks within one year of employment as an In-Home Aide. Meeting these requirements includes a correct demonstration of Level I knowledge and skills to the SWB or other appropriate professional. This demonstration of competency may take place in a variety of settings such as the classroom, laboratory, local agency, or consumer's home and must be documented by the SWB on DSB-7311: Training Record (Form F-13). Appendix F contains a listing of Level I tasks and related areas of competency from which testing may be conducted.

B. Prospective aides not having the required knowledge and skills must successfully complete a 40-hour training program conducted by the SWB or other appropriate professional. This training may be implemented through a variety of methods such as classroom instruction, on-the-job training, and/or individual instruction and coaching. Appendix F lists recommended minimum hours of training needed for Level I - Home Management when offered through classroom instruction. Use of other methods may modify the number of hours needed.

C. Training is not required if the aide brings documentation from a previous employer or training program which verifies that competency requirements were met. Newly-hired aides with this type of documentation will, however, be subject to selected job-specific competency testing by the SWB.

D. Resource: The North Carolina Division of Aging and Adult Services have a model guide, “In-Home Aide Services Competency Testing Tools” online. 
http://www.ncdhhs.gov/aging/inhtools/inhtools.htm  

III. REPORTING REQUIREMENTS FOR LEVEL I - HOME MANAGEMENT

A. Use code 360: Adjustment Services for the Blind and Visually Impaired to account for the planning phase and case manager responsibilities associated with Level I - Home Management.

B. Use code 350 to report and document consumer's receipt of Level I - Home Management services.

C. Refer to ILS Manual section 500: Reporting Requirements for forms referenced in this section and applicable to Level I - Home Management.

D. Refer to Electronic Services System Manual for authorization requirements. Workers without access to computers and the state mainframe will contact their Area Supervisor of Social Services for current procedures.

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