Many elderly and disabled individuals don’t have the type of medical conditions which require them to live in a nursing facility. However, several have health issues which impede their ability to complete routine activities of daily living (ADL’s) and carry out instrumental activities of daily living (IADL’s) which are essential for their health and safety.
ADLs involve the routine and things a person does which involve mobility and to care for their body each day. These activities are usually learned in childhood and generally cover the following eight areas:
- Bowel / Bladder Control
IADLs are activities which a person needs to complete in order to live independently. These things are usually learned in adolescence and include tasks such as:
- Taking medication
- Using the phone
- Doing laundry
- Managing money
- Accessing transportation
The Personal Care (PC) program, also known as State Plan Personal Care (SPPC), assists individuals in carrying out these day to day tasks: and can also help with IADLs, if these tasks are directly related to the individual’s personal care needs. By assisting with these daily needs, this program helps to prevent or minimize physical health regression or deterioration.
Although Personal Care alone is not considered to be a Long Term Care program, with each application for either Personal Care or ADvantage Waiver, authorizations for both must be placed in application status and financial eligibility must be determined for both.
When the AFS worker determines that a client is not financially eligible for PC services, but is for ADvantage Waiver services, he or she needs to deny the PC authorization and place the ADvantage authorization into “F” status. If client is not eligible for medical unless ADvantage is approved the AFS worker will leave the “Type Action Taken” block in the Medical General FACS Tab (D section) in application status. ELDERS will take the appropriate action on both the authorization and the “Type Action Taken” block in the Medical General FACS Tab (D section).
When the AFS worker determines that a client is not financially eligible for ADvantage Waiver services, but is for PC services, he or she needs to deny the ADvantage authorization and place the PC authorization into “F” status. If not already open, the “Type Action Taken” block in the FACS Medical General Tab should be updated to “CERTIFIED” since client is eligible for medical services at this point.