1. health and fitness
2. aging

FSSA Division of Aging
Operations Manual
(Revised 2006)
FSSA DIVISION OF AGING
January, 2005
1st Revision 5/13/05
2nd Revision 7/01/05
3rd Revision 4/10/06
Table of Contents
ADDITIONS, REVISIONS AND CORRECTIONS
ACRONYMS
GLOSSARY
FEDERAL AND STATE LAW DIRECTIVE
AMERICANS WITH DISABILITIES ACT DIRECTIVE
SECTION 1
1000 INTRODUCTION - OPERATIONS MANUAL; PURPOSE, DESIGN, USE,
AVAILABILITY AND DISTRIBUTION
1001 ESTABLISHMENT OF THE FSSA DIVISION OF AGING
1002 ORGANIZATION AND STAFFING OF THE FSSA DIVISION
OF AGING
SECTION 2
2000 ADMINISTRATIVE AREAS OF RESPONSIBILITY OF THE FSSA AGING
AND IN-HOME SERVICES NETWORK - MISSION AND DUTIES OF
THE FSSA DIVISION OF AGING (FSSA DA)
2001 PERFORM AS THE STATE LEADER IN ALL AGING ISSUES
2002 IMPLEMENT ADVOCACY POLICIES
2003 DESIGNATE A PLANNING AND SERVICE AREA(PSA)
2004 DESIGNATE AN AREA AGENCY ON AGING (AAA)
2005 DEVELOP THE INTRASTATE FUNDING FORMULA
2006 GIVE PREFERENCE TO OLDER ADULTS WITH THE GREATEST NEED
2007 MONITOR THE AREA AGENCIES ON AGING
2008 ASSURE THE REQUIREMENT OF OUTREACH EFFORTS
2009 COORDINATE SERVICES WITH AREA AGENCIES ON AGING
2010 ASSURE THE QUALITY OF SERVICES
2011 TAKE INTO ACCOUNT THE VIEWS OF OLDER ADULTS
2012 NEEDS ASSESSMENT
2013 OLDER ADULTS WITH SEVERE DISABILITIES
2014 DEVELOP AND IMPLEMENT THE STATE PLAN
2015 STATE PLAN AMENDMENTS
2016 CONTACT INFORMATION FOR THE FSSA DIVISION OF AGING
2017 MISSION OF THE AREA AGENCY ON AGING
2018 ADVISORY COUNCIL
2019 OTHER ADVISORY BODIES
2019.1 Indiana Commission on Aging
2019.2 Community and Home Options to Institutional Care for the
Elderly and Disabled (CHOICE) Board
2019.3 Alzheimer’s Disease and Related Senile Dementia Task Force
2019.4 Money Management Program Advisory Council
2020 CONTACT INFORMATION FOR THE 16 AREA AGENCIES ON AGING
CHART 1
2021 MAP OF THE 16 PLANNING AND SERVICE AREAS
CHART 2
2022 AREA PLAN ON AGING
2022.1 Direct Provision of Services
2022.2 Submission of the Area Plan
2022.3 AAA Policy Regarding Direct Provision of Services
2022.4 Area Plans and Public Hearings
2023 CONFLICT OF INTEREST
CHART 3
2023.1 Conflict of Interest Rules
2024 NEPOTISM
2025 ACCEPTANCE OF GIFTS
2026 CONFIDENTIALITY
2027 COORDINATION
2028 DIRECT DELIVERY OF SERVICES
2029 INFORMATION SHARING
2030 MARKETING MATERIALS
2031 RETENTION OF RESOURCE RECORDS
2032 GOVERNOR’S CONFERENCE ON AGING
2033 INDIANA STATE FAIR
2034 MONITORING AND ASSESSMENT
2034.1 Monitoring Visit to the AAA
2034.2 Monitoring and Assessment Regarding the Americans with
Disabilities Act (ADA)
2035 NEEDS ASSESSMENT
2036 PRIORITY SERVICES
2037 REPORTING REQUIREMENTS
2038 TARGET POPULATIONS
SECTION 3
3000 HEARINGS AND APPEALS PROCESS
(INCLUDING WITHDRAWAL AND DE-DESIGNATION PROCEDURES OF
AREA AGENCIES ON AGING AND PLANNING AND SERVICE AREAS)
3000 PUBLIC HEARINGS
3000.1 The FSSA DA Procedure Regarding Public Hearings
3000.2 Additional FSSA DA Actions that Require Public Hearings
3000.3 Appeal Process
3001 The FSSA DA Policy and Procedure Regarding the Withdrawal of an AAA
Designation
3001.1 Reasons for Withdrawal of the Designation of an Area Agency on
Aging (AAA)
3001.2 The FSSA DA Preparation for the Withdrawal of the Designation
of an AAA
3001.3 Withdrawal of an AAA Designation
3001.4 Administrative Review
3001.5 Appeals to the Assistant Secretary of the Administration on Aging
3001.6 Continuity of the Functions of the AAA within the PSA
3002 THE FSSA DA DESIGNATION OF AN ADDITIONAL PLANNING AND
SERVICE AREA (PSA)
3002.1 Appeal Procedure Regarding the Designation of an Additional PSA
or Change or Revision of the Boundaries of an Existing PSA
3003 The FSSA DA APPEALS PROCESS REGARDING AN ADVERSE
ACTION OTHER THAN THE WITHDRAWAL OF THE DESIGNATION OF
AN AAA OR THE ADDITION OR CHANGE OF THE BOUNDARIES OF A
PSA
3003.1 Step 1: Documentation
3003.2 Step 2: Informal Review with the FSSA DA
3003.3 Step 3: Public Hearing
3003.4 Step 4: Administrative Review
3004 INVOLVEMENT OF AAAs, SERVICE PROVIDERS, OLDER ADULTS,
AND PERSONS WITH DISABILITIES
3005 FSSA DA APPEALS CHART
3006 CLIENT/APPLICANT APPEALS
3006.1 Notification of Client Rights
3006.2 Procedure for Providing Written Notice of Client Rights
3006.3 FSSA DA Procedure Regarding Appeals and Hearings1
3007 THE FSSA DA APPEAL POLICY AND PROCEDURE FOR
CLIENTS/APPLICANTS APPLYING FOR OR RECEIVING SERVICES
FOR SSBG, CHOICE, AND TITLE III (EXCLUDING IPAS AND PASRR)
3007.1 Step 1: Informal Review with the Case Manager, the Case
Manager Supervisor, and/or an Appropriate Representative
3007.2 Step 2: Agency Review
3007.3 Step 3: Administrative Hearing
3007.4 Assistance Available to a Client/Applicant during the Appeal
Process
3007.5 Requests for Reconsideration and Appeal of Adverse Action
3008 RIGHTS OF CLIENTS/APPLICANTS APPLYING FOR OR RECEIVING
IPAS OR PASRR
3008.1 Process to Request Reconsideration of an Adverse Action
3008.2 Appeal Procedure for Clients/Applicants Applying For or
Receiving IPAS or PASRR Services
3008.3 Appeal Procedure for Title III Service Providers
3008.4 Appeal Process for Service Providers
3008.4.1 Step 1: Informal Review with the AAA
3008.4.2 Step 2: Agency Review
3008.4.3 Step 3: Appeal Hearings at the State Level
1
Added 5/13/05
For appeal process for individuals applying for or receiving services funded by the
Medicaid Home and Community-Based Waiver Program, please refer to the appropriate
Medicaid Waiver document.
SECTION 4
4000 SERVICE DEFINITIONS
4001 ADAPTIVE AIDS AND DEVICES
4001.1 Allowable Adaptive Aids and Devices
4001.2 Adaptive Aids and Devices Not Allowed
4001.3 Funding Sources for Adaptive Aids and Devices
4001.4 The FSSA DA Policy and Procedures Regarding Adaptive Aids
and Devices
4001.5 AAA Policy and Procedures Concerning Adaptive Aids and
Devices
4001.6 Service Provider Responsibilities Concerning Adaptive Aids and
Devices
4001.7 Unit of Service
4002 OTHER SERVICES FUNDED BY CHOICE
4002.1 Services Not Allowed
4002.2 Funding Sources for Other Services
4002.3 The FSSA DA Policy and Procedures Regarding Other Services
4002.4 AAA Policy and Procedures Concerning Other Services
4002.5 Service Provider Responsibilities Specific to CHOICE Funding
4002.6 Unit of Service
4003 ADULT DAY SERVICES
4003.1 Allowable Activities
4003.2 Activities Not Allowed
4003.3 Funding Sources Administered by the FSSA DA for Adult Cay
Care Services
4003.4 The FSSA DA Policy and Procedures Regarding Adult Day Care
Services Providers
4003.5 AAA Policy and Procedures Regarding Adult Day Care Services
4003.6 Service Provider Responsibilities Concerning Adult Day Care
Services
4003.7 Day Care Meal
4003.8 Day Care Transportation
4003.9 Unit of Service
4004 ADULT GUARDIANSHIP SERVICES
4004.1 Funding Sources
4004.2 The FSSA DA Policy and Procedures Regarding Guardianship
Services
4004.3 Service Provider Responsibilities Concerning Adult Guardianship
Services
4004.4 Allowable Adult Guardianship Services
4004.5 Activities Not Allowed
4005 ADULT PROTECTIVE SERVICES
4005.1 Definition of Endangered Adult
4005.2 Exceptions to Definition of Endangered Adult
4005.3 Allowable Activities
4005.4 Funding Sources for Adult Protective Custody
4005.5 Unit of Service
4006 ALZHEIMER’S DISEASE AND RELATED SENILE DEMENTIA (AD/RSD)
PROGRAMS
4006.1 Funding Sources for AD/RSD
4006.2 The FSSA DA Policy Regarding AD/RSD Services
4006.3 The FSSA DA Procedures Regarding Alzheimer’s/Dementia
Special Care Unit Disclosure Form (State Form 48896)
4006.4 Consultation
4006.5 Service Provider Responsibilities and Procedures Regarding
AD/RSD Services
4007 ATTENDANT CARE SERVICES
4007.1 Allowable Activities
4007.2 Activities Not Allowed
4007.3 Funding Sources for Attendant Care Services
4007.4 The FSSA DA Policy and Procedures Regarding Attendant Care
Services
4007.5 AAA Policy and Procedures Regarding Attendant Care Services
4007.6 Service Provider Responsibilities Concerning Attendant Care
Services
4007.7 Unit of Service
4008 CASE MANAGEMENT SERVICES
4008.1 Independent Case Managers
4008.2 Case Management Allowable Activities
4008.3 Services Not Allowed Under Case Management
4008.3.1 Services Not Allowed to be Supplied by Independent
Case Managers
4008.3.2 Entities Not Allowed to Conduct Case Management
Services
4008.4 Funding Sources for Case Management Services
4008.5 The FSSA DA Policy and Procedures Regarding Case
Management Services
4008.6 AAA Policy and Procedures Regarding Case Management
Services
4008.7 Case Manager Qualifications
4008.7.1 Minimum Qualifications for Individual Case Managers
4008.8 The FSSA DA Policy and Procedures Regarding Certification of
Case Managers
4008.9 The FSSA DA Policy and Procedures De-certification Procedures
for Case Managers Employed by AAA or by Independent Case
Management Agencies
4008.10 AAA Policy and Procedures Concerning Certification of Case
Managers
4009
4010
4011
4012
4013
4008.11 AAA Policy and Procedures Concerning De-certification of Case
Managers
4008.12 Service Standards for Case Management Services
4008.12.1 Information Concerning an Older Adult or Person With a
Disability
4008.13 Unit of Service
CONTINUING EDUCATION SERVICES
4009.1 Funding Sources for Continuing Education Services
4009.2 The FSSA DA Policy and Procedures Regarding Continuing
Education Services
4009.3 The AAA Policy and Procedures Regarding Continuing Education
Services
DISEASE PREVENTION AD HEALTH PROMOTION SERVICES
4010.1 Target Population
4010.2 Funding Sources
4010.3 Allowable Disease Prevention and Health Promotion Services
Activities
4010.4 Unit of Service
FAMILY CAREGIVER SUPPORT PROGRAM
4011.1 Funding Sources for the Family Caregiver Support Program
4011.2 Populations Served by the Family Caregiver Support Program
4011.3 Access Assistance
4011.4 Information for Caregivers
4011.5 Counseling
4011.6 Respite
4011.7 Supplemental Services
4011.8 The FSSA DA Policy Regarding the Family Caregiver Support
Program
4011.9 The FSSA DA Procedures Regarding the Family Caregiver
Support Program
4011.10 AAA Policy and Procedures Regarding the Family Caregiver
Support Program
4011.11 Reports
4011.12 Unit of Service
HOME HEALTH SERVICES
4012.1 Allowable Home Health Services
4012.2 Home Health Services Not Allowed
4012.3 Funding Sources for Home Health Services
4012.4 The FSSA DA Policy and Procedures Regarding Home Health
Services
4012.5 AAA Policy and Procedures Concerning Home Health Services
4012.6 Service Provider Responsibilities Concerning Home Health
Services
4012.7 Unit of Service
HOMEMAKER SERVICES
4013.1 Allowable Homemaker Services
4014
4015
4016
4017
4013.2 Activities Not Allowed
4013.3 Funding Sources for Homemaker Services
4013.4 FSSA DA Policy and Procedures Regarding Homemaker
Services
4013.5 AAA Policy and Procedures Concerning Homemaker Services
4013.6 Service Provider Responsibilities Concerning Homemaker
Services
4013.7 Unit of Service
HOME REPAIR/MAINTENANCE SERVICES
4014.1 Allowable Home Repair/Maintenance Activities
4014.2 Activities Not Allowed
4014.3 Funding Sources for Home Repair/Maintenance Services
4014.4 The FSSA DA Policy and Procedures Regarding Home
Repair/ Maintenance Services
4014.5 AAA Policy and Procedures Regarding Home
Repair/ Maintenance Services
4014.6 Service Provider Responsibilities Concerning Home
Repair/ Maintenance Services
4014.7 Unit of Service
INDIANA PRE-ADMISSION SCREENING PROGRAM (IPAS)
4015.1 Funding for Indiana's Pre-Admission Screening Program
4015.2 Eligibility Requirements for Indiana's Pre-Admission Screening
Program
4015.3 The FSSA DA Policy and Procedures Regarding Indiana's PreAdmission Screening Program
4015.4 AAA Duties Regarding Indiana's Pre-Admission Screening
Program
4015.5 AAA Procedures Concerning Indiana's Pre-Admission Screening
Program
4015.6 IPAS Final Determination
4015.7 Appeals and Fair Hearings
INFORMATION AND ASSISTANCE SERVICES (I&A)
4016.1 Allowable Information and Assistance Services Activities
4016.2 Funding Sources for Information and Assistance Services
4016.3 The FSSA DA Policy and Procedures Regarding Information and
Assistance Services
4016.4 AAA Policy and Procedures Regarding Information and
Assistance Services
4016.5 Unit of Service
LEGAL ASSISTANCE SERVICES
4017.1 Allowable Legal Assistance Activities
4017.2 Activities Not Allowed
4017.3 Funding Sources for Legal Assistance Services
4017.4 The FSSA DA Policy and Procedures Regarding Legal
Assistance Services
4017.5 AAA Policy and Procedures Concerning Legal Assistance
4018
4019
4020
4021
Services
4017.6 Service Provider Procedures
ENVIRONMENTAL MODIFICATIONS SERVICES
4018.1 Allowable Environmental Modifications Services
4018.2 Activities Not Allowed
4018.3 Funding Sources for Environmental Modifications Services
4018.4 The FSSA DA Policy and Procedures Regarding Environmental
Modifications Services
4018.5 AAA and Case Manager Policy and Procedures Regarding
Environmental Modifications Services
4018.6 Documentation Standards
4018.7 Provider Qualifications
4018.8 Unit of Service
MONEY MANAGEMENT SERVICES PROGRAM
4019.1 Activities of the Money Management Program
4019.2 Representative Payee
4019.3 Bill Payer
4019.4 Bill Payer Monitor
4019.5 Activities Not Allowed
4019.6 Money Management Services Program Safeguards
4019.7 Reporting
4019.8 Program Size
4019.9 Income and Liquid Assets
4019.10 Funding Sources for the Money Management Services Program
4019.11 Local Sponsor Eligibility
4019.12 Recommendations for Assisting Clients Above the Income and
Asset Limits
4019.13 The FSSA DA Policy Regarding the Money Management
Services Program
4019.14 State Advisory Council
4019.15 AARP/National Sponsor Procedures
4019.16 The FSSA DA Procedures Regarding the Money Management
Services Program
4019.17 The FSSA DA Procedures Regarding Monitoring of the Money
Management Services Program
4019.18 Local Sponsor Responsibilities Regarding Money Management
Services
LONG TERM CARE OMBUDSMAN
4020.1 Allowable Activities
4020.2 Unit of Service
OUTREACH SERVICES
4021.1 Allowable Outreach Services
4021.2 Funding Sources for Outreach Services
4021.3 The FSSA DA Policy and Procedures Regarding Outreach
Services
4021.4 AAA Policy and Procedures Concerning Outreach Services
4021.5 Unit of Service
4022 PERSONAL ASSISTANCE SERVICES (Funded by Medicaid Waiver Only)
4023 PRE-ADMISSION SCREENING/RESIDENT REVIEW (PASRR)
4023.1 Funding Sources for PASRR
4023.2 Eligibility and Participation Requirements for PASRR
4023.3 Participation in the IPAS Program
4023.4 Determination of Criteria
4023.4.1 Level I
4023.4.2 Level II
4023.5 PASRR -Two Part Program
4023.5.1 Pre-admission Screening
4023.5.2 Resident Review
4023.6 Responsible Entities in the Assessment Process
4023.7 PASRR Final Determination
4023.8 Appeals and Fair Hearings
4024 RCAP (MOVED TO SECTION 11)
4025 RESPITE CARE
4025.1 Allowable Services Covered Under Respite Care Services
4025.2 Activities Not Allowed
4025.3 Funding Sources for Respite Care Services
4025.4 The FSSA DA Policy and Procedures Regarding Respite Care
Services
4025.5 AAA Policy and Procedures Concerning Respite Care Services
4025.6 Service Provider Responsibilities Concerning Respite Care
Services
4025.7 Unit of Service
4026 SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM
(See Section 9)
4027 SENIOR CENTERS
4027.1 Allowable Activities
4027.2 Activities Not Allowed
4027.3 Funding Sources Specific for Senior Centers
4027.4 The FSSA DA Policy and Procedures Regarding Senior Centers
4027.5 AAA Policy and Procedures Regarding Senior Centers and Focal
Points
4028 THERAPY SERVICES
4028.1 Allowable Therapy Service Activities
4028.2 Funding Sources for Therapy Services
4028.3 The FSSA DA Policy and Procedures Regarding Therapy
Services
4028.4 AAA Policy and Procedures Concerning Therapy Services
4028.5 Service Provider Procedures Concerning Therapy Services
4028.6 Unit of Service
4029 TRANSPORTATION SERVICES
4029.1 Allowable Transportation Services
4029.2 Activities Not Allowed
4029.3 Funding Sources Specific for Transportation Services
4029.4 The FSSA DA Policy and Procedures Regarding Transportation
Services
4029.5 AAA Policy and Procedures Regarding Transportation Services
4029.6 Documentation and Service Standards
4029.7 Service Provider Procedures Regarding Transportation Services
4030 VOLUNTEER SERVICES
4030.1 Funding Services for Volunteer Services
4030.2 The FSSA DA Policy and Procedures Regarding Volunteer
Services
4030.3 AAA Policy and Procedures Concerning Volunteer Services
4031 REQUESTS FOR AUTHORIZATION OF SERVICES (RFA)
4031.1 AAA Procedures Regarding Request for Authorization of
Services
4031.2 The FSSA DA Procedure Regarding the Request for
Authorization of Services
4032 TRANSFER OF CLIENTS
4032.1 AAA Procedures Regarding Transfer of Clients
SECTION 5
5000 FUNDING SOURCES AND ELIGIBILITY REQUIREMENTS
5001 THE OLDER AMERICANS ACT OF 1965, AS AMENDED
5001.1 Title I: Declaration of Objectives
5001.2 Title II: Administration on Aging
5001.3 Title III: Grants for State and Community Programs for Aging
5001.4 Title IV: Training, Research, and Discretionary Projects and
Programs (OAA 401-402)
5001.5 Title V: Community Services Employment for Older Americans
5001.6 Title VI: Grants for Native Americans
5001.7 Title VII: Allotments for Vulnerable Elder Rights Protection
Activities
5001.8 Title VIII: Native American Programs
5001.9 Responsibility for the Older Americans Act (OAA)
5001.10 Administration on Aging
5001.11 Regional Office of the OAA
5002 COMMUNITY AND HOME OPTIONS TO INSTITUTIONAL CARE FOR
THE ELDERLY AND DISABLED (CHOICE)
5002.1 Summary of the Indiana Code IC 12-10-10
5002.2 CHOICE Funding Requirements
5002.3 Eligibility Requirements for Choice Funding
5006.4 Financial Eligibility and Cost Share Requirements
5003 SOCIAL SERVICE BLOCK GRANT – TITLE XX
5003.1 Eligibility Requirements for SSBG Funding
5004 NUTRITION SERVICES INCENTIVE PROGRAM (NSIP) (OAA 311(D)) OF
2000, AS AMENDED
5005 GENERAL FUNDING ELIGIBILITY REQUIREMENTS
5005.1 Title III Funding Requirements
5005.1.1 Eligibility Requirements for Title III Funding
5005.2 Title V Funding Requirements (OAA)
5005.2.1 Eligibility Requirements for Title V Funding
5005.2.2 Financial Eligibility for Title V
5006 ELIGIBILITY REQUIREMENTS FOR OLDER HOOSIER ACCOUNT
FUNDING
5006.1 Eligibility Requirements for Older Hoosier Account
Funding
5006.2 Financial Eligibility
5007 FISCAL POLICIES AND PROCEDURES APPLICABLE TO THE FSSA DA
CONTRACTS WITH THE AAA ONLY
5007.1 Funding Accounts
5007.2 Budgets
5007.3 Contracts
5007.4 Allocation of Funds
5007.4.1 Funding Formulas
5007.4.2 AAA Provisions for Expenditures
5007.5 Program and Other Income
5007.5.1 Fees
5007.5.2 Allowable Uses of Program Income
5007.5.3 The FSSA DA Procedures Regarding Contributions
5007.5.4 Service Providers Policy and Procedures Regarding
Program Income
5007.5.5 In-Kind Contributions
5007.5.6 The FSSA DA Procedures Regarding In-Kind
Contributions
5007.5.7 AAA Policy and Procedures Regarding In-Kind
Contributions
5007.5.8 Service Provider Policy and Procedures Regarding InKind Contributions
5007.5.9 Carryover Funds
5007.5.10 Matching Funds
5007.6 Services
5008 ADULT PROTECTIVE SERVICES POLICIES AND PROCEDURES
APPLICABLE TO THE FSSA DA CONTRACTS (2005 COMPLIANCE
NEW SECTION)
5008.1 Adult Protective Services Funding Account
5008.2 Adult Protective Services Budgets
5008.3 Adult Protective Services Funding Formula
5008.4 Distribution of Adult Protective Services Funding Formula
5008.4.1 Adult Protective Services Prosecutors Provisions for
Expenditures
5009 FISCAL POLICIES AND PROCEDURES APPLICABLE TO ALL THE
FSSA DA CONTRACTS (AAA SPECIFIC)
5009.1 Insurance and Bonding
5009.2 Procurement
5009.2.1 Procurement Guidelines
5009.2.2 The FSSA DA Policy and Procedures Regarding
Procurement
5009.2.3 AAA Policy and Procedures Regarding Procurement
(Applicable to AAAs Only, not Contracts with Other Providers)
5009.3 Equipment
5009.3.1 Equipment Purchases
5009.3.2 Purchase of Vehicles
5009.3.3 Equipment Inventory Records
5009.3.4 Disposal of Property
5009.3.5 Disposal of Vehicles
5009.4 Audits
5009.5 Claim Reimbursement Polices and Procedures
5009.5.1 How to Fill Out Claim Forms
5009.5.2 Lost Claims Procedures
5009.5.3 Late Claims Procedures
SECTION 6
6000 THE FSSA DA DATA MANAGEMENT SYSTEMS
6000 DATA MANAGEMENT
6001 ADMINISTRATIVE SERVICE UNIT
6002 DATA MANAGEMENT UNIT
6003 COMPUTER SOFTWARE SYSTEM MANAGEMENT SYSTEM
6003.1 Other Uses for Computer Software Management Systems
6003.2 Reports and Queries
6003.3 Ad-Hoc Requests and Queries
6003.4 Technical Support
6003.5 Software Contractor Liaison
6003.6 EDS/MARS (Electronic Date Services/Management and Report
System)
6003.7 Related FSSA DA Software Support
6004 AAA RESPONSIBILITIES
6004.1 AAA Data Entry Completion Time Frames
6004.2 The Bureau of Information Directory (BID)
6004.3 The FSSA DA Website1
SECTION 7
7000 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
OF1996 (HIPAA)
7000 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
OF1996 (HIPAA) (PC 104-191)
1
Added 5-13-05
7001 THE FSSA DA POLICY AND PROCEDURES REGARDING HIPAA
COMPLIANCE
7002 HIPAA COMPLIANCE POLICY FOR THE FSSA DA INCLUDING
SECURING CENTRAL, ELECTRONIC AND INDIVIDUAL FILES (DESKS)
7002.1 Copy Room
7002.2 Fax Machines
7002.3 Copier/Printer
7002.4 Phone/Public Areas
7003 DISPOSAL OF PROTECTED HEALTH INFORMATION (PHI)
7004 AAA POLICY AND PROCEDURES
7005 SERVICE PROVIDERS POLICY AND PROCEDURES
SECTION 8
8000 NUTRITION PROGRAM SERVICES
8001 RESPONDING TO THE NEEDS OF INDIANA’S OLDER ADULTS
8002 FUNDING SOURCES FOR INDIANA’S NUTRITION PROGRAM
8003 NATIONAL SERVICE INCENTIVE PROGRAM (NSIP)
8003.1 NSIP Meals
8003.2 Cash or Commodities to Supplement Meals
8004 PROGRAM SERVICES ELIGIBILITY
8004.1 Nutrition Services Program Income
8004.2 Voluntary Contributions
8004.3 Cost Sharing and Means Test
8004.4 Client Privacy
8005 DIVISION OF AGING POLICY AND PROCEDURES REGARDING
NUTRITION SERVICES
8005.1 Monitoring and Assessment
8005.2 Training Activities
8006 AAA POLICIES AND PROCEDURES REGARDING NUTRITION
SERVICES
8006.1 Congregate and Home Delivered Meals
8006.2 Congregate Meal Sites
8006.2.1 Meal Site Location
8006.2.2 Meal Site Services
8006.2.3 Postings at Meal Sites
8006.2.4 Home Delivered meals
8006.2.5 Meal Delivery
8006.3 Meal Services Requirements
8006.3.1 Meal Frequency and Form
8006.3.2 Meal Planning Requirements
8006.4 Emergency Meals
8006.5 Volunteer and Disabled Individual Meals
8006.6 Restaurant Voucher Meals
8006.7 Requested Information
8006.8 Nutrition Screens
8006.9 Nutrition Education Activities
8006.10 Nutrition Counseling
8006.11 National Program Information System (NAPIS)
8006.11.1 Units of Service (For NAPIS Reporting)
8006.12 Provision of Nutrition Services
8006. 12.1 AAA and Provider Monitoring
8007 SENIORS FARMER’S MARKET NUTRITION PROGRAM (SFMNP)
8007.1 Eligibility for SFMNP
SECTION 9
9000
9001
9002
9003
9004
9005
9006
9007
9008
SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM (SCSEP)
FUNDING SOURCES
RECRUITMENT AND SELECTION OF ELIGIBLE INDIVIDUALS
INITIAL ELIGIBILITY REQUIREMENTS
BASIC ELIGIBILITY REQUIREMENTS FOR SCSEP
9004.1 Income Inclusions and Exclusions
9004.2 Preference Criteria and Enrollment Priorities
9004.2.1 Definition of a Veteran and Definition of a Spouse of a
Veteran
9004.2.2 Definition of Special Consideration Criteria
SERVICES AND RESPONSIBILITIES OF THE SUBGRANTEE (AAA)
9005.1 Policy Governing Political Patronage
9005.2 Nepotism
9005.3 One Stop Delivery System
9005.4 Termination of a Participant
9005.4.1 IEP Related Termination (Not Appropriate)
9005.5 Wages
9005.6 Fringe Benefits
9005.7 Participant Activities Not Allowed
THE FSSA DA POLICY AND PROCEDURES REGARDING SCSEP
9006.1 The FSSA DA Coordinator
HOST AGENCIES
9007.1 Subgrantees (AAAS) Policy and Procedures Regarding the Host
Agencies
9007.2 Unsubsidized Employment
9007.3 Activities and Services Not Allowed
9007.4 Miscellaneous
THE ANNUAL AND QUARTERLY REPORTS
9008.1 National Grantee Recommendations Regarding the State Plan for
Indiana SCSEP
9008.1.2 Information Included in the State Plan for Indiana SCSEP
9008.2 Equitable Distribution Report (ED)
9008.3 SCSEP Grant Application to the DOL
9008.4 Financial Quarterly Reports to the DOL
9008.5 Close Out Financial Reports to the DOL
9009 DOL PERFORMANCE STANDARDS FOR GRANTEES (FSSA DA)
9009.1 Indiana Performance Measures for the Program Year
9010 PERFORMANCE MEASURES SANCTIONS
9011 APPEALS POLICY AND PROCEDURES FOR SCSEP PARTICIPANTS
(SAME AS FOR CLIENTS)
SECTION 10
RESERVED FOR COMMUNITY AND HOME OPTIONS TO INSTITUTIONAL
CARE FOR THE ELDERLY AND DISABLED PROGRAM (CHOICE)
SECTION 11
11000 RESIDENTIAL CARE ASSISTANCE PROGRAM (RCAP) - PURPOSE
11001 CLIENT ELIGIBILITY
11001.1 Financial Eligibility
11001.2 Non-Financial Eligibility
11002 THE ROLE OF FSSA DA
11003 CASE PROCESSING
11003.1 Budgeting
11004 PROVIDER INFORMATION
11004.1 Provider Services
11004.2 Reimbursement
11004.3 Payment for Provider Services
11004.4 Claims Management Process
SECTION 12
12000 - MEDICAID NURSING FACILITY LEVEL OF CARE HOME AND
12000 MEDICAID WAIVER
12000.1 Aged and Disabled Waiver (A&D)
12000.2 Assisted Living
12000.3 Traumatic Brain Injury (TBI)
12000.4 Medically Fragile Children’s Waiver (MFC)
LISTING OF CHARTS
Part 1
Section 2- CHART 1 - Contact Information for the 16 Area Agencies on
Aging
Section 2 - CHART 2 - Map of the 16 PSA’s
Section 2 - CHART 3 - Conflict of Interest Rules
Section 3 - CHART 4 - Older Americans Act, Section 305
Section 3 - CHART 5 - FSSA DA Appeals Chart
Section 3 - CHART 6 - Rights for Frail Older Individuals
Section 3 - CHART 7 - AAA Appeal Process
Part 2
Section 4 - CHART 8 - Family Caregiver- Report Due Dates
Section 4 - CHART 9 - Older Americans Act, 321(a)(3) and 45 CFR
1321.17(f)(8) Information and Assistance
Section 4 - CHART 10 - Content of State Plan
Section 4 - CHART 11- PASRR Laws
Section 5 - CHART 12 - Administration of Programs
Indiana Code 12-10-1-3
Section 5 - CHART 13 - Public Law 89-73
Section 5 - CHART 14 - United States Code 42, USC 3030c-2
Section 6 - CHART 15 - Illustration of the Data Upload Process
Part 3
Section 8 - CHART 16 - Older Americans Act, Section 339(2)(B)
Section 8 - CHART 17 - Older Americans Act, Section 315(b)(2)
Section 8 - CHART 18 - Older Americans Act, Section 315(b)(i)
Section 8 - CHART 19 - Division of Aging Policy Statement Regarding
Nutrition Services
Section 8 - CHART 20 - Older Americans Act, Section 339(2)(G)
Section 8 - CHART 21 - Older Americans Act, Section 339(2)(J)
Section 9 - CHART 22 - Senior Community Service Employee Program
Final Rule, April 19, 2004
Section 9 - CHART 23 - SCSEP Citations and Codes
Section 9 - CHART 24 - Enrollment Priorities
Section 9 - CHART 25 - SCSEP Organizational Chart
Section 9 - CHART 26 - Tips for Success
Section 9 - CHART 27 - Performance Measures
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Appendices
APPENDIX I
STATE PLAN PROVISIONS
APPENDIX II
FSSA DA SERVICE CODES
APPENDIX III
NOTIFICATION OF CLIENT RIGHTS
Nutrition Appendices
APPENDIX A
Menu Standards
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
FSSA Division of Aging
Operations Manual,
Additions, Revisions and Corrections
1. 5/13/05
2. 7/01/05
3. 4/10/06
Additions
1. 5/13/05
ADA Compliance Statement
Acronyms and Glossary
BOOK, CMGT, FFY, MOA, SCC, TRVL
Glossary of Terms
Authorized Representative
Caterer
Section 1005 (d)
Distribution
Section 1014.3
AAA Advisory Council
Section 3005.1, 3005.2, 3005.3
Client/Applicant Appeals
Section 4031, 4031.1, 4031.2
Request for Authorization of Services (RFA)
Section 4032
Transfer of Clients
Section 6004.3
The FSSA DA Website
Appendix III
Notification of Client Rights
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
2. 7/01/05
Senior Community Service Program (SCSEP)
Definitions - OJT
Section 9005 (i) (1) (A-G) (20 and (3)
Senior Community Service Program (SCSEP)
3. 4/10/06
Acronyms
ACCM, ADRC, CM, DOL, FMV, IEP, IPPM, MAR, MOA, OACSEP, OJT,
RSDI, SEP
Glossary of Terms
All terms originally defined in Section 9 - Senior Community
Employment Program Definitions have been moved to Glossary of
Terms
RevisedActivities of Daily Living (ADLs)
Addedalternate dessert
case management
Centers for Medicare and Medicaid Services
regular diet
Medicaid Waiver
Request for Proposals
Also added Section 2034.1
Monitoring and Assessment Regarding the Americans with Disabilities
Act (ADA)
Section 4008.1
Independent Case Managers
Section 4008.3.1
Services Not Allowed to be Supplied by Independent Case Managers
Section 4008.7.1(c)
Minimum Qualifications for Individual Case Managers
Section 4010
Disease Prevention and Health Promotion Services
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 4010.1
Target Population
Section 4010.2
Funding Sources
Section 4010.3
Allowable Disease Prevention and Health Promotions Services
Activities
Section 4010.4
Unit of Service
Section 5002.3
Eligibility Requirements for CHOICE Funding
(a)(4)
Section 10
Reserved for Community and Home Options to Institutional Care for the Elderly
and Disabled Program
Section 11
Residential Care Assistance Program (RCAP)
Section 12
Medicaid Waiver
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Revisions
1. 5/13/05
Section 1002
Design
Section 1005 (b) and (c)
Distribution
Section 4001.4
The FSSA DA Policy and Procedure Regarding Adaptive Aids and Devices
Section 4001.5
AAA Policy and Procedure Concerning Adaptive Aids and Devices
Section 4018.5
AAA and Case Manager Policy and Procedure Regarding Environmental
Modifications Services
Section 9004.1
Income Inclusions and Exclusions
Appendix I
State Plan Provisions
2. 7/01/05
Section 9007 (2) (C-E) and (3)
Removed
Name change from DDARS to DDRS
Nutrition Services (Entire Section)
Appendix A
Nutrition Services –Menu Standards
CHART
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
3. 4/10/06
Division of Aging (DOA) changed to FSSA Division of Aging (FSSA DA)
Section 1001
Purpose
Section 1002
Design
Section 1003
Use
Section 1004
Availability
Section 1005
Distribution
Section 1006
Information on Indiana’s Aging and In-Home Services
Integrated into Section 1000
Operations Manual; Purpose, Design, Use, Availability and
Distribution
Section 1007
Establishment of the FSSA Division of Aging
Moved toSection 1001
Section 1008
Administration of Programs
Integrated into Section 1000
Operations Manual; Purpose, Design, Use, Availability and
Distribution
Section 1009
Medicaid Waivers (or Office of Medicaid Policy and Planning Medical
Model Waivers)
Moved toSection 12000
Medicaid Nursing Facility Level of Care Home and Community-Based
Services Waivers
Section 1010
Organization and Staffing of the DOA
Moved toSection 1002
Organization and Staffing
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 1011
Mission and Duties of the DOA
Changed to Section 2000
Mission and Duties of the FSSA Division of Aging (FSSA DA)
Section 1011.1
Perform as the State Leader in All Aging Issues
Moved toSection 2001
Section 1011.2
Implement Advocacy Policies
Moved to Section 2002
Section 1011.3
Designate Planning and Services Area (PSAs)
Moved to Section 2003
Section 1011.4
Designate Area Agencies on Aging (AAA)
Moved to Section 2004
Designate an Area Agency on Aging (AAA)
Section 1011.5
Develop the Intrastate Funding Formula
Moved to Section 2005
Section 1011.6
Give Preference to Older Adults with the Greatest Need
Moved to Section 2006
Section 1011.7
Monitor the AAAs
Moved to Section 2007
Monitor the Area Agencies on Aging
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 1011.8
Assure the Requirement of Outreach Efforts
Moved to Section 2008
Section 1011.9
Coordinate with Other State Agencies
Integrated intoSection 2009
Coordinate Services with the Area Agencies on Aging
Section 1011.10
Coordinate with the AAAs
Changed toSection 2009
Coordinate with the Area Agencies on Aging
Section 1011.11
Assure the Quality of Services
Moved to –
Section 2010
Section 1011.12
Take into Account the Views of Older Adults
Moved toSection 2011
Section 1011.13
Develop and Implement the State Plan
Moved toSection 2014
Section 1012
State Plan
and
Section 1012.1
The DOA Procedures Regarding the State Plan
Integrated intoSection 2014
Develop and Implement the State Plan
Section 1012.2
The DOA Procedures Regarding Older Adults with Severe Disabilities
and the State Plan
Integrated intoSection 2013
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Older Adults with Severe Disabilities
Section 1012.2.1
The DOA Procedures Regarding Conflict of Interest
Integrated intoSection 2023
Conflict of Interest
Section 1012.3
Submission of the State Plan
and
Section 1012.3.1
The FSSA DA Procedures Regarding the State Plan
and
Section 1012.3.2
Requirements of the State Plan
and
Section 1012.3.3
Verification of Intent
and
Section 1012.3.4
Background and Introduction
and
Section 1012.3.5
Mission Statements
and
Section 1012.3.6
Strategies for Service Delivery and Systems Enhancement
and
Section 1012.3.7
General Assurances
and
Section 1012.3.8
Administrative Structure
and
Section 1012.3.9
Program Goals and Objectives
and
Section 1012.4
State Plan Assurances
and
Section 1012.4.1
Statistics
Integrated intoSection 2014
Develop and Implement the State Plan
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 1012.4.2
AAA Policy and Procedures Regarding the State Plan Amendments
and
Section 1012.4.3
State Plan Amendments
and
Section 1012.4.4
The FSSA DA Procedures Regarding State Plan Amendments
Integrated intoSection 2015
State Plan Amendments
Section 1013
Contact Information for the Division of Aging
Moved toSection 2016
Contact Information for the FSSA Division of Aging
Section 1014
Area Agencies on Aging and In-Home Services
Moved toSection 2022
Area Plan on Aging
Section 1014.1
Designation of an AAA
Moved toSection 2004
Designate an Area Agency on Aging
Section 1014.2
Mission of the AAA
Moved to Section 2017
Mission of the Area Agency on Aging
Section 1014.3
AAA Advisory Council
Moved to Section 2018
Advisory Council
Section 1015
Advisory Bodies
Changed to FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 2019
Other Advisory Bodies
Section 1016
Indiana Commission on Aging
Moved to Section 2019.1
Section 1017
Community and Home Options to Institutional Care for the Elderly
and Disabled (CHOICE) Board
Moved to Section 2019.2
Section 1018
Alzheimer’s Disease and Related Senile Dementia Task Force (also
known as The Governor’s Task Force on Alzheimer’s Disease and Related
Dementia)
Moved to Section 2019.3
Section 1019
Money Management Program Advisory Council
and
Section 1019.1
Money Management Program Advisory Council Members
Moved to Section 2019.4
Money Management Services Program Advisory Council
Section 1020
Planning and Service Areas (PSAs)
Integrated into Section 2003
Designate Planning and Service Area (PSAs)
Section 1021
Indiana’s 16 Planning and Service Area (PSAs)
and
Section 1021.1
Redesignation of a PSA
and
Section 1021.2
Denial of an Application for Designation as a PSA
Integrated into Section 3002
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
The FSSA DA Designation of an Additional Planning and Service
Area (PSA)
Section 1022 - Contact Information for the 16 Area Agencies on
Aging
Moved to Section 2020
Section 1022.1
Map of the 16 PSAs
Moved to Section 2021
Section 1023
Independent Case Managers
Moved to Section 4008.1
Case Management Services
Section 2001
Advocacy
and
Section 2001.1
The DOA Procedures Regarding Advocacy
and
Section 2001.2
AAA Policy Regarding Advocacy Services
and
Section 2001.3
AAA Procedures Regarding Advocacy Services
Changed to Section 2002
Implement Advocacy Policies
Section 2002
Area Plans
and
Section 2002.1
The DOA Procedures Regarding Advocacy Services
and
Section 2002.2
AAA Policy Regarding Advocacy Services
Section 2002.3
and
AAA Procedures Regarding Advocacy Services
Integrated intoSection 2022
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Area Plan on Aging
Section 2003
Conflict of Interest
and
Section 2003.1
Conflict of Interest Situations
and
Section 2003.2
The DOA Policy Regarding an AAA Conflict of Interest Situations
and
Section 2003.3
The DOA Procedure Regarding Conflict of Interest
and
Section 2003 3.1
Nepotism
and
Section 2003. 3.2
and
Acceptance of Gifts
Section 2003.4.2
and
AAA Policy and Procedure Regarding Conflict of Interest
Section 2003.5
and
Area Plan Assurances Regarding Conflict of Interest
Section 2003.5.1
Moved toSection 2023
Section 2003.6
Conflict of Interest Rules
Moved toSection 2023.1
Section 2004
Confidentiality
and
Section 2004.1
Ethics Training
and
Section 2004.2
AAA Policy and Procedures Regarding
Confidentiality
Moved toSection 2026
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 2005
Coordination
and
Section 2005.1
The DOA Procedures Regarding Coordination of Services
and
Section 2005.2
AAA Policy and Procedures Regarding Coordination of Services
Moved toSection 2027
Section 2006
Direct Delivery of Services
and
Section 2006.1
The DOA Procedures Regarding Direct Delivery of Services
and
Section 2006.2
AAA Policy Regarding Direct Delivery of Services
and
Section 2006.3
AAA Procedures Regarding Direct Delivery of Services
and
Section 2006.4
Service Providers Policy and Procedures Regarding Direct
Delivery of Services
Moved toSection 2028
Section 2007
Information sharing
and
Section 2007.1
The DOA Policy Regarding Information Sharing
and
Section 2007.2
The DOA Procedures Regarding Information Sharing
Moved toSection 2029
Section 2007.2.1
Marketing Materials
Moved toSection 2030
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 2007.2.2
Retention of Resources Records
Moved toSection 2031
Retention of Resource Records
Section 2007.2.3
Governor’s Conference
Section 2007.2.4
Governor’s Conference Policy and Procedures
Moved toSection 2032
Section 2007.3
Indiana State Fair
Section 2007.3.1
Indiana State Fair Policy and Procedures
Moved toSection 2033
Indiana State Fair
Section 2007.4
AAA Policy and Procedures Regarding Information Sharing
Moved toSection 2029
Information Sharing
Section 2008
Monitoring and Assessment
Section 2008.1.1
The DOA Procedures Regarding Monitoring and Assessment
Section 2008.1.2
Assessment
Section 2008.2
AAA Policy and Procedures Regarding Monitoring and
Assessment
Moved toSection 2034
Section 2009
Needs Assessment
and
Section 2009.1
The DOA Procedures Regarding Needs Assessment
and
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 2009.3
AAA Procedures Regarding Needs Assessment
and
Section 2009.4
AAA Procedures Regarding Needs Assessment and the Area Plan
Moved toSection 2035
Section 2010
Priority Services
and
Section 2010.1
The DOA Procedures Regarding Priority Services
and
Section 2010.2
AAA Policy and Procedures Regarding Priority Services
Moved to Section 2036
Priority Services
Section 2011
Reporting Requirements
and
Section 2011.1
Required Reports from the FSSA Division of Aging
Moved to Section 2037
Section 2012
Public Hearings
and
Section 2012.1
The DOA Procedures Regarding Public Hearings
and
Section 2012.2
Additional DOA Actions that Require Public Hearings
Moved to Section 3000
Public Hearings
Section 2012.3
Area Plans or Area Plan Amendments
Moved to Section 3000
Public Hearings
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 2013
Target Populations
Moved toSection 2038
Section 4008.1
Case Management Allowable Activities
Moved toSection 4008.2
Section 4008.2
Services Not Allowed Under Case Management
Moved toSection 4008.3
Section 4008.3
Entities Not Allowed to Conduct Case Management Services
Moved toSection 4008.3.2
Section 4010
Family Caregiver Support Program
Changed toSection 4011
Home Health Aide (Department of Health Term)
Removed
Section 4008.7.1(c)
Minimum Qualifications for Individual Case Managers
Wording changed
Section 4016 - Chart 9
45 CFR 1321.53(b)(1)
Replaced with
Older Americans Act, 321(a)(3)
Section 5003.1
Eligibility Requirements for SSBG Funding
Condensed
Section 5007.4.2
AAA Provisions for Expenditures
Footnote1
Footnote removed
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 5009.5.3
Late Claims Procedures
Footnote1
Footnote revised
Section 6003.6
BAIHS Annual Report
Removed
Section 8000
Nutrition Services Program Administration
Title changed toNutrition Program Services
Section 8006.10
Case Management
Removed
Section 8006.12
National Program Information System (NAPIS)
Changed toSection 8006.11
Section 8006.12.1
Unit of Service (For NAPIS Reporting)
Changed toSection 8006.11.1
Section 8006.13
Provision of Nutrition Services
Changed toSection 8006.12
Section 8006.13.1 AAA and Provider Monitoring
Changed toSection 8006.12.1
Section 9009
DOL Performance Standards for the Grantee (FSSA DA)
Section 9 – More Information Page
Revised
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Nutrition Services - Appendix A - Menu Standards
Menu Planning (Part 6) (III)
Revised
Revised Chart Numbering
Chart 1 - Contact Information for the 16 Area Agencies on Aging
Chart 2 - Map of the 16 PSA’s
Chart 3 - Conflict of Interest Rules
Chart 4 - Older Americans Act, Section 305
Chart 5 - FSSA DA Appeals Chart
Chart 6 - Client/Applicant Appeals
Chart 7 - AAA Appeal Process
Chart 8 - Family Caregiver - Report Due dates
Chart 9 - 45 CFR 1321.53(b)(i)
Chart 10 - Content of State Plan
Chart 11 - PASRR Laws
Chart 12 - Administration of Programs
Indiana Code 12-10-1-3
Chart 13 - Public Law 89-73
Chart 14 - United States Code42, USC 3030c-2
Chart 15 - Illustration of the Data Upload Process
Chart 16 - Older Americans Act, Section 339
Chart 17 - Older Americans Act, Section 315(b)(2)
Chart 18 - Older Americans Act, Section 315(b)(i)
Chart 19 - Division of Aging
Policy Statement Regarding Nutrition Services
Chart 20 - Older Americans Act, Section 339
Chart 21 - Older Americans Act, Section 339(2)(g)
Chart 22 - Senior Community Service Employment Program Final Rule,
April 19, 2004
Chart 23 - SCSEP Citations and Codes
Chart 24 - Enrollment Priorities
Chart 25 - SCSEP Organizational Chart
Chart 26 - Tips for Success
Chart 27 - Performance Measures
Corrections
1. 5/13/05
Section 1008 (11)
Administration of Programs
Section 1022 –Chart 25
AAA Contact Information
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
Section 4010.11
Reports
Section 4012.4
The FSSA DA Policy and Procedure Regarding Home Health Services
Section 4012.5
AAA Policy and Procedure Concerning Home Health Services
Section 4016(b)
Information and Assistance Services (I&A)
Section 5002
(Title Only)
Community and Home Options to Institutional Care for the Elderly and Disabled
(CHOICE)
Section 5005.1.1(d)
Eligibility Requirements for Title III Funding
Section 5009.2.1 (a), (d) and (e) - Procurement Guidelines
2. 7/01/05
Removal of Chart 3 - Representation of the Aging and In-Home Services Network
Chart numbering corrected to conform to removal of Chart 3
PART 1
SECTION 1
ACRONYMS
GLOSSARY OF TERMS
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
ACRONYMS
AND
GLOSSARY OF TERMS
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
ACRONYMS
A&D
AAA
AAC
AARP
ACSI
ADA
ADC
ADS
ADL
AD/RSD
ADRC
ADP
AFDC
AGS
ALJ
ANHA
AoA
APS
APWA
ARCH
ASPA
ASU
ACCM
Aged and Disabled Medicaid Waiver
Area Agency on Aging
Area Advisory Council
American Association of Retired Persons
American Customer Satisfaction Index (SCSEP term)
Americans with Disabilities Act
adult day care
adult day services
activities of daily living
Alzheimer's Disease and Related Senile Dementia
Aging and Disability Resource Center
alternative disposition plan
Aid to Families with Dependent Care
Adult Guardianship Services
Administrative Law Judge
American Nursing Home Association
Administration on Aging
Adult Protective Services
Aging Public Welfare Association
Assistance to Residents in County Homes
Aging Service Provider Association
Administrative Services Unit
Assessment for Case Combine Management
BAA
BDDS
BID
BOOK
BQIS
broad agency announcement
Bureau of Developmental Disabilities Services
Bureau Information Directory
Books, materials, recreation, education (Children’s CHOICE/TANF) 1
Bureau of Quality Improvement Services
CAA
CAAP
CFR
CHOICE
CICOA
CM
CM
CMGT
CMHC
CMS
CRF/DD
CSMS
CSSU
community action agency
Community Action Against Poverty
Code of Federal Regulations
Community and Home Options to Institutional Care for the Elderly and
Disabled
Central Indiana Council of Aging
case manager
claims management (as related to RCAP) 2
case management (Children’s CHOICE/TANF)3
community mental health center
Centers for Medicare and Medicaid Services or Contract Management System
Community Residential Facility/Developmentally Disabled
Computer Software Management System
Client Support Services Unit (Part of the FSSA DA)
D&E
DD
DDRS
Diagnostic and Evaluation
developmentally disabled 4
5
Division of Disability and Rehabilitative Services
1
Added 5/13/05
Added 4/10/06
3
Added 5/13/05
4
Revised 4/10/06
5
Changed 7/01/05
2
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
1
DFR
DHHS
DMHA
DOL
DOT
DSM-IV
DTS
DWD
Division of Family Resources
Department of Health and Human Services (federal)
Division of Mental Health and Addiction
U.S. Department of Labor, including its agencies and organizational units
(as related to SCSEP)1
Department of Transportation
Diagnostic and Statistical Manual of Mental Disorders, fourth edition
Department of Technology Services
Department of Workforce Development
E&A
EAP
EDS/MARS
EMOD
Evaluation and Assessment
Energy Assistance Program or Employee Assistance Program
Electronic Data Systems/Management and Report System
Environmental Modifications
FFP
FFY
FMV
FR
FSSA
FY
Federal Financial Participation
2
Federal Fiscal Year (FFY)
3
Fair Market Value
Federal Register
Family and Social Services Administration
fiscal year
GAAP
GAO
GPRA
GTF AD/RSD
Generally Accepted Accounting Procedures
General Accounting Office
Government Performance and Results Act of 1993
Governor's Task Force (on Alzheimer's Disease and Related Senile Dementia)
HCBS
HCFA
HDM
HHS
HIPAA
HOP
HUD
HWSE
Home and Community Based Services
Health Care Financing Administration
home-delivered meal (nutrition)
Department of Health and Human Services
Healthcare Insurance Portability and Accountability Act of 1996
healthy older people
Housing and Urban Development
housing with services establishment
IAAAA
I&A
IAC
IADL
IAHSA
FSSA DA
IC
ICF
ICF/MR
IDEA
IDOA
IDETS
IEP
IFF
Indiana Association of Area Agencies on Aging
information and assistance
4
Indiana Administrative Code
instrumental activities of daily living
Indiana Association of Homes and Services for the Aging
FSSA Division of Aging
Indiana Code
intermediate care facility
intermediate care facility for the mentally retarded
Individuals with Disabilities Education Act
Indiana Department of Administration
Indiana Department of Employment and Training Services
5
Individual Employment Plan (as related to SCSEP)
intrastate funding formula
1
Moved from Section 9 - 4/10/06
Added 5/13/05
3
Added 4/10/06
4
Moved from Section 9 - 4/10/06
5
Moved from section 9 - 4/10/06
2
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
2
IHCA
IMD
INDOT
INsite
IPAS
IPPM
ISDH
IU
Indiana Health Care Association
Institution for Mental Diseases
Indiana Department of Transportation
Indiana In-Home Services Information Systems
Indiana Pre-Admission Screening (state program)
ICES Policy and Procedure Manual 1
Indiana State Department of Health
International Units (nutrition term)
LD
LCE
LOC
LOS
LTCA
learning disability
legal council for the elderly
level of care
level of services
long term care application
MAR
MAW
MCD
MFC
MI
MNT
MOA
MOU
MOW
MPSC
MR
MR/DD
MRT
MSW
MSA
MUA
MWU
Medicaid Recipient2
Medicaid Waiver Program
Medicaid
Medically Fragile Children Medical Model Waiver
mentally ill
Medical Nutrition Therapy
Memorandum of Agreement 3
Memorandum of Understanding
Meals on Wheels
multi-purpose senior center
mental retardation
mentally retarded/developmentally disabled
Medical Review Team
Master of Social Work
metropolitan statistical area
medically underserved area
Medicaid Waiver unit
NAAAA
NANASP
NAPIS
NASUA
NCEA
NCOA
NF
NF LOC
NF LOS
NRTA
NSI
NSIP
National Association of Area Agencies on Aging
National Association of Nutrition and Aging Service Providers
National Aging Program Information System
National Association of States Units on Aging
National Center on Elder Abuse
National Council on Aging
nursing facility
nursing facility level of care
nursing facility level of services
National Retired Teachers Association
Nutrition Screening Initiative
Nutrition Services Incentive Program
OAA
OACSEP
OASDHI
OBRA
OMB
Older Americans Act
4
Older Americans Community Service Employment Act
Old Age, Survivors, Disability, and Health Insurance Program
Omnibus Budget Reconciliation Act (1987 & 1990)
Office of Management and Budget (Federal)
1
Added 4/10/06
Added 4/10/06
3
Added 5/13/05
4
Moved from Section 9 - 4/10/06
2
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
3
OMPP
OJT
OT
Office of Medicaid Policy and Planning
1
On the Job Training (as related to SCSEP)
Occupational Therapy
PAS
PASRR
PDF
PERS
PHI
PL
PMU
PNA
POC/CCB
POE
PSA
PT
Pre-Admission Screening (first part of federal program PASRR)
Pre-Admission Screening/Resident Review
portable document format
personal emergency response system
protected health information
public law
professional management unit
Personal Needs Allowance – RCAP term
plan of care/cost comparison budget
point of entry
planning and service area
physical therapy
QA
QMRP
quality assurance
qualified mental retardation professional
RBA
RD
RES
RFA
RFI
Room and Board Assistance
Registered Dietitian
respite care
request for approval to authorize services
request for information
RFP
ROM
RR
RSDI
RSVP
RT
request for proposal
Regional Office Memorandum
Resident Review (second part of federal PASRR)
Retirement, Survivors, Disability Insurance (as related to SCSEP)2
Retired Senior Volunteer Program
Recreation Therapist
SCC
SCSEP
Specialized Child Care (Children’s CHOICE/TANF)3
Senior Community Services Employment Program
(authorized by Title V of the Older Americans Act)
Service Corps of Retired Executives
Single Entry Point
State Fiscal Year
state nursing facility
Social Security Administration
Social Services Block Grant
Supplemental Security Income
Social Security Disability Income
Social Security number
Social Security
Supplemental Security Income
specific learning disability
state unit on aging
social work
SCORE
SEP
SFY
SNF
SSA
SSBG
SSI
SSDI
SSN
SS
SSI
SLD
SUA
SW
1
Moved from Section 9 - 4/10/06
Moved from section 9 - 4/10/06
3
Added 5/13/05
2
FSSA DIVISION OF AGING Operations Manual
Revised 4/10/06
4
TA
TAG
TANF
TBI
TEGL
TEN
Title III
Title III-B
Title III-C
Title III-D
Title III-E
Title V
Title VII
Title XX
TRVL
TVP
Technical Assistance
Technical Assistance Guides
Temporary Assistance for Needy Families
Traumatic Brain Injury Medical Model Waiver
Training and Employment Guidance Letters (SCSEP)
Training and Employment Notices (SCSEP)
Grants for State and Community Programs for Aging
Supportive Services and Senior Centers
Nutrition Services
Disease Prevention and Health Promotion Services
National Family Caregiver Support Program
Community Service Employment for Older Americans
Allotments for Vulnerable Elder Rights Protection Activities
Social Services Block Grant – SSBG
Travel and Related Costs for Working Parent (Children’s CHOICE/TANF)1
Textured Vegetable Products (Nutrition Term)
USC
USDA
USDoL
United States Code
United States Department of Agriculture
United States Department of Labor
VR
Vocational Rehabilitation
WHCOA
WIA
White House Conference on Aging
Workforce Investment Act
*******
1
Added 5/13/05
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GLOSSARY OF TERMS
-Aabuse
Any of the following kinds of mistreatment:
(1) Intentional or willful infliction of physical verbal or demonstrative harm caused by
physical touch, oral or written language, or gestures with disparaging or derogatory
implications.
(2) Any necessary physical or chemical restraints or isolation not found in the care
plan.
(3) Punishment with resulting physical harm or pain.
(4) Sexual molestation, rape, sexual misconduct, sexual coercion, and sexual
exploitation.
(5) Any harm caused by:
(A) unreasonable confinement;
(B) intimidation;
(C) humiliation;
(D) harrassment;
(E) threats of punishment;
(F) deprivation;
(G) neglect; or
(H) physical or financial exploitation.
access
The availability and ability to obtain needed services and assistance.
access services
A category of services that provide information concerning public and voluntary
services and linkage to appropriate community resources through case management,
information and assistance, and outreach.
Acquired immunodeficiency syndrome (AIDS)
A viral disease that impairs the body's ability to fight disease. People with AIDS are
susceptible to a wide range of life-threatening diseases that would not ordinarily
threaten a person whose immune system is working normally. The AIDS virus is
transmitted in at least four ways: (1) through sexual contact, (2) by sharing an
infected hypodermic needle, (3) by receiving AIDS-infected blood or blood products
through transfusion or injection, and (4) by an infected mother transmitting AIDS to
her baby during pregnancy, during delivery, or from breast feeding.
act — see Older Americans Act
active treatment
In referring to persons who are mentally ill or mentally retarded, active treatment
means identifying the social, developmental, intellectual, behavioral, medical, and
nutritional strengths and needs of the client; developing a program intended to turn
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1
the identified strengths and needs into measurable objectives; and implementing an
individual written care plan that is reevaluated on a regular basis.
activities of daily living (ADLs)
A measurement of a person’s degree of independence when eating, bathing,
dressing, and moving from one place to another. Also refers to an activity
described in the long term care services eligibility screen.1
adaptive aids and devices
Controls, appliances, or supplies determined necessary to enable the client to
increase his or her ability to function in a home- and community-based setting with
independence and physical safety.
Administration on Aging (AoA)
A federal agency established in the Office of the Secretary of Health and Human
Services that is headed by the assistant secretary of aging. The AoA is the federal
agency responsible for administering the OAA (except for Title V, which is
administered by the Department of Labor).
admission date (IPAS and PASRR)
The date that an individual is physically admitted to a NF and an active record is
opened for that individual.
adult abuse (Older Americans Act)
The willful infliction by a person of injury, unreasonable confinement, intimidation,
cruel punishment, or deprivation of goods or services that is necessary to avoid
physical harm, mental anguish, or mental illness of an adult and that results in
physical harm, pain, or mental anguish.
adult child with disabilities (Older Americans Act)
A person who is 18 years of age or older, has a disability, and is financially
dependent on an older adult who is the person's parent.
adult day services
A structured, comprehensive program that provides a variety of health, social,
recreational, and supportive services in a protective setting for persons who require
daytime supervision. An alternative between receiving care in the home and care in
an institution for persons over 18.
adult foster care services
A living arrangement in which an individual lives in the private home of a principal
caregiver who is unrelated to the individual.
Adult Guardianship Services (AGS)
Includes the provision of full guardianships as well as less restrictive alternative
services. Adult guardianship services are provided to indigent, incapacitated adults
who are unable to care for themselves properly or manage their own affairs without
assistance due to certain incapacities. Program services include the identification and
evaluation of indigent adults in need of guardianship services through assessment
and intensive case work. Individualized service plans are developed to provide the
least restrictive type of guardianship or related service for the protected person and
to involve them in the planning and decision making to the fullest extent their
capabilities allow.
1
IC 12-10-10-1.5 added 4/10/06
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Adult Protective Services (APS)
Protects adults 18 years of age or older from neglect, battery, and exploitation. It is
administered by the FSSA DA and implemented by the offices of the prosecuting
attorney on the local level. Regional offices investigate reports of suspected abuse as
defined in the law. Hoosiers are required by law to report suspected abuse of older
adults. Failure to report is a crime.
advance directives
Legal tools used for lifetime planning to help persons make decisions for an
individual who has become incapacitated and is no longer able to make decisions for
him/herself. Examples of advance directives are power of attorney, health care
representative, and living-will and life-prolonging procedures declaration.
advance funds (advances)
Funds paid to grantees at grant initiation to provide funds for cash flow.
advisory bodies
A group, commission, board, council, or task force comprised of persons who share
particular interests and provide FSSA DA with consultation, counsel, advice, and
recommendations regarding specific services, programs, and plans.
advocacy
The process by which the needs of older adults are brought to the attention of
decision makers at all levels of government, and in private and nonprofit sectors of
society, as well. As an instrument for social and policy change, it includes
identification of problems and strong support of the best solutions; the formulation of
policy issues; policy development; recommendations concerning resource allocation;
and analysis of various social trends as they are likely to affect older adults and
persons with disabilities. This includes all efforts to promote, obtain, or maintain the
rights, services, and benefits of older adults and persons with disabilities.
advocacy representation
Actions taken on behalf of an older adult or person with disabilities to secure his or
her rights or benefits. It includes receiving, investigating, and working to resolve
disputes or complaints. Advocacy representation does not include services provided
by an attorney or a person under the supervision of an attorney.
advocate
A person who assists an individual with decision making and self determination; and
is chosen by the individual or the individual’s legal representative, if applicable. An
advocate is not a legal representative unless legally appointed.
Aged and Disabled Medicaid Waiver
A Medicaid-funded program that provides services to persons 65 years of age or
older and/or to persons who meet Medicaid disability guidelines. Aged and Disabled
Waiver services provide quality in-home care to Medicaid-eligible individuals who
require the level of care found in a NF and are at risk of institutionalization.
ageism
Discrimination against people on the grounds of age, specifically discrimination
against older adults.
aging network
A term used to describe the entire system providing services to older adults.
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The aging network includes state agencies, AAAs, the Administration on Aging, and
advocacy groups and organizations that are providers of direct services to older
adults receiving funds from the OAA.
alcoholism
A chronic disease in which repeated episodes of drinking alcoholic beverages cause
injury to the individual's health, social functioning, or economic well-being. Alcohol
impairs mental alertness, judgment, and physical coordination, further increasing the
risk of falls and accidents already common among older adults. Alcohol can also
produce a wide range of side effects similar to those of prescription and over-thecounter medications.
alternate dessert (as related to Nutrition Services)
A substitute dessert item offered in place of the main dessert (to be defined by
an individual AAA). Typically, the alternate dessert is lower in calories, fat, and
simple (refined) carbohydrates. Examples include fresh fruit, sugar-free gelatin
and pudding, small servings (typically limited to one time per week) of angel
food cake, sponge cake without icing, gingersnaps, vanilla wafers or similar
items.1
Alzheimer's disease
A form of dementia that produces severe intellectual deterioration in older adults and
is currently considered an irreversible disease.
Alzheimer's Disease and Related Senile Dementia Task Force—also see disclosure form
A program funded through a state appropriation to provide education, and/or training
to caregivers, professionals, paraprofessionals, students, teachers, and the general
public on AD/RSD.
American Association of Retired Persons (AARP)
A national organization that represents special interests and issues affecting older
adults in state and national legislation. AARP also produces publications and
educational programs concerning specific aging issues, administers a volunteer
talent bank, and sponsors a network of AARP community service projects.
Americans with Disabilities Act (ADA)
Federal legislation passed in 1990 designed to address and eliminate discrimination
faced by people with disabilities. The Act is divided into the following five titles that
provide for equal opportunities and access:
Title I states that no covered entity shall discriminate against a qualified individual
with a disability because of the disability of such individual in regard to any terms,
conditions, and privileges of employment.
Title II prohibits discriminating against or excluding a qualified person with a disability,
by reason of the disability, from participation in or denying benefits of the services,
programs, or activities of a public entity.
Title III prohibits discrimination with respect to public accommodations by private
entities.
Title IV requires common carriers, as defined under the Communications Act of 1934,
to provide telecommunication relay services.
1
Added 4/10/06
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Title V contains miscellaneous provisions and enforcement policies.
Annual Report (FSSA DA)
The FSSA DA annual report which reports on the progress and accomplishments of
the FSSA DA. (See IC 12-10-10-11)
annual review
A review of an individual’s services that may include the following: visits and/or
conversations with the individual, family or advocate, and service providers;
assessment of skills; and a review of available documentation of an individual’s
progress on goals and objectives or other report.
appeal
An administrative Procedures in which an older adult or person with disabilities may
seek to reverse or change a decision or denial regarding their eligibility for services.
application
The act of requesting a screening or assessment to comply with program mandates.
The written or printed form on which the request is made.
applicant (FSSA DA)
a natural person or entity who applies to the FSSA DA for approval to provide one or
more home and community based services.
Area Advisory Council (AAC)
Each area agency has an advisory council that carries out advisory functions to
further the area agency's mission of developing and coordinating community-based
systems of service for older adults in the agency's PSA.
Area Agencies on Aging (AAAs)
An established network of independent agencies that provide services to older adults
and persons with disabilities through the use of funds provided by various federal,
state, and local sources. Each area agency is the local leader in regards to all aging
issues for older adults in their designated planning and service area (PSA).
area plan
Each area agency must develop and prepare a 1 to 4 -year area plan with
adjustments to be made on an annual basis. The area plan, if approved by the FSSA
DA, serves as the basis of agreement between the FSSA DA and the area agency.
The area plan must outline and include certain assurances and provisions regarding
services and recipients of services funded with OAA (Title III) funds and all other
funding sources. The area plan must meet the requirements of the area plan format
provided to the area agencies by the FSSA DA.
assessment screening
Standard examinations, procedures, or tests for the purpose of gathering information
about a person to determine need and/or eligibility for services.
Assistance to Residents in County Homes (ARCH)—see Residential Care Assistance
Program
assisted living
A program approach within a prescribed physical structure, which provides or
coordinates a range of supportive personal and health services, available on a 24
hour basis, for support of resident independence in a residential setting. Assisted
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living promotes and supports resident self-direction in decisions that emphasize
choice, dignity, privacy, individuality and independence in home-like surroundings.
assistive technology
Technology, engineering methodologies, or scientific principles appropriate to meet
the needs of, and to address the barriers confronted by older adults with functional
limitations and persons with disabilities.
(a) A term used to indicate that an older adult or person with disabilities is vulnerable
or susceptible to serious illness or harm due to the person's mental, physical, or
social condition and is in need of supportive services or placement.
(b) A common medical term used by geriatricians to indicate that older people,
especially frail older adults, are susceptible to periods of confusion when placed
under physical or mental stress.
attendant care
A service necessitated by a client's physical or mental impairment. Such services
primarily involve hands-on assistance with a client’s physical-dependency needs.
These maintenance or supportive services are furnished in the home of frail or
impaired persons to ensure health and safety and are defined in the plan of care.
attorney for proposed protected person (Guardianship term)
An attorney who represents the protected person and the protected person's wishes
in a guardianship case. A protected person is a person who has been declared
incapacitated and in need of a guardian by the court.
Authorized Representative
Legal representative1
autism
A condition that starts in infancy or childhood (prior to age 36 months) and is
characterized by an impairment in reciprocal socialization skills, impairment in verbal
and nonverbal communication skills and imaginative activity, and/or a noticeably
restricted repertoire of activities and interests.
authorized position level (as related to SCSEP)
A number of enrollment opportunities that can be supported for a 12-month
period based on the average national unit cost. The authorized position level is
derived by dividing the total amount of funds appropriated for age unit cost per
participant for that Program Year as determined by the DOL. The national
average unit cost includes all costs of administration, other participant costs,
and participant wage and fringe benefit costs as defined in section 506(g) of
the OAA. A grantee’s total award is divided by the national unit cost to
determine the authorized position level for each grant agreement.2
-Bbid guarantee
A firm commitment such as a bid bond, certified check, or other negotiable instrument
accompanying a bid as assurance that the bidder will, if its bid is accepted, execute
the required contractual documents within the time specified.
1
2
Added 5-13-05
Moved from Section 9 - 4/10/06
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Bill Payer Services
A component of the Money Management Program. It is a financial protective service
program that assists lower-income older adults or persons with disabilities who have
difficulty with budgeting, keeping track of financial matters, and paying routine bills.
The Bill Payer Program is administered by the FSSA DA.
blind
(a) A central visual acuity of 20/200 or less in the individual's better eye with the best
correction; or
(b) a field of vision that is not greater than 20 degrees at its widest diameter.
bond (Guardianship term)
Required by the court in many states to ensure a guardian will faithfully discharge the
duties of a guardian of the person/or estate of the protected person. The bond is
fixed by the court in an amount sufficient to protect the person's property, estate, and
creditors.
budget
Financial plan of operation applicable to a specific time period, as required by statute
or regulation, that includes authorized expenditures and anticipated revenues. The
purpose of a budget is to keep expenditures within available resources.
FSSA Division of Aging (FSSA DA)
The FSSA DA is the State’s Unit on Aging and one of the entities within the Family
and Social Services Administration.
(a) The FSSA DA is the principal agency in Indiana responsible for the
implementation of the OAA. It is the focal point for all matters relating to the needs of
older persons within the state of Indiana and the lead advocate for older Hoosiers in
planning, coordinating, funding, and evaluating programs and administering the
resources and programs it is responsible for through federal and state legislation.
(b) In addition, the FSSA DA manages and coordinates a comprehensive in-home
services program for older adults and persons of all ages with disabilities who are at
risk of losing their independence. It uses available federal, state, and local resources
to ensure that, within funding capabilities, eligible older adults and persons of all ages
with disabilities are able to remain in their homes as long as possible, while
enhancing their sense of dignity and worth.
Bureau of Developmental Disabilities Field Service Office (IPAS and PASRR term)
The locally based entity that is staffed by field services coordinators. There are 8
BDDS field offices located statewide.
Bureau of Developmental Disabilities Field Service Coordinator (IPAS and PASRR term)
An individual employed by the BDDS Field Service Office who is responsible for
assisting in assessing service needs for MR/DD individuals, providing case
management of services, and offering the PASRR residential alternative.
Bureau of Developmental Disabilities Services (BDDS)
The entity within DDRS that is responsible for defining, funding and monitoring a
variety of supported living services for individuals who have developmental
disabilities and who reside in Indiana.
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Bureau of Fiscal Services (BFS)
Supports all DDRS operations with budget, fiscal, and contract management.
Bureau of Quality Improvement Services (BQIS)
Continually assesses the quality of services of the three program bureaus and
recommends improvements.
-Ccaregiver
An individual who has the responsibility for the care of an individual voluntarily, by
contract, by receipt of payment for care, or as a result of the operation of law.
care plan (also called plan of care)
A plan written by the case manager, from the comprehensive assessment, to
establish supports and strategies intended to accomplish the individual’s long term
and short term goals by accommodating the financial and human resources offered,
as well as behavioral-related assistance to the individual through paid provider
services or volunteer services or both, as designed and agreed upon by the
individual.
caretaker (Older Americans Act)
A family member or other individual who provides (on behalf of such individual or of a
public or private agency, organization, or institution) uncompensated care to an
individual who needs supportive services.
case cap
An established maximum number of units or dollar level that the total cost of the
services to be provided under the care plan cannot exceed.
case management
An administrative function conducted locally by an area agency on aging that
includes:
assessment of an individual to determine the individual’s functional
impairment level and corresponding need for services.
development of a care plan addressing an eligible individual’s needs.
supervision of the implementation of appropriate and available services
for an eligible individual.
advocacy on behalf of an eligible individual.
monitoring the quality of community and home care services provided
to an eligible individual.
reassessment of the care plan to determine the continuing need and
effectiveness of the community and home care services provided to an
eligible individual.
provision of information and referral services to individuals in need of
1
community and home care services.
1
IC 12-10-10-1 expanded - 4/10/06
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case management services
Services that enable an individual to receive a full range of appropriate services in a
planned coordinated efficient and effective manner including but not limited to, an
appropriate, complete, accurate and comprehensive assessment.
case manager
An employee of an area agency, a private case-management agency, or an
independently employed person who provides case management.
catchments area
Refers to the geographic area from which a particular program, agency or facility
draws the bulk of its users.
caterer – Organization contracted by the nutrition service provider to provide meal services
within the planning and service area.1
categorically needy
Medicaid cases of aged, blind, or disabled individuals or families and children eligible
for Medicaid who meet financial-eligibility requirements for Aid to Families with
Dependent Children (AFDC) or SSI.
Centers for Medicare and Medicaid Services
A branch of the Department of Health and Human Services. This Federal agency is
responsible for administering the Medicare and Medicaid programs and approves all
waivers amendments. Formerly HCFA (Health Care Financing Administration).2
certification
Certification enables the service provider to receive payments from a government
funding source such as CHOICE or Title III funding. Certification may also be within
the scope and range of other staff unconnected with licensing. Licensing is decided
by each state. A license allows a service provider to operate. Licensing staff may
evaluate a service provider for licensing and certification separately.
Certified Dietitian (as related to Nutrition Services)
An individual who is a registered dietitian in the State of Indiana who also has been
designated as a “Certified Dietitian”. Certification for a registered dietitian in Indiana
is not mandatory. It is a title protection. The registered dietitian who holds the
designation of a “Certified Dietitian” must complete 30 CEUs – 2 year period).3
child
As used in Title III-E of the OAA with respect to the National Family Caregiver
Support Program, means an individual who is not more than 18 years old.
Claim
(a) With respect to an incapacitated person or a minor, any liability of the
incapacitated person or minor—whether arising in contract, tort, or otherwise—and
any liability against an incapacitated person’s or a minor’s property that arises before,
at, or after the appointment of a guardian, including expenses of administration.
(b) A document or form used to submit for payment for services.
1
Added 5/13/05
Added 4/10/06
3
Added 7/01/05
2
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client
A term used to describe an individual who resides in Indiana and had submitted an
application to the local AAA for services, is receiving services provided through case
management originating from the area agency, or has applied for and/or is receiving
social services.
Code of Federal Regulations
Found in the Federal Register published by the Department of Health and Human
Services, Offices of Human development and Administration on Aging.
co-enrollment (as related to SCSEP)
Completed for any individual who meets the qualifications for participation as
well as the qualifications for any other relevant program as defined in the
1
Individual Employment Plan.
co-insurance
The share paid by the patient for Medicare-covered services above the deductible
amount set by Medicare.
Commission on Aging (IC 12-10-2)
A 16-member advisory group appointed by the Governor to do the following: to
encourage study and discussion of issues relating to the aging and the aged; to
promote the organization of and to officially recognize voluntary councils for the study
and discussion of problems of the aging and the aged; and to assist FSSA DA in the
development of a comprehensive plan to meet the needs of older adults.
Community Action against Poverty (CAP)
A statewide program providing local services and advocacy not otherwise provided
by state agencies to Indiana's disadvantaged, elderly, and disabled. Services include
recreation and employment training; access to medical services; home energy
assistance; weatherization; Head Start; emergency food and shelter; and
transportation.
Community and Home Options to Institutional Care for the Elderly and Disabled (CHOICE)
Program (authorized by Indiana Code 12-10-10)
CHOICE provides case management services, assessment, and home and
community based service to adults who are at least 60 years of age or persons of
any age who have a disability due to a mental or physical impairment and who are
found to be at risk of losing their independence. CHOICE is the funding of last resort
for home and community based services. Accordingly, CHOICE funding shall be
used after all other possible payment sources have been identified and all
reasonable efforts have been employed to utilize those sources (including services
under Medicaid and Medicaid waivers.)
community health center (also known as neighborhood health center)
An ambulatory health-care program, usually serving a catchments area with scarce
or non-existent health services or a population with special health needs. Community
health centers attempt to coordinate federal, state, and local resources in a single
organization capable of delivering both health care and related social services to a
defined population.
Community mental health center (CMHC)
A locally based service agency designated by the Division of Mental Health authority
to receive money, provide mental health services, and act within the parameters of a
1
Moved from Section 9 - 4/10/06
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CMHC defined within the Federal Mental Health Act. A CMHC liaison (IPAS and
PASRR term) is the individual employed by techs who is designated to perform Level
II assessments for mentally ill persons and to act as an intermediary within the
mental health system on behalf of these programs.
community service (Title V term)
Employment assignments in social, health, welfare, and educational services for
eligible individuals enrolled in the OACSEP.
community services
Services provided within the home or community rather than in an institutional
setting.
community services (as related to SCSEP)
Services which include, but are not limited to, social, health, welfare, and
educational services (including literacy tutoring); legal assistance, and other
counseling services, including tax counseling and assistance and financial
counseling; library, recreational, and other similar services; conservation,
maintenance, or restoration of natural resources; community betterment or
beautification; anti-pollution and environmental quality efforts; weatherization
activities; and economic development. (OAA SECTION 516(1))1.
comprehensive care facility (IPAS and PASRR term)
Also referred to as health facility, nursing facility, or nursing home. An institutional
setting licensed under IC 16-10-4 by the Department of Health, Division of Long Term
Care, to provide comprehensive nursing care, room, food, laundry, administration of
medications, special diets, and treatments, and that may provide rehabilitative and
restorative therapies under the order of an attending physician. Comprehensive care
facilities may be private only, Medicare certified, or Medicare/Medicaid certified. For
purposes of IPAS and PASRR, the terms nursing facility and comprehensive care do
not include an ICF/MR or facilities licensed for residential care.
comprehensive and coordinated system (Older Americans Act)
A system for providing all necessary supportive services, including nutrition services,
in a manner designed to:
(A) facilitate accessibility to and utilization of all supportive services and
nutrition services provided within the geographic area served by such system
by any pubic or private agency or organization;
(B) develop and make the most efficient use of supporting services and
nutrition services in meeting the needs of older individuals;
(C) use available resources efficiently and with a minimum f duplication; and
(D) encourage and assist public and private entities that have unrealized
potential for meeting the service needs of older individuals to assist the older
individuals on a voluntary basis.
Computer Software Management System
A computer application used by the FSSA Division of Aging to gather and
organize data on clients receiving in-home and community-based services.
conflict of interest
1
Moved from Section 9 - 4/10/06
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A conflict between the public obligations and the private interests of an official. In
order to establish uniform guidelines within the FSSA DA and within the area
agencies and to avoid giving preferential/favorable treatment, the hiring of family
members is restricted or is not allowed.
congregate meals (Older Americans Act)
A meal provided to a qualified individual in a congregate or group setting. The meal
as served meets all the requirements of the Older Americans Act and State/Local
laws.
continuing-care retirement center (CCRC)
A life-care multi-level living arrangement consisting of several settings intended to
meet an individual's needs at various stages of life that usually includes individual
dwellings, apartments, or nursing facilities. Parameters of individual care are outlined
and provided in a life-care contract executed between the individual and the CCRC.
continuing education
The compilation and distribution of information on institutions of higher learning within
each PSA concerning courses of study offered to older adults and the policies related
to fee charges to older adults.
Core Services
Services described in Section 134(d) (2) of Workforce Investment Act. 1
cost share (CHOICE term)
A method of cost reimbursement for those individuals who can pay all or a portion of
the cost of services rendered.
County Council on Aging
An organization formed within a county that participates in planning, assessing the
needs, and advocating for older adults in their county.
Court
The court having probate jurisdiction and, where the context permits, the court having
venue of the guardianship.
day-care meal
The day-care meal is a meal provided to the client—at least once a day at the adult
day-care site—that is nutritionally balanced and provides a minimum of one-third of
the current daily recommended dietary allowance (RDA) specified appropriate for the
client.
deductible
Specified amount to be paid by a client or patient for covered services before
reimbursement begins.
Department of Health and Human Services (DHHS)
The federal agency responsible for implementing all health and human servicesrelated legislation enacted by Congress. It includes such agencies as the AoA, SSA,
Food and Drug Administration, and Health Care Financing Administration.
Department of Labor (as related to SCSEP)
The United States Department of Labor, including its agencies and
organizational units which administers a variety of Federal labor laws including
those that guarantee workers’ rights to safe and healthful working conditions;
1
Added 4/10/06
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a minimum hourly wage and overtime pay; freedom from employment
1
discrimination; unemployment insurance; and other income support.
DetermineYour Nutritional Health Checklist (as related to Nutrition Services)
Developed and distributed by the Nutrition Screening Initiative, sponsored in part
through a grant from Ross Products Division, Abbott Laboratories, American
Academy of Family Physicians and The American Dietetic Association.2
developmental disability
A severe, chronic disability that is attributable to a mental or physical impairment or a
combination of mental or physical impairments (other than a sole diagnosis of mental
illness). Manifestation occurs before the person attains 22 years of age and is likely
to continue indefinitely.
Diagnostic and Evaluation Team (D&E Team—PAS term)
The D&E Team is a group of professionals with different expertise who are
responsible for evaluating MR/DD individuals to determine their level of functioning.
The D&E Team is responsible for completing the evaluation of an MR/DD individual
who is seeking admission to a NF and does not meet the requirements to be exempt
from the screening.
diagnostic services
(a) The provision of coordinated services, including, but not limited to, psychological,
social, medical, and other services as necessary to identify the presence of
developmental disability, its cause, and complications.
(b) In physical health, diagnostic services are x-ray, laboratory, and pathology
services when such services are directed toward the diagnosis of illness or injury.
Dietary Supplements (as related to Nutrition Services)
Defined in Section 201 of the Federal Food, Drug, and Cosmetic Act as a product
(other than tobacco) intended to supplement the diet that bears or contains one or
more of the following ingredients.
(1) a vitamin;
(2) a mineral;
(3) an herb or other botanical;
(4) an amino acid;
(5) a dietary substance for use by man to supplement the diet by increasing
the total dietary intake; or
(6) a concentrate, metabolic, constituent, extract, or combination of any
3
ingredient described in clause (1), (2), (3), (4), or (5). Dietary supplements
of vitamins and minerals do not provide macronutrients (protein,
carbohydrate, fat, calories), nor do they usually contain the more than 40
nutrients needed daily and the hundreds of additional substances found in
plant and animal foods that are important to health. 4
direct cost
Those costs that are readily identifiable with a specific contract and program (i.e.,
salaries, purchases, or services furnished specifically for the program).
direct delivery of services
1
Moved from Section 9 - 4/10/06
Added 7/01/05
3
Use of Medical Food and Food for Special Dietary Uses in Older Americans Act Nutrition Program,
5/04: National Policy & Resource Center on Nutrition & Aging, Florida International University)
4
Added 7/01/05
2
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Services provided directly to an older adult or person with disabilities, by the staff of
an AAA, or the FSSA DA, in a PSA.
disabled
A person who is incapacitated according to established eligibility criteria. (Different
programs have different eligibility criteria.)
disability (Older Americans Act)
The term “disability” means (except when such term is used in the phrase “severe
disability”, “developmental disabilities”, “physical or mental disability”, physical or
mental disabilities” or “physical disabilities” ) a disability attributable to mental or
physical impairment, or a combination of mental and physical impairments that
results in substantial functional limitations in 1 or more of the following areas of major
life activity: (A) Self-care (B) Receptive and expressive language, (C) learning, (D)
mobility, (H) cognitive functioning, and (I) emotional adjustment.
disability (as related to SCSEP)
A disability attributable to mental or physical impairment, or a combination of
mental and physical impairments, that result in substantial functional
limitations in one 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 functioning, and
(I) emotional adjustment. 1
disbursement
Payments made by either cash or check.
Disease Prevention and Health Promotion Services
Disease Prevention and Health Promotion Services, funded under Title III, Part F of
the OAA, provides information, counseling, and services at senior centers,
congregate meal sites, and other appropriate sites. In carrying out these services,
priority is given to serving those older adults who have the greatest economic need
and who are living in areas that are medically underserved.
Disclosure Form—Alzheimer’s and Dementia Special Care
A state-mandated form (IC 12-10-5.5) prepared by a health facility and submitted
each December to the FSSA DA regarding care provided in a health facility to
individuals with Alzheimer’s and dementia. The form discloses the following: the
health facility’s mission statement; staff qualifications; assessment criteria for
admission, transfer, and discharge, including the process used in preparing and
changing a plan of care; an itemization of fees and charges; and guidelines for using
physical and chemical restraints. The forms are available upon request.
Disclosure Form—Housing with Services Establishment (HWSE)
A state mandated form (IC 12-10-15) prepared by a HWSE and submitted to the
FSSA DA after the first resident has signed a contract and after the first resident has
moved into the HWSE, annually thereafter, and within 30 days of certain changes or
1
Moved from Section 9 - 4/10/06
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amendments. The form discloses HWSE information regarding the following: the
owners and operators; types of living quarters and base rate ranges; services offered
and fees charged; contract information; and a complaint Procedures. A list of all
establishments that filed a disclosure form is available upon request.
Division of Disability, and Rehabilitative Services (DDRS ) – Formerly DDARS
Part of the FSSA within the government of Indiana. It consists of the following
entities:
(a) Blind and Visually Impaired Services
(b) BDDS
(c) BQIS
(d) Deaf and Hard of Hearing Services (DHHS)
(e) Disability Determination Bureau
(f) Vocational Rehabilitation Services
Durable power of attorney
A power of attorney that:
(a) Is executed by an incapacitated person before that person became an
incapacitated person;
(b) Provides that the power survives the person’s incompetence; and
(c) Is executed in accordance with the effective law in effect in the jurisdiction in
which it was executed on the date it was executed.
-Eeconomic need
The need resulting from an income level at or below the poverty level as established
by the OMB.
equitable distribution report (as related to SCSEP)
A report based on the latest available Census data, which lists the optimum number
of participant positions in each designated area in the State, and the number of
authorized participant positions each grantee serves in that area, taking the needs of
underserved counties into account. This report provides a basis for improving the
1
distribution of positions.
elder abuse
Abuse of an older individual.
Eldercare (national campaign)
The AoA sponsored program to establish and promote public and private
partnerships that address the needs of the growing population of older persons and
their caretakers.
eligibility criteria for in-home services program
Eligibility for in-home services varies and is based on which state or federal funding
source is used to pay for services. Eligibility ranges from an individual having to be
60 years of age or older and meeting eligibility for Medicaid to being at risk of losing
one's independence.
1
Moved from Section 9 – 4/10/06
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eligibility determination
The procedures required to establish that an individual or family fulfills the criteria for
receiving services based on the need for a service, residency in Indiana, and
variables of family size and income.
eligible
A term to describe a client who has been determined to meet the criteria for receiving
a service, approved by the FSSA DA.
employment counseling
A service that assists eligible persons in obtaining and maintaining employment. (see
Older American Community Service Employment Program)
encumbrance
A legal claim against an account or program (e.g., a contract, a purchase order, or an
unpaid invoice). A reserve of funds set aside for outstanding obligations.
environmental modifications
A physical adaptation to an individual’s home without which the individual would
require institutionalization. Environmental modifications may include the following:
(1) Installation of lifts or ramps
(2) Installation of grab bars
(3) Widening of doorways
(4) Modification of kitchen or bathroom facilities
(5) Other services specified in Section 6108—Minor Home
(6) Modifications/Environmental Modifications
exploitation (Older Americans Act, Section 102 (24))
The illegal or improper act or process of an individual, including a caregiver, using the
resources of an older adult for monetary or personal benefit, profit, or gain.
extended care facility (ECF)
Sub-acute care or non-acute care beds physically located within the confines of an
acute-care hospital. These beds are usually used for such purposes as extended
recuperative care for hospital inpatients, as a holding bed area for individuals
awaiting transfer to a free-standing NF, or for other designated purposes specified by
the hospital with approval of the Department of Health. The Indiana Code citations
under which these beds are licensed depend primarily on who administers the unit. If
the hospital retains full control and administration over the unit, it is usually licensed
under IC 16-21-2. However, if the unit operates independently of the hospital
administration, either under contract or subcontract to another entity or through
another means, it is usually licensed under IC 16-28-2. Licensure under IC 16-10-4
requires compliance with the IPAS requirements.
-Ffamily and caregiver training services
Training and education to instruct a parent, family member, or primary caregiver in
the treatment regimens and use of equipment specified in an individual’s care plan.
Training to improve the ability of the parent, family member, or primary caregiver to
provide care for the individual.
Family and Social Services Administration (FSSA)
An Indiana government administration that works with families, children, senior
citizens, people with disabilities and people with mental illness, providing services to
promote self-sufficiency, independence, prevention, health and safety. The agency
FSSA DIVISION OF AGING Operations Manual
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has four main divisions: Division of Family and Children; Division of Mental Health
and Addiction; Division of Disability, Aging and Rehabilitative Services; Office of
Medicaid Policy and Planning. The four divisions report to the FSSA Secretary, who
is a member of the Governor's cabinet.
family caregiver
An adult family member or other individual who is an informal provider of in-home
and community care to an older individual.
federal funds authorized
Represents the total amount of funds approved or the ceiling to be provided under
the grant or contract with the State.
federal poverty level
As defined by federal guidelines, the federal poverty level is measured by maximum
annual income level and the size of the family. Poverty guidelines are to be used by
area agencies to determine greatest economic need under Title III of the OAA.
fiscal year (FY)
A 12-month period covered by an annual budget and at the end of which financial
position and results of operations are determined. The FSSA DA contracts for
services on the state fiscal year.
State Fiscal Year: July 1–June 30
Federal Fiscal Year: October 1–September 30
focal point (Older Americans Act)
A highly visible facility established to encourage the maximum collocation and
coordination of services for older individuals where anyone in a community can
obtain information and access to aging services. Many multi-service senior centers
as well as other types of centers are designated by the area agency to serve as
designated focal points.
functionally impaired
A term to describe individuals unable to perform without assistance a number of
ADLs and/or IADLs. May include cognitive impairment.
-Ggeneral purpose unit of local government—see unit of general purpose local government
geriatric evaluation unit
A unit housed within the immediate-care area of a hospital that provides care for
older-adult patients needing hospitalization but who no longer require acute care.
geriatrician
A physician who specializes in the diagnosis and treatment of the diseases and
problems specific to aging.
geriatrics
The branch of medicine that deals with the diagnosis and treatment of diseases and
problems specific to aging.
gerontology
The study of physiological and pathological phenomena associated with aging.
Governor's Conference on Aging and In-Home Services (Indiana)
FSSA DIVISION OF AGING Operations Manual
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17
Legislatively mandated (IC 12-10-1-4(17)), the Governor's Conference on Aging and
In-Home Services is conducted annually as a forum for learning about issues related
to the aging and aged, as well as individuals with disabilities.
grandparent or older individual who is a relative caregiver
A grandparent or step grandparent of a child, or a relative of a child by blood or
marriage, who is 60 years of age and 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.
grant period (as related to SCSEP)
The period between the effective date of the grant and the ending date of the
award, which includes any modifications extending the period of performance,
whether by the DOL’s exercise of options contained in the grant agreement or
otherwise. Also, referred to as “projected period” or “award period”. 1
grantee
An agency or entity which is receiving funds granted or awarded by the sponsoring
agency. The AAAs are grantees of the State Agency and the service providers are
the subgrantees of an Area Agency on Aging. (Also, see subgrantees.)
grantee (as related to SCSEP)
An entity receiving financial assistance directly from DOL to carry out
activities. The grantee is the legal entity that receives the award and is legally
responsible for carrying out the SCSEP, even if only a particular component of
the entity is designated in the grant award document. Grantees include States,
Tribal organizations, territories, public and private non-profit organizations,
agencies of a State government or a political subdivision of a State, or a
combination of such political subdivisions that receive grants from the DOL
(OAA Section 502). In the case of section 502(e) projects, grantee may be used
to include private business concerns. As used here, the term “grantees” has
the meaning is defined in 29 CFR 97.3 and “recipients” as defined in 29 CFR
95.2(g). For Indiana, the grantee is FSSA DA. 2
grants
The awarding of a sum of money for a specified purpose. The award may have
stipulations covering the expenditures and it may or may not be continuous in nature.
greatest economic need (Older Americans Act)
Signifies those older persons with incomes at or below the Bureau of Census poverty
threshold.
greatest social need (Older Americans Act)
The need caused by non-economic factors, including physical and mental disabilities;
language barriers; and cultural, social, or geographical isolation, including isolation
caused by racial or ethnic status, that restrict the ability of an individual to perform
normal daily tasks or threaten the capacity of the individual to live independently.
group average
1
2
Moved from Section 9 - 4/10/06
Moved from Section 9 - 4/10/06
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A method for managing costs of care plans across a group of clients, so low cost
clients can compensate for the clients who are considered as high cost. The ceiling
applies to an average of the care plans for an established group of clients.
guardian (Guardianship term)
A person who is a fiduciary and is appointed by a court to be a guardian or
conservator responsible, as the court may direct, for the person or the property of an
incapacitated person or a minor. The term includes a temporary guardian, a limited
guardian, and a successor guardian but excludes one who is only a guardian ad
litem. The terms guardian and conservator are interchangeable.
guardian ad litem (Guardianship term)
A person, usually an attorney, appointed to represent the best interests (not
necessarily the protected person's desires) of the potential protected person at a
guardianship hearing. The judge may appoint a guardian ad litem when a
disinterested person is needed for an objective investigation of the protected person's
situation.
guardian of the estate (Guardianship term)
A person appointed to manage the financial affairs of the protected person by paying
bills, managing investments, and handling property within the limits prescribed by the
court. In Indiana, this person is also called a conservator.
guardian of the person (Guardianship term)
A person with responsibility for the health, well-being, and personal needs of the
protected person. The guardian of the person makes such decisions as where the
protected person will live, who will provide care, and the kinds of services the
protected person will receive.
guardianship (Guardianship term)
Someone appointed by a court to make decisions for an incapacitated person has
guardianship of that incapacitated person. In Indiana, conservator and guardian
mean the same thing. Types of guardianships include temporary guardianship,
permanent guardianship, limited guardianship, and plenary (full) guardianship.
guardianship property
The property of an incapacitated person or a minor for which a guardian is responsible.
-Hhabilitation services
Essential services designed to maximize the functioning level of older adults and
persons with developmental disabilities in order to develop and retain capacity for
independence, self-care, and social functioning. These services are coordinated
through a program of objectives designed to obtain goals related to diversion of the
individual from an institutional placement or enabling deinstitutionalization of the
client, as well as meeting active treatment needs.
health-care facility
Structure that is licensed and/or certified for a specific level of care, in which healthcare activities are carried out. This includes hospitals; psychiatric hospitals;
tuberculosis hospitals; skilled-nursing facilities; immediate-care nursing facilities;
kidney-disease treatment centers; and freestanding NFs.
FSSA DIVISION OF AGING Operations Manual
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health education
Instructional information on health-related topics, lifestyle issues, and health risk
factors designed to change perceptions of health matters and issues.
health screening
An initial, basic exam or test designed to detect abnormalities before such
abnormalities become chronic or debilitating. Many of these screenings are
performed free of charge in locations easily accessible for older adults, such as
senior centers, congregate meal sites, or community centers.
High Nutritional Risk (as related to Nutrition Services)
An individual who scores 6 or higher on the Determine Your Nutritional Health
Checklist published by the Nutrition Screening Initiative. 1
home-and community-based services (HCBS)
Supportive services required to help functionally impaired older adults or persons
with disabilities living in the community to remain independent or self-sufficient. The
functional impairment may be temporary, short term, or a permanent or long-lasting
condition.
home-delivered meal (HDM)
A meal provided to qualified individual in his/her place of residence. The meal is
served in a program administered by AAA and meets all of the requirements of the
Older Americans Act and State/Local law.
home equity conversion mortgage (Housing term)
Creative financial product that allows older adults or persons with disabilities to turn
home equity into cash flow and allows them to stay in their homes.
home health aide
A Department of Health term set out in 410 IAC 17-6-1(d) through (k) (Indiana) and
42 CFR, Part 484.36 (federal) that provides information regarding home health aide
qualifications, the subject areas covered in the aide training program and in the
competency-evaluation program, and the frequency of supervisory visits.
home health aide services
The provision of professionally directed services as defined in the plan of care and
performed by a trained home health aide in the client's home. A home health aide is
under the general supervision of a registered nurse. A home health aide provides
personal care such as assistance with grooming and personal hygiene. (see 410 IAC
17-1.1-11; 410 IAC 17-6-1(d) through (k); 42 CFR, Part 484.36.)
home health services and supplies
Includes all health-service activities performed in the home, including supervision of
administering medication and dressing changes.
home repair and maintenance services
Planned and supervised maintenance or repair activities essential for the prevention
and/or correction of health and safety hazards that would prevent premature
institutionalization of older adults or persons with disabilities.
homebound (as related to Nutrition Services)
The status of individuals that are physically homebound (by reason of illness or
incapacitating disability and under the care of a physician) and/or socially
1
Added 7/01/05
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20
homebound; and are unable to prepare meals for himself or herself because of:
limited physical mobility; or
a cognitive impairment; or
lacks the knowledge or skills to select and prepare nourishing and wellbalanced meals; and
lacks an informal support system such as family, friends, neighbors, or others
who are willing and able to perform the service(s) needed, or the informal
support system needs to be temporarily or permanently supplemented.
Transportation is not provided.1
homemaker services
Includes direct and practical assistance with household tasks and related activities
when the client or an informal caregiver is unable to meet the client’s needs.
hospital discharge planner (IPAS and PASRR)
An employee of an acute-care hospital who is responsible for performing the
necessary activities associated with identification of service needs and linkage to
service providers following discharge from the hospital.
The acute-care hospital discharge planner may be appointed by the local IPAS
agency, with approval of the FSSA DA, to function as an IPAS program designee to
authorize "direct from hospital" temporary admissions to a NF. The discharge planner
designee will base such approval on the applicant's need for care as demonstrated in
a review of the hospital's record ("substantially complete assessment").
host agency (SCSEP - Title V term)
A public agency or private nonprofit organization, other than a political party or any
facility used or to be used as a place for sectarian religious instruction or worship,
that is exempt from taxation under certain provisions of the Internal Revenue Code of
1986, which provides a work site and supervision for an enrollee.
Housing and Urban Development (HUD)
United States Department of Housing and Urban Development administers programs
concerned with housing needs and fair housing opportunities nationally.
housing with services establishment (HWSE)
An establishment that provides sleeping accommodations to at least five residents
and offers or provides for a fee a variety of supportive services further described in IC
12-10-15-6. An operator of a HWSE must file a disclosure form with FSSA DA that
sets forth the contract provisions between the HWSE and the resident as well as
other information listed in IC 12-10-15-11. (see disclosure form)
1
Added 7/01/05
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-Iincapacitated person
An individual who:
(a) Cannot be located upon reasonable inquiry;
(b) Is unable:
(1) To manage in whole or in part the individual’s property;
(2) To provide self care; or
(3) Both;
Because of insanity; mental illness; mental deficiency; physical illness; infirmity;
habitual drunkenness; excessive use of drugs; incarceration; confinement; detention;
duress; fraud; undue influence of others on the individual; or other incapacity; or
(c) Has a developmental disability (as defined in IC 12-7-2-61).
Independent case manager
Case-management services can be provided to older adults and persons with
disabilities by private, independent case-management companies or by individual
case managers outside of the AAAs, if the personnel providing the casemanagement services meet the minimum qualifications for an individual case
manager.
independent service provider
A person who is paid to provide services to an older adult client and who is not acting
as an agent of a service provider agency.
Indiana Governor's Conference — see Governor's Conference on Aging and In-Home
Services.
Indiana Pre-Admission Screening (IPAS)
Also known as pre-admission certification. Pre-admission screening is an
assessment process that evaluates for the appropriateness of NF admission and is
required for every applicant, regardless of age, seeking admission to a NF. PAS
provides the opportunity for the provision of long term care services in a location that
is conducive to the physical and the psychological well-being of the individual while
also functioning as an effective mechanism of health-care cost containment.
indirect costs
Costs that are incurred for a common purpose, benefit more than one objective or
grant program, and are not readily assignable to individual programs.
Individual Employment Plan or IEP (as related to SCSEP)
A plan for a participant that includes an employment goal, achievement of
objectives, and appropriate sequence of services for the participant based on
an assessment conducted by the subgrantee and jointly agreed upon by the
participant. (OAA Section 502(b) (1) (N). Intensive services means those
services authorized by Section 134(d) (3) of the Workforce Investment Act. 1
information and assistance services (I&A)
A service that includes all efforts to provide information about services or benefits
available to older adults or persons with disabilities and assistance in accessing the
services needed.
1
Moved from Section 9- 4/10/06
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1
in-home services
Services provided for older adults or persons with disabilities in their own home or
apartment, such as homemaker, home-health aide, attendant care, home-delivered
meals, and case management.
IN-Home Services Program
Funding from federal, state, and local funds brought together to provide a broadbased approach to organizing and arranging for delivery of home- and communitybased long-term care services to individuals at least 60 years of age and persons
with disabilities who are at risk of losing their independence. A case management
system implemented to provide a single point of entry for services through the AAAs.
INsite
An automated case management system designed to allow case managers to
process individual cases via computers rather than using hard copy forms and
procedures. INsite allows case managers to assign and select service providers and
rates, and create individual care plans. INsite also has query and report capabilities
to allow management of individual cases, including monitoring procedures. INsite is
used to create fiscal records for CHOICE, SSBG and Title III funded services.
intake
The initial interview to identify the client's needs and to collect demographic data.
intermediate care facility/mentally retarded (ICF/MR)
A facility that cares solely or has particular services for the mentally retarded.
IPAS agency
The local entity designated by DDRS and under contract with Medicaid to administer
the IPAS program and perform IPAS assessments. Currently, the IPAS agencies are
synonymous with the 16 area agencies on aging.
IPAS area manager
An individual employed by the IPAS agency who is responsible for overall program
operations. The individual must have a thorough understanding of the objectives and
operation of the IPAS program and of long-term care services and must be able to
function effectively in a leadership position with the screening team. The area team
must be able to assure the accomplishment of the IPAS process by providing
necessary direction and technical assistance.
IPAS coordinator
An individual employed by the IPAS agency, subject to the approval of FSSA DA ,
who may authorize temporary admittance to a NF within the parameters of the IPAS
program without the final approval required under IPAS.
IPAS designee
An individual appointed by the IPAS agency, subject to the approval of the FSSA DA
, who may authorize temporary admittance to a NF within the parameters of the IPAS
program without the final approval required under IPAS.
institutional care
Continuous, 24-hour NF care provided by, among others, hospitals, skilled-nursing
facilities for the mentally retarded, community residential facilities for the
developmentally disabled, and state-owned and -operated mental hospitals.
FSSA DIVISION OF AGING Operations Manual
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2
interpreting/translating
A service that provides for explaining oral and written communication to a person
who cannot understand English and/or has disabilities that hinder conventional
communication methods.
Isolation (as related to Nutrition Services)
Isolation due primarily to an individual residing in a rural location which does not
afford access to a congregate meal setting because:
(1) A congregate setting is not located or available in the community; and
(2) No transportation is available to a neighboring community with a
congregate setting; or
(3) The eligible individual is not able, or chooses not, to drive to a
neighboring community with a congregate setting.1
-JJobs for Veterans Act
The program established in Section 2 of the Public Law 107-288 (2002) (38
U.S.C. 4215), that provides a priority for veterans and the spouse of a member
of the Armed Forces on active duty who has been listed for a total of more than
90 days as missing in action, captured in the line of duty by a hostile force, or
forcibly detained by a foreign government or power , the spouse of any veteran
who has a total disability resulting form a service-connected disability
resulting from a service connected disability so evaluated was in existence,
who meet program eligibility requirements to receive in any DOL funded
workforce development program. 2
-K-
-Lleast-restrictive environment
An environment that does not limit life activities unnecessarily and in which older
adults or persons with disabilities may receive appropriate services.
Legal Assistance Services (also known as Legal Service)
Legal advice and representation for persons over 60 years of age (as funded under
OAA) in civil matters by an attorney and counsel, or representation by a non-lawyer
where permitted by law, including counseling or other appropriate assistance by a
paralegal and under the supervision of an attorney regardless of location.
The medical, physical, and social care given to persons who have severe chronic
impairments. Can mean care in the home by family members, assistance through
voluntary or employed help, or care in an institution.
1
2
Added 7/01/05
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Level I: Identification Screen (IPAS and PASRR)
A screening tool that consists of eight questions designed to ascertain an individual's
condition to determine the following: (1) whether the PASRR definition of mental
illness (MI) and/or MR/DD is met; and (2) the need for NF services, specialized
services, and/or services of a lesser intensity than specialized services.
Level II: PASRR Assessment (IPAS and PASRR)
A multidimensional assessment designed to assess or evaluate the individual's
condition to determine whether the PASRR definition of mental illness (MI) and/or
MR/DD applies.
licensed health facility administrator (IPAS and PASRR)
An individual employed by a licensed comprehensive-care facility/NF to manage,
supervise, and have general administrative charge over its operation. The
administrator may or may not have any ownership interest in the facility. His or her
functions and duties may be shared with one or more other individuals.
Long Term Care Eligibility Screen
Eligibility screen used by the FSSA DA to make eligibility determinations. The
long term eligibility screen must conform to the established activities of daily
living.1
Local Board (as related to SCSEP)
A local Workforce Investment Board established under Section 117 of the
Workforce Investment Act.2
local Workforce Investment Area or local area (as related to SCSEP)
An area established by the Government of a State under Section 116 of the
Workforce Investment Act.3
low-income
Persons who are at or below the income level as determined by the OMB for a given
number of persons per household.
low-income minority elderly
Minority elderly with an annual income at or below the federally established poverty
level.
-Mmeans test
Procedures used to determine if and how much of a client’s income and resources
can be used to contribute to the individual’s authorized services. Evaluation of an
older adult’s income or resources to determine eligibility for services.
mediation (negotiation) (Legal Assistance term)
Action or remedy to resolve minor disputes on rights, benefits, and services. As the
client's representative, program staff may contact other persons concerned with the
client's legal problem in order to clarify factual or legal contentions and possibly reach
an agreement to settle legal claims.
1
IC 12-10-10-4.5 added 4/10/06
Moved from Section 9 - 4/10/06
3
Moved from Section 9 - 4/10/06
2
FSSA DIVISION OF AGING Operations Manual
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Medicaid
A medical-assistance program that provides federal grant dollars to match state
dollars for programs of hospital and medical services. Medicaid provides
reimbursement for medical and health-related services to persons who are medically
indigent. NF care for needy older adults is also covered by Medicaid.
Medical Food (as related to Nutrition Services as defined in Public Law 100-290)
The Orphan Drug Amendment of 1988 is food which is formulated to be consumed or
administered internally under supervision of a physician and which is intended for the
specific dietary management of a disease or condition for which distinctive nutritional
requirements, based on recognized scientific principles, are established by medical
1
evaluation. Medical foods are known by a variety of names, such as nutrition
supplements, “liquid meals”, and oral supplements. However, the most appropriate
statutory term is medical food. Medical foods may not replace conventional meals
unless a physical disability warrants their sole use.
Medical Nutrition Therapy (as related to Nutrition Services)
Medical nutrition therapy (MNT), a multi-step process begins with assessment of the
nutritional status of the individual with a condition, illness, or injury that puts them at
nutritional risk. MNT is often an important component of the clinical management of
chronic diseases, such as heart, lung, kidney diseases, stroke, diabetes, and some
types of cancer. MNT is also used in the treatment of acute conditions, such as
fractures, pre/post surgery, burns, and other traumas. MNT also addresses the
multitude of factors influencing one’s nutritional status, from chewing and swallowing
problems, appetite changes, gastrointestinal problems such as nausea, vomiting,
diarrhea and constipation, food procurement problems of mobility and limited
finances. Once significant nutrition problems are identified, a care plan is then
developed that includes provision of appropriate type(s) of nutrition services including
diet modification, counseling and/or nutrition interventions/ treatments using special
products. While medical nutrition therapy involves the expertise of a
registered/licensed dietitian, the care plan is often a multidisciplinary effort because
of the multi-factorial nature of malnutrition problems. 2
Medicaid Waiver
The Medicaid waiver programs are funded with both State and Federal dollars.
All waiver programs have been initiated by the Indiana General Assembly and
approved by the CMS. Eligibility for all waiver programs requires:
The recipient must meet Medicaid guidelines.
The recipient would require institutionalization in the absence of the waiver
and/or other home based services.
The total aggregate Medicaid cost of serving the recipient on the waiver (waiver
cost plus other Medicaid services) cannot exceed the total aggregate cost to
Medicaid for serving the recipient in an appropriate institutional setting.
Current Indiana waivers include:
Aged and Disabled waiver
Autism Waiver
DD Waiver
1
Use of Medical Food and Food for Special Dietary Uses in Older Americans Act Nutrition Program),
5/04: National Policy & Resource Center on Nutrition & Aging, Florida International University. Added
7/01/05
2
Added 7/01/05
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Medically Fragile Children’s waiver
Traumatic Brain Injury Waiver
Assisted Living Waiver
Support Services Waiver
Medicaid Waivers administered by the FSSA DA are the Aged and Disabled
Waiver, the Assisted Living Waiver, the Traumatic Brain Injury Waiver and the
Medically Fragile Children’s Waiver. 1
Medically Fragile Children Medical Model Waiver
A Medicaid-funded program that provides in-home and community-based services on
behalf of medically fragile children and is designed to divert or deinstitutionalize
certain special-needs children from hospital or NF care. In addition to being Medicaid
eligible, the client must (1) be less than 18 years of age; (2) be medically fragile, with
severe, chronic physical conditions that result in prolonged dependency on medical
care or technology to maintain health and well-being characterized by periods of
acute exacerbation or life-threatening condition; and (3) have a need for
extraordinary supervision and observation and frequent or time-consuming
administration of specialized treatments or have a dependency on mechanical
support devices.
medically underserved area (MUA)
A designation granted by the United States Public Health Service for a county, a
census tract, or a minor civil division. The designation of MUAs has significance for
eligibility or priority in a number of federal health programs, including Title III -Part F of
the OAA.
The MUA index developed by the federal government uses the percentage of
population below poverty level, the percentage of population over 65 years of age,
the average infant-mortality rate for the preceding five years, and the number of
primary care physicians per 1,000 people for each area to define medical
underservice.
medically underserved population
The population of an urban or rural area with a shortage of personal-health services.
Another population group may be defined in terms of one or more of the following
categories: population with incomes below the poverty level, number of persons
Medicaid eligible, medically indigent population, migrant workers and their families,
and Indians or Alaskan natives.
Medicare
A national health-insurance program for people 65 years of age or older, certain
persons with disabilities who are under 65 years of age, and people of any age who
have permanent kidney failure. The Health Care Financing Administration (HCFA) is
the agency that administers the Medicare program.
(a) Hospital insurance (Part A Medicare) is financed by a portion of payroll (FICA) tax
that also pays for Social Security; and
(b) Medical insurance (Part B Medicare) is partly financed by monthly premiums paid
by the people who choose to enroll.
1
Added 4/10/06
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mental illness
Emotional disability that seriously impairs feelings, thought processes, and behavior
to such a degree that working, relating, and communicating with others becomes
difficult or impossible. There are usually biological, psychological, and
socioenvironmental factors influencing the development of a mental illness.
mental retardation (MR)
A significantly sub-average general intellectual functioning existing concurrently with
deficits in adaptive behavior and manifested during the developmental period.
minor
An individual who is less than 18 years of age and who is not an emancipated minor.
minor home modifications services
Selected internal and external modifications to the home environment that will assist
older adults and persons with disabilities to increase their functional ability and
enhance their safety and well-being in order to avoid institutionalization.
minority elderly
Persons over the age of 60 who are:
(a)
(b)
(c)
(d)
American Indian or Alaska Native;
Asian or Pacific Islander;
Black, not of Hispanic origin; or
Hispanic.
Moderate Nutritional Risk (as related to Nutrition Services)
An individual who scores a 4 or 5 on the Determine Your Nutritional Health Checklist
published by the Nutrition Screening Initiative. 1
Modified Meals (as related to Nutrition Services)
The consistency of the food is changed by chopping, pureeing, thickening, blending,
mincing, braising, or otherwise softening hard to chew foods, such as meats, poultry,
etc. The provision of such foods should be planned and prepared under the advice
of a physician, registered nurse, registered dietitian, or other appropriate
professional, such as an Occupational Therapist or Speech Therapist. 2
money management services
The Money Management Program was established in coordination with AARP/LCE,
the SSA, and nonprofit agencies at the local level. The two components of the Money
Management Program are (a) the representative payee component, where trained
volunteers manage the benefits of individual clients, and (b) the bill-payer component
where the client retains control of his or her money, receiving assistance on money
management from trained volunteers.
monitoring
The ongoing process of gathering and analyzing data for the purpose of evaluating
program performance and compliance.
multi-purpose senior center (MPSC) (Older Americans Act)
A community facility for the organization and provision of a broad spectrum of
services that shall include health, social, nutritional, and educational services, and
the provision of facilities for recreational activities for older adults.
1
2
Added 7/01/05
Added 7/01/05
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-NNational grantee (as related to SCSEP)
Federal public agencies and organizations, private nonprofit agencies and
organizations, or Tribal organizations that operate under Title V of the OAA that
are capable of administering multi-State projects under a national grant from
the DOL. (See OAA Section 506(g)(5)). 1
needs assessment services
The evaluation of needs of older adults and persons with disabilities in communities
where all federal and state services are not currently available.
neglect (Older Americans Act)
The failure to provide for oneself or the failure of a caregiver to provide the goods or
services necessary to avoid physical harm, mental anguish, or mental illness.
Non-Coercive (as related to Nutrition Services)
Does not force a participant to act or think in a given way by pressure, threats, or
intimidation.2
no means test (SSBG)
No eligibility limitations.
non-eligible participant
Person required to pay full costs of a service, such as a meal eaten at a congregate
meal site.
non-profit (Older Americans Act)
An agency, institution, or organization that consists of, or is owned and operated by,
one or more corporations or associations. No part of its net earnings inures, or may
lawfully inure, to the benefit of any private shareholder or individual. (501(C)(3) entity.
nursing facility (NF) (also see comprehensive care facility)
A health-care facility that provides health-related care and services that are above
the level of room and board and below the level of acute care provided in a hospital
setting and:
1
2
(a)
Is primarily engaged in providing nursing care and related services for
patients who require medical or nursing care and rehabilitation services;
(b)
Has formal policies that are developed with the advice of a group of
professional personnel to govern the nursing care and related medical
services it provides;
(c)
Has a physician, a registered professional nurse, or a medical staff
responsible for the execution of such policies;
(d)
Requires that the health care of every patient be under a physician's
supervision and makes provision for a physician to be available to furnish
necessary emergency medical care;
(e)
Maintains medical records on all patients;
Moved from Section 9 - 4/10/06
Added 7/01/05
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(f)
Provides 24-hour nursing service with at least one registered professional
nurse present at all times;
(g)
Provides for dispensing and administering of drugs;
(h)
Has a utilization-review plan that meets the requirements of the law;
(i)
May be certified to participate in Medicare or Medicaid or both; and
(j)
Is licensed pursuant to Indiana law and approved by the state agency
responsible for licensing institutions of this nature as meeting standards
established for such licensing.
nursing-facility payments
Payments (including both federal and state share) to Medicaid certified vendors for
NF services. Payments to nursing facilities fall into two principal categories—
payments to an intermediate-care facility for the mentally retarded (ICF/MR) and
payments to other nursing facilities that include all other Medicaid-certified ICF and
skilled-care facilities. ICF services include all services provided by an institution
furnishing health-related care and services to individuals who do not require the
degree of care provided by hospitals or skilled-nursing facilities as defined under Title
XIX of the SSA.
nutrition counseling (As related to Nutrition Services)
Information and guidance to individuals who are at nutritional risk because of their
health or nutrition history, dietary intake, chronic illnesses, or medications use, or to
caregivers. Counseling is provided one-on-one by a registered dietitian, and
addresses the options and methods for improving nutrition status. 1
nutrition education
A program to promote better health by providing accurate and culturally sensitive
nutrition, physical fitness, or health (as it relates to nutrition) information and
instruction to participants , caregivers, or participants and caregivers in a group or
individual setting overseen by a Dietitian or individual of comparable expertise. 2
Nutritional Supplement - See medical food definition.
3
4
Nutrition Services Incentive Program (NSIP)
A Nutrition Services Incentive Program (NSIP) Meal is a meal served that meets all
the requirements of the OAA, means at a minimum that: (1) it has been served to a
participant who is eligible under the OAA and has NOT been means-tested for
participation; (2) it is compliant with the nutrition requirements; (3) it is served by an
eligible agency; and (4) it is served to an individual who has an opportunity to
contribute. NSIP meals also include home delivered meals provided as
Supplemental Services under the National Family Caregiver Support Program (Title
III-E) to persons aged 60 and over who are either care recipients (as well as their
spouse of any age) or caregivers.
Nutrition Service Provider (as related to Nutrition Services)
Organization designated by the AAA to provide nutrition services with the program
1
Added 7/01/05
Administration on Aging, HHS, Reporting Requirements For Title III and VII, September 26, 2003
3
Added 7/01/05
4
Added 7/01/05
2
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service area.
-OOmbudsman
As required by the OAA, the ombudsman is responsible for responding to complaints
regarding the health, welfare, quality of life, and rights of NF residents. The
ombudsman is required to investigate complaints and to provide information
regarding the program, NF/patient responsibilities, and patient rights to anyone who
is interested.
Office of Management and Budget (OMB)
A federal agency with the authority to assemble and revise the requests for
appropriations of various federal departments and establishments as well as wholly
owned government corporations.
Office of Medicaid Policy and Planning (OMPP)
The state agency that does the following: administers the Medicaid program in
Indiana; handles reimbursements to Medicaid providers; grants prior authorization to
nursing facilities for level of care; terminates Medicaid eligibility for the Medicaid
disability program; and is involved in policy issues that affect determination of
Medicaid benefits.
Old Age, Survivors, Disability, and Health Insurance Program (OASDHI)
A program administered by the SSA that provides monthly cash benefits to retired or
disabled workers and their dependents and to survivors of insured workers. It also
provides health-insurance benefits for persons 65 years of age and older, and for the
disabled under 65 years of age. The health-insurance component of OASDHI was
initiated in 1965 and is generally known as Medicare. (see Medicare)
older adult
An individual who is 60 years of age or older. 1 For some services and programs,
other than those supported through Title III funding, older adult refers to an individual
who is 55 years of age or older.
Older Americans Act (OAA)
Federal legislation first enacted in 1965 that created the structure for dealing
comprehensively with the needs of older adults through the AoA within the DHHS.
Each section of the act is called a title and makes provision for various services to
older adults. The act's eight titles are:
1
Title I
Declaration of Objectives
Title II
Administration on Aging
Title III
Grants for State and Community Programs on Aging
Title IV
Training, Research, and Discretionary Projects and Programs
Title V
Older American Community Service Employment Program
Title VI
Grants for Native Americans
Title VII
Allotments for Vulnerable Elder Rights Protection Activities
Older Americans Act, Section 102 (34)
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Older Hoosier Account
A state appropriation of funds to be used by the FSSA DA to cost share/match dollars
with various funding sources that support programs and activities for older adults.
ombudsman
As required by the OAA, the ombudsman is responsible for responding to complaints
regarding the health, welfare, quality of life, and rights of NF residents. The
ombudsman is required to investigate complaints and to provide information
regarding the program, NF/patient responsibilities, and patient rights to anyone who
is interested.
One-Stop Center (as related to SCSEP)
The One-Stop Center system in a WIA Local Area which must include a
comprehensive One-Stop Center through which One-Stop partners provide
applicable core services and which provides access to other programs and
services carried out by the One-Stop partners. (See WIA SECTION 134(c)(2)).1
One-Stop Delivery System (as related to SCSEP)
A system under which employment and training programs, services, and
activities are available through a network of eligible One-Stop partners, which
assures that information about and access to core services is available
regardless of where the individuals initially enter the statewide workforce
investment system. (WIA SECTION 134(c)(2)). 2
One-Stop partner (as related to SCSEP)
An entity described in Section 121(b)(1) of the Workforce Investment Act; i.e.,
required partners, and an entity described in section 121(b)(2) of the Workforce
Investment Act, i.e., additional partners. 3
Other participant (enrollee) cost (as related to SCSEP)
The cost of participant training, including the payment of reasonable costs to
instructors, classroom rental, training supplies, materials, equipment, and
tuition, and which may be provided on the job or in conjunction with a
community service assignment, in a classroom setting, or under other
appropriate arrangements; job placement assistance, including job
development and job search assistance; participant supportive services to
assist a participant to successfully participate in a project, including the
payment of reasonable costs of transportation, health care and medical
services, special job-related or personal counseling, incidentals (such as work
shoes, badges, uniforms, eyeglasses, and tools), child and adult care,
temporary shelter, and follow-up services; and outreach, recruitment and
selection, intake orientation, and assessments. (OAA Section 502(c)(6)(A)). 4
outreach services
Activities initiated to seek out and identify hard-to-reach individuals; provide
information about available services and benefits; explain how individuals may
1
Moved from Section 9
Moved from Section 9
3
Moved from Section 9
4
Moved from Section 9
2
- 4/10/06
- 4/10/06
- 4/10/06
- 4/10/06
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become recipients of services; or identify persons with the greatest social and/or
economic needs.
over-the-counter drug (OTC drug)
A drug that is advertised and sold directly to the public without a prescription.
-Pparent
A biological or adoptive parent. The term does not include a stepparent, foster
parent, or grandparent.
Part B payments
Payments made on behalf of persons eligible for Medicare Supplementary Medical
Insurance (SMI) by the state Medicaid program as part of a coverage group under a
federal-state agreement.
Participant (as related to SCSEP)
An individual who is eligible for, has been enrolled and is receiving services as
prescribed under subpart E of this part. 1
payment to client (as related to SCSEP)
Direct financial assistance in the form of money or a voucher. Includes wages (such
as for the OACSEP), stipends, and supplemental living allowance payments made
directly to the client or paid to a provider on the client's behalf.
periodic
Periodic, as used in the OAA with respect to evaluations of and public hearings on
activities carried out under state and area plans, means, at a minimum, once each
fiscal year.
permanent guardianship (Guardianship term)
This type of guardianship is of permanent duration and is established after a full
hearing. A person is judged incapacitated, and a guardianship is established
providing either for the care of the protected person or total management of his or her
estate, or both. The protected person loses substantial rights to self-determination
and in many states may no longer vote, marry, make a will, sign a contract, or choose
his or her own residence. The guardianship continues until either the court enters an
order to terminate the guardianship or the protected person dies.
person
An individual or an organization, association, nonprofit corporation, corporation for
profit; limited-liability company, partnership, financial institution, trust; or other
governmental entity or other legal entity.
Person-In-Charge (as related to Nutrition Services - Indiana Retail Food Code Title 410 IAC
7-24, Section 96, (Effective November 13, 2004)
Indiana Retail Food Code requires that there be a “person-in-charge” at the food
establishment during all hours of operation. The person shall be able to identify and
take corrective actions to eliminate high-risk practices that increase the potential for
food-borne illness. 2
person with disabilities
Any person who (a) has a physical, mental, or emotional impairment, or any
1
2
Moved from Section 9 - 4/10/06
Revised 4/10/06
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12
combination thereof that substantially limits one or more of the person's major life
activities; (b) has a record of such impairment; or (c) is regarded as having such an
impairment.
personal assistance (Medicaid waiver)
Service that provides the necessary assistance to help clients meet their daily needs
and to ensure adequate functioning in an independent-living arrangement or within
the family or alternative-family home.
The primary emphasis of the service is on direct assistance with daily living and
personal-adjustment activities, rather than the achievement of habilitative goals and
objectives by the individual.
Personal Emergency Response System Supports (PERS)
An electronic communication device that allows an individual to communicate the
need for immediate assistance in case of an emergency.
physical harm (Older Americans Act)
Bodily injury, impairment, or disease.
physician (IPAS and PASRR)
A duly licensed medical practitioner who is the applicant's medical doctor of choice,
as designated by the applicant at the time of application for IPAS. The physician must
know or be able to obtain knowledge of the individual's overall functioning abilities
and specialized service needs.
Placement (as related to SCSEP)
Employment placement into public or private unsubsidized employment means
full-or part-time paid employment in the public or private sector by a
participant for 30 days within a 90-day period without the use of funds under
Title V or any other Federal or State employment subsidy program, or the
equivalent of such employment as measured by the earnings of a participant
through the use of wage records or other appropriate methods. (OAA Section
513(c)(2)(A)). 1
plan of care—see care plan
planning and service area (PSA) (Older Americans Act)
Distinct area designated after consideration of geographical distribution of older
adults in the state; the incidence of the need for supportive services, nutrition
services, multipurpose senior centers, and legal assistance; the distribution of older
adults who have greatest economic need (with particular attention given to lowincome minorities) residing in such areas; the distribution of older adults who are
Native Americans; the distribution of resources available to provide such areas or
centers; and the boundaries of existing areas within the state that were drawn for the
planning or administration of supportive services programs, the location of units of
general purpose local government within the state, and any other relevant factors
and served by a designated AAA.
plenary (full) guardianship
This type of guardianship is of permanent duration and is established after a full
hearing. A person is judged incapacitated and a guardianship is established
providing for the care of the protected person. The protected person loses substantial
rights to self-determination, and in many states, may no longer vote, marry, make a
1
Moved from Section 9 - 4/10/06
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will, sign a contract, or choose his own residence. The guardianship continues until
either the court enters an order to terminate the guardianship or the protected person
dies. In some states the plenary guardianship is established for both the protected
person's person and estate.
Poor employment prospects (as related to SCSEP)
The likelihood that an individual will not obtain employment without the
assistance of SCSEP or any other workforce development program. Persons
with poor employment prospects include, but are not limited to, those without
a substantial employment history, basic skills, and/or English-language
proficiency; displaced homemakers, school dropouts, persons with
disabilities, including disabled veterans, homeless individuals, and individuals
residing in socially and economically isolated rural or urban areas where
1
employment opportunities are limited.
poverty line (Older Americans Act)
The official poverty line as defined by the OMB and adjusted in accordance with the
2
Community Services Block Grant Act.
Pre-Admission Screening/Resident Review (PASRR)
A program funded by Medicaid that assesses the needs of persons with MI or MR/DD
who are applicants to or residents of NFs for identifying needed services and to
determine if NF placement is appropriate.
Pre-packaged Meals (as related to Nutrition Services)
A program meal that is pre-portioned on plates, trays, or other single service
containers at an Indiana State Department of Health licensed facility for delivery to a
non-traditional setting for immediate consumption.3
preparation of legal documents (Legal Assistance Service)
Time spent preparing documents that support any other allowable activity. Writing
documents that serve to protect individual rights, such as contracts and advance
directives.
priority services
Services for which an AAA must spend at least a specified adequate portion of its
Title III-B social services allotment (excluding the amount used for administration).
Priority services are access, in-home, and legal assistance. There is also established
minimum percentage expenditure for the delivery of ombudsman services at the state
level.
program development
Activities directly related to either the establishment of a new service or the
improvement, expansion, or integration of an existing service. Program -development
activities must be intended to achieve a specific service goal or objective and must
occur within a specified time period, rather than being cyclical or ongoing.
program income
All funds directly resulting from service delivery, specifically including contributions
from eligible clients and charges to non-eligible clients. Also, earnings realized from
grant- or contract-supported activities, including such fees for service or sales of
supplies or assets. Interest earned on cash deposits or investments is not program
1
Moved from Section 9 - 4/10/06
Older Americans Act Section 102, (38)
3
Added 7/01/05
2
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income.
Program year (as related to SCSEP)
One-year period beginning July 1 and ending on June 30. (OAA Section 515(b)).
Project
an undertaking by a grantee or subgrantee according to a grant agreement that
provides community service, training, and employment opportuni ties to eligible
individuals in a particular location within a State.
promulgate
Usually refers to federal regulations, just as the term adopt is usually used to refer to
state rules. To publish or make known officially; to put a law into effect by publishing
its terms.
protected person (Guardianship term)
An individual for whom a guardian has been appointed or with respect to whom a
protective order has been issued.
protective proceeding
A proceeding for a protective order under IC 29-3-4.
protective services
Services necessary to ensure that older adults are aware of their rights; that the
rights of persons with disabilities are protected; and, in cases of abuse, that the least
restrictive services are available to alleviate abuse. Protective services may include
adult protective services, bill-payer services, guardianship services, legal assistance
services, ombudsman services, and representative payee services.
provider/service provider
A person or entity approved by the DDRS or its designee to provide the individual
with agreed upon services.
public hearing
An open and publicly announced meeting in which the public, administrative, and
elected officials have the opportunity to participate and comment on issues.
-Qquality assurance
The process of assessing, evaluating, and measuring the degree and consistency of
the quality of services and programs and taking responsibility for following up with
appropriate action in response to the results of quality assessment.
quorum
The minimum number of members who must be present at a meeting in order for
business to be legally transacted.
-R–
recipient
A grantee includes ‘‘recipients’’ as defined in 29 CFR 95.2(g) and “grantees’’ as
defined in 29 CFR 97.3. 1
1
Moved from Section 9 - 4/10/06
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referral
The practice of recommending a client for specific services or programs or an
individual who has been referred for services.
Region V
One of the federal regional offices whose function is to work directly with the state
agencies administering DHHS federal programs. The FSSA DA reports to the AoA
office of Region V.
Registered Dietitian (R.D.) (as related to Nutrition Services)
An individual who has completed academic and experience requirements established
by the Commission on Dietetic Registration (CDR) ADAs (American Dietetic
Association) credentialing agency, including a minimum of a bachelor’s degree from
an accredited college/university, and an accredited preprofessional experienced
program. Also, adheres to continuing professional educational requirements to
maintain registration established by the CDR. 1
Regular Diet (as related to Nutrition Services)
A meal which adheres to the Meal Planning Requirements and Appendix A: Menu
Standards.
regulation
A term usually applied to the interpretation of federal statutes that provide detailed
procedures for performing services under those laws. Rule is the term usually applied
to the interpretation of state statutes.
representative payee
An individual who is appointed by a government agency to handle the government
checks, such as Social Security or Civil Service, of someone who is unable to
manage his or her financial affairs.
Request for Approval to Authorize Services
A form that is required to be completed and submitted to the appropriate
administering entity, when requesting funds to purchase services, modifications, aids
or devices.
Request for Proposals (RFP)
Initial specifications for potential contract bidders; outlined programs. 2
Residence (as related to SCSEP)
An individual’s declared dwelling place or address as demonstrated by
appropriate documentation. 3
Residential Care Assistance Program (RCAP)
RCAP provides state supplemental assistance through ARCH and RBA. The
assistance is for eligible persons who are aged, blind, or disabled and who are
unable to live in their own homes but have less than NF level of care needs. Financial
eligibility is based on income and resources that are determined by the local Office of
Family and Children. ARCH and RBA funding sources provide payment for room and
board, laundry, nursing services, and minimal administrative duties. Individuals
residing in a residential care facility are generally ambulatory and physically and
mentally capable of managing their own affairs.
1
Added 7/01/05
Added 4/10/06
3
Moved from Section 9 - 4/10/06
2
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respite care services
Service provided to individuals unable to care for themselves that are furnished on a
temporary, intermittent, short term basis because of the absence or need for relief of
an unpaid caregiver.
responsible party (IPAS and PASRR)
An individual chosen by an applicant, or if the applicant is a minor or has been
adjudicated incompetent, a parent or the legal representative of an applicant who
assists in the process of making application for IPAS. The legal representative must
sign all applicable documents.
restoration (Guardianship term)
The court may find that the protected person's capacity to make and communicate
decisions has improved sufficiently such that a guardianship may no longer be
necessary. A hearing may be required to make this determination. This situation most
commonly arises when the protected person has an illness or injury from which he or
she recovers after a period of time.
Retail Food Establishment
“Retail Food Establishment” mean an operation that stores, prepares, packages,
serves, vends, or otherwise provides food for human consumption. For specific
definitions, see Retail Food Establishment Sanitation Requirements, Title 410 IAC 724, Section 79 (Effective November 13, 2004), Indiana State Department of Health.1
Retention in public or private unsubsidized employment (as related to SCSEP)
Full-or part-time paid employment in the public or private sector by a
participant for 6 months after the starting date of placement into unsubsidized
employment without the use of funds under Title V or any other Federal or
State employment subsidy program.(OAA Section 513(c)(2)(B)).2
Retention Schedule (as related to Nutrition Services)
Ideally, a retention schedule describes a discrete set of records and outlines its
disposition, which allows researchers to determine the location and/or the existence
of records dealing with a particular topic or issue. Consequently, retention schedules
are key to understanding what records are produced by the AAA and their
contractors. 3
Room and Board Assistance Program (RBA)—see Residential Care Assistance Program
rural elderly
Older persons who live in rural zip code designations as defined by the federal AoA.
-Ssenile dementia
A broad term that includes several subgroups such as Alzheimer's disease, multiple
strokes, normal-pressure hydrocephalus, and other similar disorders. Dementia
symptoms include changes in memory that can be mild, but can become severe to
1
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Added 7/01/05
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the point of total loss of recent and remote memory, developing into a confused state
and, eventually, death.
senior center
Senior centers are the hub of community services and are often the entry point into
the service network for older adults. They offer a broad spectrum of services to older
adults including health, social, and educational services, and some centers serve as
meal sites.
senior center activities
Activities and services provided in senior centers that prevent isolation, improve
personal life satisfaction, and promote successful independent living. Activities may
include intergenerational activities, current-events discussions, field trips, healthpromotion/fitness activities, recreational activities, and arts and crafts activities.
Senior Community Employment Service program (Title V)
A program that fosters and promotes useful, part-time employment opportunities for
low-income persons (below 125% of poverty guidelines) who are 55 years of age or
older.
service area (as related to SCSEP)
The geographic area served by a local project. 1
service authorization
The function of approving the type and quantity of services a client can receive, in
accordance with state policies. Explicit authorization is needed for a client to gain
access to the program's services.
service provider
Local organizations, businesses, companies, and individuals that area agencies
contract with to deliver various services under the area plan to eligible older adults
and persons with disabilities.
severe disability
A chronic disability attributable to mental or physical impairment or a combination of
mental or physical impairments that:
(a) Is likely to continue indefinitely; and
(b) Results in substantial functional limitation in three or more of the
following activities:
(1) Self-care;
(2) Receptive and expressive language;
(3) Learning;
(4) Mobility;
(5) Self-direction;
(6) Capacity for independent living; and
(7) Economic self-sufficiency.
shared housing (Housing term)
Arrangement in which two or more related persons share a house or apartment.
Usually private sleeping quarters are available while the rest of the house is shared.
single point of entry
Refers to an identifiable local agency with primary responsibility for access and
1
Moved from Section 9 - 4/10/06
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linkage. Functions performed as a part of the single entry point mechanism can
include screening; assessment; eligibility; development of a care plan; service
authorization; referral; arrangement of services; monitoring; client tracking; and
reporting. The 16 AAAs are the single point of entry for the IN-Home Services
Program.
single-room occupancy (Housing term)
Renter-occupied one-room housing units in an apartment building or a residential
hotel available to low-income persons.
Social Security Administration (SSA)
As part of the United States DHHS, SSA manages the Social Security Program. SSA
manages Medicare through the Bureau of Health Insurance.
Social Security Retirement, Survivors, and Disability Insurance
Monthly cash benefits that are administered by the SSA.
Social Services Block Grant (SSBG)
SSBG is a consolidated federal grant given to states to use for a variety of services.
The FSSA DA uses SSBG money to fund a compilation of in-home, communitybased, and facility-oriented services targeted for low-income older adults and
persons with disabilities.
Special Meals (as related to Nutrition Services)
A meal which is designed to meet the particular dietary needs arising from the ethnic
backgrounds, or religious requirements of program participants.1
special resident services
Provide screening and needs-assessment recommendations for older adults and
mentally ill and mentally retarded persons regarding the appropriateness of NF
placement. Also assists older adults and persons with disabilities who are unable to
live in their own home but do not need the degree of care provided in a NF by
providing supplemental cash assistance for residential care facilities.
Standardized Recipe (as related to Nutrition Services)
An established set of instructions describing the way a particular establishment
prepares a particular dish. In other words, it is a customized recipe developed by an
operation for the use of its own cooks, using its own equipment, to be served to its
own patrons. 2
state agency
The state agency designated by the state under Section 305 (a) (1) of the OAA, as
amended 2000.
State Plan
A document submitted to the AoA, for approval, that outlines the rationale, goals,
mission statement, assurances, and strategies for service delivery and systems
enhancement of an aging network in a State.
state unit on aging
The term used by the AoA to identify the unit of state government that administers
OAA funds and services.
subgrantee
1
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An agency that subcontracts with a grantee agency. Subgrantee usually refers to the
service providers. (For SCSEP the subgrantee is the Area Agency on Aging)
subrecipient (Title V term)
A legal entity to which a subgrant is awarded by a recipient and that is accountable to
Sub-subgrantee (SCSEP term)
An agency that subcontracts with a subgrantee agency. Used when referring to
entities such as Experience Works. (See Section 9 – Senior Community Service
Employment Program)
Supplemental Security Income (SSI)
SSI is a federal program of income support for low-income aged, blind, or disabled
persons administered by the SSA.
support
Care, maintenance, and education or training, if appropriate.
supported living services (Medicaid Waiver term)
Effective October 1, 1997, supported living services are designed to provide an
individually tailored support service that combines the activities available through
Residential-Based Habilitation and Personal Assistance. See habilitation services.
suspension (Guardianship term)
A guardian may be suspended by the court if he or she fails to perform duties
properly, including adequate and timely reports to the court about care of the
protected person and/or the estate.
-Ttarget population
An identified group of persons toward which specific services are directed.
temporary guardianship (Guardianship term)
This guardianship is limited in duration and is usually sought when the protected
person is in imminent danger or if the protected person has a temporary need (e.g.,
consent to medical treatment or surgery, change of residence, or temporary vesting
of parental rights). Often a temporary guardianship is granted immediately with
provision for a hearing within a matter of days. Temporary guardianships typically
expire at the end of 30–180 days.
technical assistance (as related to Nutrition Services)
The provision of consultation/information toward which specific services are
directed.1
therapeutic diets (as related to Nutrition Services)
Refer to the current edition of the Manual of Clinical Dietetics, American Dietetic
Association, Chicago, Illinois for outlined Purpose, Indications for Use, Description,
2
and Discussion Points.
therapeutic diets include the following:
1. Carbohydrate Restricted Diet 2. Low-Concentrated-Carbohydrate Diet
3. Fat Restricted Diet
1
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4. Fiber-Restricted Diet
5. High-Fiber Diet
6. High-Calorie, High-Protein Diet
7. Long-Chain-Triglyceride-Restricted, Medium-Chain-Triglyceride Diet
8. Purine-Restricted Diet
9. Tyramine-Controlled Diet
10. Modified Mineral Diets
Calcium-Rich Diet
Iron-Rich Diet
Potassium-Modified Diet
Sodium-Restricted Diet 1
title
A section of a state or federal law. (There are 36 titles in the Indiana Code; Title 12
refers to human services. There are eight titles in the OAA.)
Title III
The federal Social Security Act designed to assist older adults in leading independent
lives and avoiding unnecessary institutionalization. The FSSA DA has the obligation
to allocate federal program Title III funds to the state's area agencies on aging. (see
Older Americans Act)
Title V (SCSEP)
The Older American Community Service Employment Act is a program that fosters
and promotes useful, part-time employment opportunities for low-income persons
(below 125% of poverty guidelines) who are 55 years of age or older. The goal of the
program is to provide salary and wages for meaningful employment in the area of
community service.
Title XIX (Medicaid)
A part of the Social Security Act that provides federal grants to match state programs
of hospital and medical services for welfare recipients and the medically indigent. It is
the principal legislative authority for the Medicaid program and, therefore, a common
name for the program.
Title XX — see Social Services Block Grant
training services (as related to SCSEP)
Services authorized by Section 134(d)(4) of the Workforce Investment Act.2
transportation
Taking a client from one place to another.
transportation services
Services for the transportation of an individual in a vehicle by a provider approved
under this article to provide transportation services. 3
-Uunit of general purpose local government
A political subdivision of a state that is generally a city; municipality; county;
township; town; borough; other subdivision; or an Indian tribal organization whose
1
Added 7/01/05
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3
460 IAC 1.1-3-52
2
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authority is general and not limited to only one function or combination of related
functions. (OAA).
unit of service
A measure of service or standard of quantity used for billing purposes. Usually a
segment of time spent by a provider to perform a service.
-Vvisually impaired
(a) A person with visual acuity between 20/60 and 20/100 in the individual's better
eye with the best correction, or a corresponding loss in visual field.
(b) For RBA and ARCH purposes, a central visual acuity of 20/200 degrees or less in
the individual's better eye with the use of a corrective lens, or a field defect in which
the peripheral field has contracted to such an extent that the widest diameter of visual
field subtends an angular distance of no greater than 20 degrees.
volunteer services
Services provided by volunteer groups and individuals, including older adults, who
provide assistance and services appropriate to the needs of older adults and persons
with disabilities.
-W Waiver
(a) Authorized permission given to an AAA to provide direct delivered services to
eligible older adults and persons with disabilities.
(b) Policy which waives or exempts specific traditional Medicaid requirements
allowing access to medical treatment and other programs in community based setting
in lieu of institutionalization.
Workforce Investment Act (WIA) (as related to SCSEP)
The Workforce Investment Act of 1998 (Public Law) 105-220- Aug. 7, 1998;
112 Stat 936); United States Code 29, Section 2801 et seq. 1
Workforce Investment Act regulations (as related to SCSEP)
Regulations found in the Code of Federal Regulations, 20 CFR, part 652 and
2
parts 660-671.
-X-Y-Z-
1
2
Move from Section 9 - 4/10/06
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THE PROVISIONS OF THIS MANUAL ARE SUBJECT TO FEDERAL
AND STATE LAW AS WELL AS REGULATIONS AND RULES ADOPTED
UNDER FEDERAL AND STATE LAW AND ARE SUBJECT TO CHANGE
THE FSSA DA, THE 16 AREA AGENCIES ON AGING AND ALL SERVICE
PROVIDERS AND CONTRACTORS, RECEIVING FUNDING
ADMINISTERED BY THE FSSA DA SHALL ADHERE TO THE
GUIDELINES AND POLICIES OUTLINED IN THE AMERICANS WITH
DISABILITIES ACT. SEE PUBLIC LAW 101-336 AND TITLE 42 USC
CHAPTER 126, SECTION 12181, 12182 AND 12186. 1
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1000 INTRODUCTION
Table of Contents
1000 INTRODUCTION - OPERATIONS MANUAL; PURPOSE, DESIGN,
USE, AVAILABILITY AND DISTRIBUTION
1001 ESTABLISHMENT OF THE FSSA DIVISION OF AGING
1002 ORGANIZATION AND STAFFING OF THE FSSA DIVISION
OF AGING (FSSA DA)
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1000 INTRODUCTION - OPERATIONS MANUAL: PURPOSE, USE, AVAILABILITY
AND DISTRIBUTION
(a) Policy.
(1) The purpose of the FSSA DA Operations Manual shall be to address state and
contracted operations relative to Indiana’s Aging and In-Home Services network and
to provide interpretation of federal and state statutes of various aging and in-home
services programs.
(2) Because the FSSA DA Operations Manual is based on federal and state statutes
and regulations, it shall be used as a guide, a training tool, and an ongoing reference
source for the FSSA Division of Aging (FSSA DA) staff, Area Agencies on Aging
(AAAs), service providers, independent case managers, and others involved in
programs and services administered by the FSSA DA.
(3) The FSSA DA Operations Manual contains twelve sections, with additional
sections including acronyms, definitions, a glossary, and appendices. The entire
table of contents can be found at the front1 of the FSSA DA Operations Manual and
a table of contents precedes each section.
(b) Authority.
Code of Federal Regulations, 45 CFR 1321.11
(c) Procedure.
(1) It is suggested that the table of contents be used to locate subject matter. When
the material is located, it is recommended that the entire text on that topic be read,
including all cross-referenced material.
(2) Any phrase, word or acronym that is not familiar or is not satisfactorily defined in
the general text, may be looked up in the glossary or acronym sections that appear
in the front of the operations manual. Any other questions may be directed to
appropriate staff members of the FSSA DA.
(3) The FSSA DA Operations Manual will be maintained in an online version. To
access the online version, complete the following steps:
LOG ON to the INsite Program
CLICK on RELEASE NOTES
DOUBLE CLICK on FSSA MANUALS & BULLETINS - Resources Icon (looks
like a bookshelf)
CLICK on SELECT – FSSA DA OPERATIONS MANUAL
To display the entire Operations ManualCLICK on CONTENTS
FSSA DA Documents will appear next to a BOOK ICON
CLICK on the BOOK ICON
A list of SECTIONS will appear
CLICK on the SECTION you wish to open
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To find a specific topic:
CLICK on SEARCH
TYPE in KEYWORD
CLICK on LIST TOPICS
A list of sections where the KEYWORD can be found should appear
DOUBLE CLICK onto the SECTION you wish to open
(4) One CD-ROM copy of the FSSA DA Operations Manual shall be distributed to
each of the AAAs.
(5) The Operations Manual can be found on INsite and is sent to each AAA
via CD-ROM. The Operations Manual will also appear in the Bureau
Information Directory (BID) and the FSSA DA website.1
(6) When the FSSA DA needs to revise or change the FSSA DA Operations Manual
or when updates are required, a transmittal letter listing the location and description
of the changes, revisions and/or updates will be sent to the AAA’s, IAAAA and the
FSSA DA staff via postal mail, electronic mail and/or CD-Rom.2 Recipients are to
keep a record of the date and type of changes. If a CD-Rom containing the newest
version of the FSSA DA Operations Manual is sent, recipients will remove from use
the old CD-Rom and replace it with the new and/or revised version. The changes
and revisions will be listed in the front of the FSSA DA Operations Manual and
will appear in bold, colored font throughout the Operations Manual and will be
cross-referenced with footnotes showing the date of the change. The electronic
versions of the FSSA DA Operations Manual will be updated at the same time.3
(7) The effective date of any change or revision to the FSSA DA Operations Manual
will be included in the numbered, transmittal letter and with the changes or updates
sent via e-mail and in the CD-Rom copy sent through postal mail. 4
(8) AAAs or independent case managers shall not sell, charge fees, or
request in-kind services or support for supplying the FSSA DA Operations
Manual to another entity.
(9) Any requests for copies of the Operations Manual shall be directly
referred to the Administrative Services Unit of the FSSA DA.
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1001 ESTABLISHMENT OF THE FSSA DIVISION OF AGING (FSSA DA)1
(a) Policy.
(1) The FSSA DA was established to administer the Older Americans Act (OAA)
passed by Congress in 1965 and last amended in 2000. The FSSA DA shall also
administer federal, state, and local grants and appropriations, and other sources of
funding, which include the following:
(A) Older Americans Act under IC 12-9-5-1.
(B) Area Agencies on Aging Services under IC 12-10-1-3.
(C) Adult Protective Services under IC 12-10-3.
(D) Room and Board Assistance and Assistance to Residents in County
Homes under IC 12-10-6.
(E) Adult Guardianship Program under IC 12-10-7.
(F) Community and Home Options for the Elderly and Disabled under IC 1210-10 (CHOICE).
(G) Nursing Home Preadmission Screening under IC 12-10-12,
460 IAC 1-1-1, OBRA and 42 CFR 483.100 (PASRR).
(H) Long Term Care Advocacy under IC 12-10-13.
(I) Title III C - Nutrition services and home-delivered meals.
(J) Title III B - Supportive Services.
(K) Title III D - Disease Prevention and Health Promotion Services. 2
(L) Title III E - National Family Caregiver Support Program.
(M) Aging programs under the Social Services Block Grant (SSBG).
(N) Title V - Senior Employment Under Older Adult Services.
(O) Public, private, and corporate funds.
(P) Fees (cost share).
(Q) Program income, including voluntary contributions.
1
The title Indiana Division of Aging has changed to FSSA Division of Aging or FSSA DA
4/10/06
2
Corrected 5/13/05
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(b) Authority.
Indiana Code 12-10-1-1
Indiana Code 12-10-1-21
Code of Federal Regulations, 45 CFR 1321.11
Older Americans Act, Section 303(a)(1)
(c) Procedure.
Procedures are outlined separately throughout the FSSA DA Operations
manual, under specific topics.
1002 Organization and Staffing of the FSSA Division of Aging
(FSSA DA)
(a) Policy.
The FSSA DA shall have an adequate number of qualified staff to carry out the
functions prescribed in the Code of Federal Regulations and the Older Americans
Act.
(b) Authority.
Code of Federal Regulations, 45 CFR 1321.9
(c) Procedure.
The FSSA DA has developed and maintains an organizational chart that lists all
FSSA DA positions. Along with the organizational chart, the FSSA DA has complete
documentation of accurate position descriptions and job standards for all of the
FSSA DA staff which is available upon request.
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SECTION 2
2000 - ADMINISTRATIVE AREAS OF RESPONSIBILITY OF THE FSSA
AGING AND IN-HOME SERVICES NETWORK
Table of Contents
2000 ADMINISTRATIVE AREAS OF RESPONSIBILITY OF THE FSSA
AGING AND IN-HOME SERVICES NETWORK - MISSION AND
DUTIES OF THE FSSA DIVISION OF AGING (FSSA DA)
2001 PERFORM AS THE STATE LEADER IN ALL AGING ISSUES
2002 IMPLEMENT ADVOCACY POLICIES
2003 DESIGNATE PLANNING AND SERVICE AREAS (PSAS)
2004 DESIGNATE AN AREA AGENCY ON AGING (AAA)
2005 DEVELOP THE INTRASTATE FUNDING FORMULA
2006 GIVE PREFERENCE TO OLDER ADULTS WITH THE
GREATEST NEED
2007 MONITOR THE AREA AGENCIES ON AGING
2008 ASSURE THE REQUIREMENT OF OUTREACH EFFORTS
2009 COORDINATE SERVICES WITH AREA AGENCIES ON AGING
2010 ASSURE THE QUALITY OF SERVICES
2011 TAKE INTO ACCOUNT THE VIEWS OF OLDER ADULTS
2012 NEEDS ASSESSMENT
2013 OLDER ADULTS WITH SEVERE DISABILITIES
2014 DEVELOP AND IMPLEMENT THE STATE PLAN
2015 STATE PLAN AMENDMENTS
2016 CONTACT INFORMATION FOR THE FSSA DIVISION OF AGING
2017 MISSION OF THE AREA AGENCY ON AGING
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2018 ADVISORY COUNCIL
2019 OTHER ADVISORY BODIES
2019.1 Indiana Commission on Aging
2019.2 Community and Home Options to Institutional Care for the
Elderly and Disabled (CHOICE) Board
2019.3 Alzheimer’s Disease and Related Senile Dementia Task
Force
2019.4 Money Management Program Advisory Council
2020 CONTACT INFORMATION FOR THE 16 AREA AGENCIES ON
AGING
CHART 1
2021 MAP OF THE 16 PLANNING AND SERVICE AREAS
CHART 2
2022 AREA PLAN ON AGING
2022.1 Direct Provision of Services
2022.2 Submission of the Area Plan
2022.3 AAA Policy Regarding Direct Provision of Services
2022.4 Area Plans and Public Hearings
2023 CONFLICT OF INTEREST
CHART 3
2023.1 Conflict of Interest Rules
2024 NEPOTISM
2025 ACCEPTANCE OF GIFTS
2026 CONFIDENTIALITY
2027 COORDINATION
2028 DIRECT DELIVERY OF SERVICES
2029 INFORMATION SHARING
2030 MARKETING MATERIALS
2031 RETENTION OF RESOURCE RECORDS
2032 GOVERNOR’S CONFERENCE ON AGING
2033 INDIANA STATE FAIR
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2034 MONITORING AND ASSESSMENT
2034.1 Monitoring Visit to the AAA
2034.2 Monitoring and Assessment Regarding the Americans with
Disabilities Act (ADA)
2035 NEEDS ASSESSMENT
2036 PRIORITY SERVICES
2037 REPORTING REQUIREMENTS
2038 TARGET POPULATIONS
CHART 1
CONTACT INFORMATION FOR THE 16 AREA AGENCIES ON
AGING
CHART 2
MAP OF THE 16 PLANNING AND SERVICE AREAS
CHART 3
CONFLICT OF INTEREST RULES
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2000 ADMINISTRATIVE AREAS OF RESPONSIBILITY OF THE FSSA AGING AND INHOME SERVICES NETWORK - MISSION AND DUTIES OF THE FSSA DIVISION OF
AGING (FSSA DA)
(a) Policy.
In consultation with other appropriate parties in Indiana, the FSSA DA shall develop
policies governing all aspects of services and programs. The FSSA DA is
responsible for enforcement of these policies.
(b) Authority.
Older Americans Act, Section 305
Code of Federal Regulations, Title 45 CFR 1321.11(a) and (b)
Indiana Code, 12-10-1-4(2) (7) (8),(11),(12),(13),(14) and (17)
(c) Procedure.
The FSSA DA shall do the following:
(1) Conduct studies and research into the needs and problems of the aging.
(2) Evaluate programs, services, and facilities for older adults and determine
the extent to which those programs, services, and facilities meet the needs of
older adults.
(3) Coordinate programs, services, and facilities furnished for older adults by
state agencies and make recommendations regarding those programs,
services, and facilities to the Governor and the general assembly.
(4) Provide consultation and assistance to communities and groups
developing local services for older adults.
(5) Promote community education regarding the concerns of older adults
through institutes, publications, radio, television, and the press.
(6) Cooperate with agencies of the federal government in studies and
conferences designed to examine the needs of older adults and prepare
programs and facilities to meet those needs.
(7) Establish and maintain information and referral sources through-out
Indiana when not provided by other agencies.
(8) Conduct an annual conference on the issues of older adults.
(9) Examine the needs of older adults and prepare programs and facilities to
meet those needs.
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2001 PERFORM AS THE STATE LEADER IN ALL AGING ISSUES
(a) Policy.
(1) The FSSA DA shall receive and disburse federal money made available for
providing services to older adults or for related purposes.
(2) The FSSA DA shall provide for the performance of any other functions required
by regulations established under the Older Americans Act.
(3) The Older Americans Act (OAA) requires that the state unit on aging (FSSA DA)
shall be the leader relative to all aging issues on behalf of all older adults in Indiana.
The FSSA DA is the unit primarily responsible for Indiana’s state aging programs
and services.
(b) Authority.
Older Americans Act, Section 305
United States Code, 42 USC 3001
(c) Procedure.
(1) The FSSA DA shall proactively carry out a wide range of functions designed to
lead to the development or enhancement of comprehensive and coordinated
community-based systems serving areas through-out Indiana.
(2) The FSSA DA is active in functions related to the following:
(A) Advocacy
(B) Planning
(C) Coordination
(D) Interagency linkages
(E) Information sharing
(F) Brokering of services
(G) Monitoring and evaluation
(H) Protective services
(d) Cross Reference.
Indiana Code, 12-10-1-4(5) and (9)
2002 IMPLEMENT ADVOCACY POLICIES
(a) Policy.
(1) The FSSA DA shall provide a focal point for advocacy, coordination, monitoring,
and evaluation of programs for older adults.
(2) The AAA shall serve as the lead agent for the FSSA DA relative to all older adult
issues and shall carry out the function of advocate to help lead the development or
enhancement of comprehensive and coordinated community-based systems in or
serving each community in the planning and service area (PSA). In addition, the
AAA shall undertake specific advocacy efforts focused on the needs of low-income
minority older adults.
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(b) Authority.
Older Americans Act, OAA 305 (a) (1) (D)
Code of Federal Regulations, 45 CFR 1321.7(a)(1)
Code of Federal Regulations, 45 CFR 1321.13(b)
United States Code, 42 USC 3026(a)(6)(B)
(c) Procedure.
(1) The FSSA DA also shall provide technical assistance to agencies, organizations,
associations, or persons representing older adults, and, upon request, will review
and comment on applications to state and federal agencies for assistance relating to
meeting the needs of older persons .
(2) No requirement allows the FSSA DA, in completing advocacy activities, to
supersede a prohibition contained in a federal appropriation on the use of federal
funds to lobby the Congress.
(3) The AAA shall do the following:
(A) monitor, evaluate, and comment on all policies, programs, levies, and
community actions that affect older adults and may recommend any changes
that the FSSA DA considers to be appropriate;
(B) solicit comments from the public on the needs of older adults;
(C) represent the interests of older adults to local level and executive-branch
officials and public and private agencies or organizations;
(D) consult with and support the state's ombudsman program;
(E) undertake on a regular basis activities designed to facilitate the
coordination of plans and activities with all other public and private
organizations with responsibilities affecting older adults in the PSA to
promote new or expanded benefits and opportunities for older adults;
(F) undertake a lead agent role for the FSSA DA in assisting communities
throughout the PSA to target resources from all appropriate sources to meet
the needs of older adults with greatest economic or social need, with
particular attention to low-income minority individuals, including such
activities as location of services and specialization in the types of services
most needed by older adults; and
(G) forbid a service provider to employ a means test for advocacy services
funded.
(d) Cross Reference.
Indiana Code 12-10-1-4(4)
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2003 DESIGNATE A PLANNING AND SERVICE AREA (PSA)
(a) Policy.
(1) As the state’s unit on aging, the FSSA DA is the only agency that shall designate
a planning and service area (PSA).
(2) The FSSA DA may designate a PSA to any unit of general-purpose government
that has a population of 100,000 or more.
(b) Authority.
Older Americans Act, Section 305 (a)(1)(E)
Older Americans Act, Section 305 (b)(1) and (5)
United States Code 42 USC 3025(a)(1)(E)
Code of Federal Regulations, Section 45 CFR 1321.29
Code of Federal Regulations, Section 45 CFR 1321.31
(c) Procedure.
(1) The FSSA DA shall maintain the current PSAs until it determines that the present
geographic boundaries should be changed to better accomplish the purposes of the
FSSA DA and the OAA.
2004 DESIGNATE AN AREA AGENCY ON AGING (AAA)
(a) Policy.
The FSSA DA shall designate area agencies on aging in each planning and services
area in Indiana.
(b) Authority.
Indiana Code, 12-10-1-4 (18)
Code of Federal Regulations, 45 CFR 1321.33
Code of Federal Regulations, 45 CFR 1321.37(a), (b), (1) (2) and (C)
Older Americans Act, Section 305(b) (5) (B)
Older Americans Act, Section 305(c)(4)
(c) Procedure.
(1) The FSSA DA shall designate as its AAAs only those local agencies having the
capacity and making the commitment to fully carry out the mission described for area
agencies on aging in the Older Americans Act.
(2) When the FSSA DA designates a new AAA, the FSSA DA gives the right of first
refusal to a unit of general purpose local government if such unit can meet the
requirements of the OAA and the boundaries of the unit and the boundaries of the
planning and service area are reasonably contiguous.
(3) An Area Agency on Aging may be any of the types of agencies listed below:
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(A) an established office of aging which is operating within a planning and
service area (PSA);
(B) any office or agency of a unit of general purpose local government, which
is designated to function only for the purpose of serving as an Area Agency
on Aging by the chief elected official of such unit;
(C) any office or agency designated by the appropriate chief elected officials
of any combination of units of general purpose local government to act on
behalf of such combination for such purposes;
(D) any public or nonprofit private agency in a PSA, or any combination of
units of general purpose local government to act on behalf of such
combination for such purpose; or
(E) any separate organizational unit within such agency, which is under the
supervision or direction for this purpose of the designated State agency and
which can and will engage only in the planning and provision of a broad
range of supportive services, or nutrition services within such planning and
service area.
(4) The FSSA DA shall provide assurance that the Area Agency on Aging will have
the ability to develop an area plan and to carry out, directly or through contractual or
other arrangements, a program in accordance with the plan, within the PSA.
(5) The FSSA DA will give preference to an established office on aging, unless the
FSSA DA finds that such office within the PSA will have the capacity to carry out the
area plan.
(d) Cross Reference.
Indiana Code, 12-10-1-4(18)
2005 DEVELOP THE INTRASTATE FUNDING FORMULA
(a) Policy.
The FSSA DA shall act, in accordance with regulations established under the Older
Americans Act, as the agent for providing state money to the area agencies on aging
designated in each planning and service area.
(b) Authority.
Indiana Code 12-10-1-4(15)
Code of Federal Regulations, 45 CFR 1321.37(a) (b),(1)(2) and (C)
(c) Procedure.
(1) The FSSA DA, after consultation with all 16 AAAs, shall develop and use an
intrastate funding formula for the allocation of OAA funds to AAAs.
(2) The FSSA DA shall publish the formula for review and comment by older adults,
other appropriate agencies and organizations, and the general public.
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(3) The formula shall reflect the proportion among the PSAs of persons age 60 and
over in greatest economic or social need with particular attention to low-income
minority persons. The FSSA DA shall review and update its formula as often as a
new State Plan is submitted for approval.
(4) The intrastate funding formula (IFF) shall provide for a separate allocation of
funds received for preventive health services. In the award of such funds to selected
PSAs, the FSSA DA shall give priority to areas of the state that are medically
underserved, and in which there are large numbers of persons who have the
greatest economic and social need for such services.
(5) The FSSA DA shall submit the intrastate funding formula to the Administration on
Aging (AoA) for review and comment. The intrastate funding formula shall be
submitted separately from the State Plan.
2006 GIVE PREFERENCE TO OLDER ADULTS WITH THE GREATEST NEED
(a) Policy.
The FSSA DA shall provide a comprehensive and coordinated service system for
Indiana’s aging population, giving high priority to those persons in greatest need.
(b) Authority.
Indiana Code, 12-10-1-4(1)
Older Americans Act, Section 306(a)(4)(A)
Older Americans Act, Section 306 (4)(B)
(c) Procedure.
The FSSA DA must assure that preference will be given to providing services to
older adults with the greatest economic need and older adults with the greatest
social need, with particular attention to low-income minority older adults and older
adults residing in rural areas, and include proposed methods of carrying out the
preference in the State Plan.
2007 MONITOR THE AREA AGENCIES ON AGING
(a) Policy.
(1) The FSSA DA shall assure that the resources made available to AAAs under the
OAA are used to carry out the mission described for area agencies on aging in the
Code of Federal Regulations.
(2) The FSSA DA shall monitor the AAAs by gathering and analyzing data and
information. The data and information can be gathered systematically by means of
fiscal and programmatic reports or through on-site visits.
(b) Authority.
United States Code, 42 USC 3027(a) (4)
Code of Federal Regulations, 45 CFR 1321.13
Code of Federal Regulations, 45 CFR 1321.7(c)
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Code of Federal Regulations, 45 CFR 1321.53
(c) Procedure.
(1) The State Plan shall provide that the FSSA DA will conduct periodic evaluations
of, and public hearings on, activities and projects carried out in the State including
evaluations of the effectiveness of services provided to persons with greatest
economic need, greatest social need, or disabilities, with particular attention to lowincome minority persons and older individuals residing in rural areas.
(A) The FSSA DA shall monitor and assess activities, services, and
programs conducted in accordance with AAA plans and the State Plan and all
applicable laws, rules, and regulations. Monitoring activities shall be
completed for each AAA, within the 2 year period of the AAA Contract
Agreement. Monitoring and Assessment activities include the following:
(i) review of AAA area plans;
(ii) on-site visits to the AAAs; and
(iii) other data gathering activities, such as desktop review and
electronic review, completed for individual programs.
(B) The FSSA DA shall coordinate monitoring and assessment activities with
program coordinators and specialists within other units in the FSSA DA.
(C) Copies of monitoring and assessment reports are sent to the appropriate
unit supervisor and program coordinator or specialist. If the FSSA DA
requests the AAA to complete corrective actions, the AAA shall submit a
corrective action plan to the FSSA DA. The FSSA DA shall monitor any
submitted corrective action plan for compliance.
(D) If an AAA fails to submit a corrective action plan within the specified time
frame or if an AAA submits an incomplete or unsatisfactory corrective action
plan, or if the AAA does not take the appropriate corrective actions within a
specified target date, the FSSA DA may sanction the AAA through punitive
measures which may include decertification of the AAA.
2008 ASSURE THE REQUIREMENT OF OUTREACH EFFORTS
(a) Policy.
(1) The FSSA DA shall assure the requirement of outreach services that will identify
persons who are eligible for assistance, with special emphasis on the following:
(A) older adults living in rural areas;
(B) older adults with the greatest economic need (with particular attention to
low-income minority persons and older individuals living in rural areas);
(C) older adults with the greatest social need (with particular attention to lowincome minority persons and older individuals living in rural areas);
(D) older adults with severe disabilities;
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(E) older adults with limited English-speaking ability; and
(F) older adults with Alzheimer’s diseases or related disorders, and
information for these older adults or their caretakers, on availability of
assistance.
(b) Authority.
Older Americans Act, Section 306(4)(B) and (C)
Older Americans Act, Section 306(a)(4)(c)
Code of Federal Regulations, 45 CFR 1321.17(f)(8)
FSSA DA Operations Manual, Section 4021 - Outreach Services
(c) Procedure.
(1) The FSSA DA shall:
(A) monitor compliance with the policy; and
(B) provide ongoing technical assistance to AAAs and Title III projects regarding
the policy.
(2) The AAA shall ensure that each activity undertaken by the AAA will include
a focus on the needs of low-income minority older adults and to older adults
1
residing in rural areas.
(d) Cross Reference.
See FSSA DA Operations Manual, Section 2011 - Take Into Account the Views
of Older Adults.2
1
2
Older Americans Act, Section 306 (a)(4)(C) Added 4/10/06
Added 4/10/06
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2009 COORDINATE SERVICES WITH THE AREA AGENCIES ON AGING
(a) Policy.
In carrying out the FSSA DA duties the FSSA DA shall coordinate service delivery
with the area agencies on aging.
(b) Authority.
United State Code, 42 USC 3027(a)(17)
Indiana Code, 12-10-1-5
(c) Procedure.
(1) The FSSA DA will assure that the 16 AAAs will conduct efforts to facilitate the
coordination of community-based, long term care services for older adults who:
(A) live in their home;
(B) are in a hospital and are at risk of prolonged institutionalization; or
(C) are patients in long-term care facilities, but who can return to their homes
if community-based services are provided to them.
2010 ASSURE THE QUALITY OF SERVICES
(a) Policy.
The State plan shall include assurances that the State has in effect a mechanism to
provide for quality in the provisions of in-home services.
(b) Authority.
United States Code, 42 USC 3027(a) (25)
(c) Procedure.
Each AAA is contractually required to survey a percentage of In-Home Services
Program recipients to provide a basis for quality-improvement activities in the areas
of service quality and client satisfaction. Client-based information is aggregated,
preserving confidentiality, and feedback is given to providers.
2011 TAKE INTO ACCOUNT THE VIEWS OF OLDER ADULTS
(a) Policy.
The FSSA DA shall provide assurances that the views of older adults of supportive
services or nutrition services, or older adults using multipurpose senior centers, shall
be taken into account in connection with general policy arising in the administration
of the State Plan for any fiscal year. 1
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(b) Authority.
United States Code, 42 USC 3025(a)(2)(B)
Indiana Code, 12-10-1-4(3)
(c) Procedure.
The FSSA DA shall ensure the participation of older adults in the planning and
operation of all phases of the system.
2012 NEEDS ASSESSMENT
(a) Policy.
The FSSA DA shall evaluate programs, services, and facilities for older adults and
determine the extent to which those programs, services, and facilities meet the
needs of older adults. The FSSA DA shall examine the needs of older adults and
prepare programs and facilities to meet those needs.
(b) Authority.
Code of Federal Regulations, 45 CFR 1321.27
Indiana Code, 12-10-1-4 (7) and (17)
United States Code, 42 USC 3026(a)(1)
(c) Procedure.
(1) As part of the State Plan development, the FSSA DA may do the following:
(A) conduct statewide needs assessments, every 4 years, in conjunction with
the FSSA DA State Plan to determine service gaps and needs; and
(B) assure that the AAAs conduct needs assessments at least once, every 2
years, in conjunction with the AAA area plan, to determine needs and location
of services.
(C) determine the necessity of a statewide needs assessment based on data
analysis, data profile of older adults from available census data, public
hearing results, other appropriate documentation and data, and the
recommendation of the FSSA DA Director.
(D) refer to AoA Region V, Regional Office Memorandum 81-73, Subject:
State Plans Based on Area Plans, for guidance regarding needs assessment
and the relationship of the AAAs to the creation and implementation of the
State Plan.
(E) develop a written timeline including key deadlines and outcomes.
(2) A statewide needs assessment for the FSSA DA shall include the following:
(A) Cover page
(B) Table of contents
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(C) Executive summary.
(D) Bibliography/works cited section with complete referencing.
(E) A section including the following elements of the statewide needs
assessment:
(i) methodology;
(ii) survey development, structure and implementation;
(iii) report structure and design;
(iv) needs stratification by age;
(v) demographic compilations, analysis;
(vi) discoveries-other areas of need identified by the assessment;
(vii) results/correlation of survey of demographics;
(viii) recommendations;
(ix) other/miscellaneous and any other sections topics determined
through negotiation; and
(x) appendices to describe any item in greater detail for clarification
purposes or any visual representations of data
(3) The FSSA DA shall conduct at least one public hearing on the findings of the
statewide needs assessment and shall provide an opportunity for response from
interested individuals, advocates, and any other individual or entity. The public
hearing information shall be made available as part of the State Plan.
(d) Cross Reference.
Section 4029 - Transportation Services and Section 4030 – Volunteer Services –
FSSA DA Operations Manual.
2013 OLDER ADULTS WITH SEVERE DISABILITIES
(a) Policy.
The State Plan shall provide, with respect to the needs of older adults with severe
disabilities, assurances that the State will coordinate planning, identification,
assessment of needs, and services for older adults with disabilities with particular
attention to older adults with severe disabilities in coordination with State agencies
with primary responsibility for older adults with disabilities, including severe
disabilities, to enhance services and develop collaborative programs, where
appropriate, to meet the needs of older adults with disabilities .
(b) Authority.
Older Americans Act, Section 307(a)(16)(A)(iv)
Older Americans Act, Section 307(a) (17)
(c) Procedure.
The AAAs will give particular attention to older adults with disabilities in the
development of services and outreach efforts.
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2014 DEVELOP AND IMPLEMENT THE STATE PLAN
(a) Policy.
(1) The State shall, in accordance with regulations of the Assistant Secretary of the
Administration on Aging (AoA), designate a State Agency as the sole State Agency
to develop a State Plan to be submitted to the Assistant Secretary for approval.
The State Plan, at a minimum, shall do the following:
(A) conform to the provisions of the OAA;
(B) conform to the regulations found in Part 45 of the Code of Federal
Regulations, Chapter 1321;
(C) conform to any other federal or state codes regarding the administration
of OAA funds; and
(D) be based on the 16 AAAs area plans.
(2) The State Plan shall outline how the FSSA DA will manage and administer
programs authorized under the OAA. The FSSA DA shall implement and administer
the State Plan.
(b) Authority.
Older Americans Act, Section 307(a)
Older Americans Act, Section 307(a)(1)(B)
United States Code, 42 USC 3025 (a)(1)(A)
Code of Federal Regulations, 45 CFR 1321.17
Code of Federal Regulations, 45 CFR 1321.15(a)
Code of Federal Regulations, 45 CFR 1321.15(b) and (c)
Indiana Code 12-10-1-4(6)
Indiana Code 12-10-1-4(10)
(c) Procedure.
(1) The FSSA DA shall develop a State Plan, with revisions as necessary, by doing
the following:
(A) collecting information from the 16 AAAs, including existing area plans;
(B) using research data from state and national resources;
(C) reviewing federal priority issues;
(D) evaluating the need for services in the state and determining to what
extent existing public or private programs meet such needs; and
(E) collecting advice from public hearings and/or advisory bodies.
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(d) Format.
(1) The FSSA DA may use its own judgment as to the format of the State Plan, how
to collect information for the State Plan and whether the plan will remain in effect for
two, three or four years. The format of the Indiana State Plan may include the
following components:
(A) Verification of Intent
(i) The Verification of Intent section of the State Plan serves as a cover letter,
signatory letter, and summary.
(ii ) The Verification of Intent section may include the following:
(I) declaration of submission statement;
(II) short summary of State Plan contents; and
(III) signatory page for the director of the FSSA DA, the director of
DDRS, the secretary of the Indiana FSSA, and the Governor of the
state of Indiana.
(B) Background and Introduction
(i) The background and introduction section should contain the following:
(I) an overview of the programs and services administered by the
FSSA DA;
(II) a description of the case-management system used in Indiana;
(III) a list of the in-home services in Indiana available via the FSSA
DA and the AAAs;
(IV) a list of other services and programs administered by the FSSA
DA;
(V) explanation of quality assurance initiatives; and
(VI) definition of other programs and services.
(C) Mission Statements
(i) The State Plan should include mission statements for DDRS and the
FSSA DA.
(D) Strategies for Service Delivery and Systems Enhancement
(i) Strategies for Service Delivery and Systems Enhancement shall outline the
direction of the FSSA DA regarding the provision of services.
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(E) General Assurances
(i) General assurances shall include those tasks and undertakings completed
by the FSSA DA in accordance with the OAA.
(ii) Assurances are divided into the following:
(I) general administration duties;
(II) equal employment opportunities and civil rights; and
(III) provision of services.
(F) Administration Structure
This section shall contain representative charts showing the structure of the
FSSA and the FSSA DA.
(G) Program Goals and Objectives
(1) The Indiana State Plan goals and objectives shall be listed in this section
and include the following:
(i) Goals;
(ii) Objectives;
(iii) Tasks;
(iv) Key Indicators; and
(v) Outcomes.
(H) State Plan Assurances
(1) In this section of the State Plan, provisions of the OAA are listed
separately and include a short summary of each provision. The provisions are
listed by the corresponding section numbers, just as they appear in the OAA.
(2) Also included in the State Plan are the following attachments:
(i) Indiana area agencies on aging map and listing;
(ii) description of intrastate funding formula under the OAA;
(iii) rural funding; and
(iv) distribution of funding streams.
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(I) Statistics
(i) Statistics listed in the State Plan also shall be verifying assurances
and allotments.
(ii) The State Plan is submitted to the bi-regional administrator of the
AoA, which is located at the following address:
Administration on Aging
U.S. Department of Health and Human Services
233 N. Michigan Avenue, Suite 790
Chicago, IL 60601-5519
(J) Development of the State Plan
Development procedures for the FSSA DA State Plan may include the
following:
(i) obtain State Plan development guidelines from the Administration
on Aging (AoA) regional office. (Refer to Section 307(a) through (f) of
the Older Americans Act and Title 45 of the Code of Federal
Regulations, Part 1321.17, for a listing of provisions required to be
included in the State Plan. Also, Refer to Appendix 1 - State Plan
Provision Information);
(ii) elect to utilize a two, three or four year format;
(iii) outline State Plan development timeline;
(iv) gather identified priority needs from the AAA’s;
(v) develop a data profile on older adults in Indiana;
(vi) conduct statewide needs assessment activities;
(vii) analyze the results of needs assessment activities, and outline
and identify statewide priority needs;
(viii) outline and evaluate the existing service delivery system,
including services, coordination, advocacy, and training activities;
(ix) present a summary of needs and priorities to the Indiana
Commission on Aging;
(x) develop a draft summary of the State Plan;
(xi) present a State Plan summary to interested entities 18 days prior
to conducting public hearing(s) on the plan; (See Section 3000 –
Public Hearings);
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(xii) publicize the public hearing(s) at least 18 days prior to the actual
public hearing(s), outlining dates, times, and locations, and ensure
that older adults in Indiana, public officials, and other interested
parties have reasonable opportunities to participate;
(xiii) conduct the public hearing(s). Document written and verbal
comments received at the public hearing(s);
(xiv) consider written and verbal comments documented at the public
hearing(s) for addition into the revised version of the State Plan, if the
comments are deemed appropriate;
(xv) submit revised State Plan to the appropriate FSSA DA staff for
approval;
(xvi) submit final plan to the director of the FSSA DA, the director of
FSSA and the Governor, for approval;
(xvii) submit final plan to the AoA regional office for approval;
(xviii) submit the final plan to the director of the FSSA DA and DDRS
staff for approval;
(xix) place the State Plan in the appropriate written and electronic
formats; and
(xx) post the AoA approved State Plan on the State Website. Copy
the AoA approved State Plan onto a compact disc for future use.
(K) AoA Review
(i) After the State Plan is submitted, it will be sent to the AoA for review. A
final approval by the AoA will be needed before the plan can be set in place.
No expenditures can be made under a new plan or amendment until it is
approved by the AoA. The State Plan becomes effective on the date
designated by the AoA.
(ii) The State Plan shall be submitted to the AoA to be considered for
approval at least forty-five calendar days before the proposed effective date
of the State Plan or State Plan amendment .
(L) AAA Consultation
(i) At the request of the FSSA DA, the sixteen AAAs may serve as
consultants regarding the content of the State Plan.
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2015 STATE PLAN AMENDMENTS
(a) Policy.
(1) The State Plan shall be amended as necessary to reflect changes in regulating
documents, organization, or policy. Each State Plan, or State Plan amendment
which requires approval of the AoA, shall be signed by the Governor or the
Governor's designee, the secretary of FSSA, and the director of the FSSA DA,
before being submitted to the AoA. (The signatures are normally obtained on the
verification of intent page).
(2) The FSSA DA may amend the State Plan when necessary to show:
(i) revised or new federal statutes and regulations;
(ii) changes in any law, organization, policy or in the operation of the FSSA
DA;
(iii) information required annually by sections 307(a)(23) and (29) of the Older
Americans Act; or
(iv) any other necessary changes or revisions required by the OAA or the
AoA.
(b) Authority.
Code of Federal Regulations, 45 CFR 1321.19
Older Americans Act, Section 307 (a) (1) (B)
Code of Federal Regulations, 45 CFR 1321.17
(c) Procedure.
(1) If the FSSA DA intends to amend provisions of the State Plan required under the
Code of Federal Regulations, Section 45 CFR 1321.17 (a) or (f), the FSSA DA shall:
(i) contact the AoA representative (telephone contact preferred) for
recommendations and guidance regarding the proposed amendment;
(ii) amend the State Plan; and
(iii) submit the proposed amendment to the AoA for approval. The
FSSA DA need only submit the amended portions of the State Plan.
(2) If the FSSA DA amends any of the provisions of the State Plan required under
the Code of Federal Regulations, Section 45 CFR 1321.17 (b) through (d), it shall:
(i) notify the appropriate AoA representative (telephone contact
preferred); and
(ii) notify the AoA Commissioner in the manner requested by the AoA
representative.
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(3) If the FSSA DA amends any of the provisions of the State Plan required under
the Code of Federal Regulations, Section 45 CFR 1321.17 (a), (e) and (f), the FSSA
DA shall:
(i) notify the appropriate AoA representative (telephone contact preferred);
and
(ii) submit the proposed amendment(s) to the AoA to be considered for
approval at least 45 calendar days before the proposed effective date of the
State Plan amendment in the manner requested by the AoA representative.
(d) Cross Reference.
For an inventory of the provisions required to be in the State Plan, see the Older
Americans Act, Section 307, the Code of Federal Regulations, 45 CFR 1321.17 (a)
through (f), and the United States Code, Title 42, Section 3027. Also, see
Appendix 1 – State Plan Provision Information - Operations Manual.
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2016 CONTACT INFORMATION FOR THE FSSA DIVISION OF AGING (FSSA DA)
(a) The FSSA DA mailing address is as follows:
MS 21
FSSA Division of Aging
P.O. Box 7083
Indianapolis, IN 46207-7083
(b) For specific FSSA DA staff telephone numbers, call the State Information
Center—(317) 233-0800.
2017 MISSION OF THE AREA AGENCY ON AGING
(a) Policy.
(1) Each AAA shall proactively carry out, under the leadership and direction of the
FSSA DA, a wide range of functions related to advocacy, planning, coordination,
inter-agency linkages, information sharing, brokering, monitoring, and evaluation. It is
designed to lead to the development or enhancement of comprehensive and
coordinated community-based systems in, or serving, each community in the PSA.
These systems shall be designed to assist older adults in leading independent,
meaningful and dignified lives in their own homes and communities as long as
possible. A comprehensive and coordinated community-based system as described
in the Code of Federal Regulations (CFR) shall do the following:
(A) have a visible focal point of contact where anyone can go or call for
help, information, or referral on any aging issue;
(B) provide a range of options and assure that these options are readily
accessible to all older adults: the independent, semi-dependent, and totally
dependent, no matter what their income;
(C) include a commitment of public, private, voluntary, and personal
resources committed to supporting the system;
(D) involve collaborative decision making among public, private, voluntary,
religious, and fraternal organizations and older people in the community;
(E) provide specific objectives for providing services to older adults with the
greatest economic need and older adults with the greatest social need,
include specific objectives for providing services to low-income, minority
older adults residing in rural areas;
(F) provide effective referral from agency to agency to assure that
information or assistance is received, no matter how or where contact
is made in the community;
(G) evidence sufficient flexibility to respond with appropriate individualized
assistance, especially for the vulnerable older person;
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(H) have a unique character that is tailored to the specific nature
of the community; and
(I) be directed by leaders in the community who have the respect, capacity,
and authority necessary to convene all interested persons; assess needs;
design solutions; track overall success; stimulate change; and plan
community responses for the present and for the future.
(2) The resources made available to the AAA under the OAA are to be used to
finance those activities necessary to achieve elements of a community-based service
system.
(3) For the purpose of assuring access to information and services for older adults,
the AAA shall work with elected community officials in the PSA to designate one or
more focal points on aging in each community, as appropriate.
(b) Authority.
Older Americans Act, Section 305(b)(5)(B)
Older Americans Act, Section 305(c)(5)
(c) Procedure.
(1) Procedures are outlined separately for each area of responsibility identified for
the AAAs.
(d) Cross Reference.
Section 2023 - Area Plan on Aging - FSSA DA Operations Manual.1
2018 ADVISORY COUNCIL2
(a) Policy.
The AAA shall establish an advisory council consisting of older adults (including
minority older adults and older adults residing in rural areas) who are participants or
who are eligible to participate in programs assisted under the Older Americans Act,
representatives of older adults, local elected officials, providers of veterans’ health
care (if appropriate), and the general public, to continuously advise the AAA on all
matters relating to the development of the area plan, the administration of the plan
and operations conducted under the plan.
(b) Authority.
Older Americans Act, 306(a) (6)(D)
Code of Federal Regulations, 45 CFR 1321.57
(c) Procedure.
(1) The council shall carry out advisory functions which further the AAA’s mission of
developing and coordinating community-based systems of service for all older adults
in the planning and service area.
1
2
Added 4/10/06
Added 5/13/05
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(2) The council shall advise the AAA relative to:
(A) developing and administering the area plan;
(B) conducting public hearings;
(C) representing the interest of older adults; and
(D) reviewing and commenting on all community policies, programs, and
actions which affect older adults with the intent of assuring maximum
coordination and responsiveness to older adults.
(3) The council shall include individuals and representatives of community
organizations who will help to enhance the leadership role of the AAA in developing
community-based systems of service.
(4) The advisory council shall be made up of:
(A) more than 50% older adults, including minority individuals who are
participants or who are eligible to participate in programs under the OAA;
(B) representatives of older adults;
(C) representatives of health care provider organizations, including
providers of veterans’ health care (if appropriate);
(D) representatives of supportive services provider organizations;
(E) persons with leadership experience in the private and voluntary sectors;
(F) local elected officials; and
(G) the general public.
(5) The AAA shall submit the area plan and amendments for review and comment to
the advisory council before it is transmitted to the FSSA DA for approval. 1
2019 OTHER ADVISORY BODIES
(a) Policy.
(1) The following advisory bodies shall be established:
(A) Indiana Commission on Aging;
(B) CHOICE board;
(C) Alzheimer's Disease and Related Senile Dementia Task Force
(Governor’s Task Force on Alzheimer’s Disease and Related Dementia); and
(D) Money Management Program Advisory Council.
1
Added 5/13/05
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(b) Authority.
Indiana Code,12-10-2-2
Indiana Code,12-10-11-1
Indiana Code,12-10-5-2
Indiana Code,12-10-11-7
Memorandum of Understanding Between AARP and DDRS
(c) Procedure.
The FSSA DA shall provide staff services when necessary, for the various advisory
bodies.
(d) Cross Reference.
Code of Federal Regulations, 45 CFR 1321.57
2019.1 INDIANA COMMISSION ON AGING
(a) Policy.
Indiana’s Commission on Aging shall have the responsibility to encourage
discussion and study of the problems of older adults. The Commission on
Aging assists the FSSA DA in the development of a comprehensive plan to
meet the needs of older adults. The commission also works to recognize and
promote the organization of voluntary councils for the study of problems of
older adults.
(b) Authority.
Indiana Code,12-10-2-2
Indiana Code,12-10-2-3
Indiana Code,12-10-2-3(2)
Indiana Code,12-10-7
(c) Procedure.
(1) The Indiana Commission on Aging shall be made up of sixteen members
who have each been appointed for four-year terms. Terms expire on July 1 st
(at the end of the term), but a member stays in office until a successor is
appointed. The Governor of Indiana has the responsibility to appoint the
Commission on Aging members.
(2) The commission must have the following:
(A) One member from each congressional district;
(B) No more than half (eight members) from the same political party;
(C) Sixteen members who are residents of Indiana and have an
interest in aging issues;
(D) The balance of the members appointed at large; and
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(E) No more than two residents of the same county appointed as
members.
(3) Nine commission members constitute a quorum.
(4) The commission shall do the following:
(A) encourage the study and discussion of the problems of older
adults in Indiana;
(B) promote the organization of and officially recognize voluntary
councils for the study and discussion of problems of older adults; and
(C) assist the FSSA DA in the development of a comprehensive plan
to meet the needs of older adults.
2019.2 COMMUNITY AND HOME OPTIONS TO INSTITUTIONAL CARE FOR THE
ELDERLY AND DISABLED (CHOICE) BOARD
(a) Policy.
(1) The Community and Home Options to Institutional Care for the Elderly and
Persons with Disabilities (CHOICE) is a state-funded program that is intended to
allow older adults and persons with disabilities to live independently in their own
homes or in a community integrated setting.
(2) The CHOICE board has the responsibilities to do the following:
(A) establish long-term goals of the state for the provision of a continuum of
care for older adults and persons with disabilities;
(B) review state policies on community and home care services;
(C) recommend the adoption of state administrative rules;
(D) recommend legislative changes affecting community and home-care
services;
(E) recommend coordination of the board's activities with the activities of
other boards and state agencies concerned with community and home-care
services;
(F) evaluate cost effectiveness, quality, scope, and feasibility of a stateadministered system of community and home-care services;
(G) evaluate programs for financing services to those in need of a continuum
of care;
(H) evaluate state expenditures for community and home-care services,
taking into account efficiency, client choice, competition, and equal access to
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providers;
(I) develop policies that support the participation of families and volunteers in
meeting the long-term care needs of older adults and persons with
disabilities;
(J) encourage the development of funding for a continuum of care from
private resources, including insurance;
(K) develop a cost-of-services basis and a program of cost reimbursement for
those persons who can pay all or part of the cost of services rendered;
(L) establish long-term goals for the provision of guardianship services for
adults and persons with disabilities;
(M) coordinate activities and programs with the activities of other boards and
state agencies concerning the provision of guardianship services; and
(N) recommend statutory changes affecting the guardianship of indigent
adults.
(b) Authority.
Indiana Code,12-10-11-1
Indiana Code,12-10-11-8 (14)
Indiana Code, 12-10-10-11(b)
Indiana Code,12-10-11-4
Indiana Code,12-10-11-2(b)
Indiana Code,12-10-11-6
(c) Procedure.
(1) The CHOICE board is to review the annual CHOICE report and submit the
report to the general assembly after November 15th, and before December 31st.
(2) The board consists of the following fifteen members:
(A) the director of the division of family and children or the director's
designee.
(B) the chairman of the Indiana State Commission on Aging or the
chairman's designee.
(C) three citizens at least 60 years of age, nominated by two or more
organizations that represent senior citizens; and have statewide
membership.
(D) one citizen less than 60 years of age nominated by one or more
organizations that represent individuals with disabilities; and have
statewide membership.
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(E) one citizen less than sixty years of age nominated by one or more
organizations that represent individuals with mental illness; and have
statewide membership.
(F) one provider who provides services funded by CHOICE.
(G) one licensed physician, nurse, or nurse practitioner who specializes
either in the field of gerontology or in the field of disabilities.
(H) two home care services advocates or policy specialists nominated
by two or more organizations; associations; or nongovernmental
agencies; that advocate on behalf of home care consumers, including
an organization listed in (C) that represents senior citizens or persons
with disabilities.
(I) two members of the senate, who may not be members of the same
political party, appointed by the president pro tempore of the senate
with the advice of the minority leader of the members of the CHOICE
board are appointed by the Governor for two-year terms. The CHOICE
board shall meet at least six times a year. When a vacancy arises, the
Governor shall appoint someone to serve for the remainder of the
unexpired term. Currently, there is no quorum definition for the CHOICE
board in the Indiana Code. However, the CHOICE board shall establish
1
procedures to govern its deliberations.
1
Changed 4/10/06
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2019.3 ALZHEIMER'S DISEASE AND RELATED SENILE DEMENTIA TASK FORCE (ALSO
KNOWN AS T HE GOVERNOR’S T ASK FORCE ON ALZHEIMER’S DISEASE AND RELATED
DEMENTIA)
(a) Policy.
(1) The Alzheimer’s Disease and Related Senile Dementia Task Force has the
responsibility to do the following:
(A) identify areas of concern to be addressed by the FSSA DA.
(B) compile available research in the area of Alzheimer's disease or related
senile dementia.
(C) recommend services to the FSSA DA to meet the needs of persons with
Alzheimer's disease or related senile dementia, including the needs of the
persons’ families.
(D) recommend the development of training materials by the division for persons
who care for or provide services to persons with Alzheimer's disease or related
senile dementia.
(2) The Alzheimer’s Disease and Related Senile Dementia Task Force consists of 13
voting and 4 non-voting members who shall serve 4-year terms and meet at least
quarterly. Eight members constitute a quorum.
(b) Authority.
Indiana Code, 12-10-5-2
Indiana Code, 12-10-5-5
Indiana Code, 12-10-5-3(a)(9)
(c) Procedure.
(1) The Alzheimer’s Disease and Related Senile Dementia Task Force shall consist of
the following:
(A) Two representatives of an Alzheimer's disease or related senile dementia
support organization;
(B) Five individuals with expertise in Alzheimer's disease or related senile
dementia, including at least one physician with an unlimited license to practice
medicine, and one psychologist with a license to practice psychology;
(C) Two health-care providers that provide services to persons with Alzheimer's
disease or related senile dementia;
(D) One individual whose parent, spouse, brother, or sister is or was afflicted with
Alzheimer's disease or related senile dementia; and
(E) The director of the FSSA DA (or the director's designee);
(F) The commissioner of the State Department of Health (or the commissioner's
designee);
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(G) One representative of the Division of Mental Health and Addiction;
(H) Two members of the House of Representatives appointed by the Speaker of
the House of Representatives; and
(I) Two members of the Senate appointed by the president pro tempore.
2019.4 MONEY MANAGEMENT SERVICES PROGRAM ADVISORY COUNCIL
(a) Policy.
(1) The Money Management Program Advisory Council shall assist the FSSA DA by
developing and implementing a statewide program of early intervention services as an
alternative to guardianships for vulnerable lower income persons.
(2) The advisory council shall work with the FSSA DA to expand the availability of
representative payee and bill-payer services through the operation of a statewide money
management program. Members do not receive any reimbursement fees or per diem.
(3) The memorandum of understanding between DDRS and AARP/Legal Council for the
Elderly provides for the establishment of a local advisory council in conjunction with the
Money Management Program.
(4) The Money Management Program Advisory Council shall do the following:
(A) provide a network of support and guidance and issue resolutions for the
program and its participants;
(B) act as public liaison to inform the public and increase public awareness of the
program; and
(C) assist, through a separate ad hoc committee, local program sites in seeking
financial support.
(b) Authority.
(1) Memorandum of Understanding Between AARP and the Division of Disability, Aging
and Rehabilitative Services (DDRS), Article IV.
(c) Procedure.
(1) The local Money Management Program Advisory Council shall consist of
representatives from fourteen organizations and professions who meet quarterly. A
majority of the members constitutes a quorum.
(2) The State Advisory Council will be made up of interested and knowledgeable
individuals that are able to refer clientele in order to increase the size of local programs.
Bankers, legal services staff, caseworkers, person involved with guardianship services,
local business people who have an interest in serving vulnerable populations, individual
associated with academic institutions with finance or social service focus are all
examples of individuals that would be appropriate candidates for the State Advisory
Council.
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(3) Local coordinators will serve on a committee that will report to the State Advisory
Council. Members will serve two-year renewable terms. All votes will be decided by a
simple majority. The council meets on a quarterly basis. Coordinators will serve on a
coordinators subcommittee. A member will serve during the time they work as a Money
Management Coordinator.
2020 CONTACT INFORMATION FOR THE 16 AREA AGENCIES ON AGING
CHART 1
Indiana’s 16 AAAs
Counties Served and Location
Area 1
Jasper, Lake, Newton, Porter, Pulaski, Starke
Northwest Indiana Community Action Corp.
5518 Calumet Ave.
Hammond, IN 46320
(800) 826-7871
Area 2
Elkhart, Kosciusko, LaPorte, Marshall, St. Joseph
REAL Services, Inc.
PO Box 1835
South Bend, IN 46634
(800) 552-29161
Area 3
Adams, Allen, DeKalb, Huntington, LaGrange, Noble, Stueben, Wells, Whitley
Aging & In-Home Services of Northeast Indiana, Inc.
2927 Lake Avenue
Fort Wayne, IN 46805-54142
(800) 552-3662
Area 4
Benton, Carroll, Clinton, Fountain, Montgomery, Tippecanoe, Warren, White
Area Agency and Community Action Programs
PO Box 4727
Lafayette, IN 47903
(800) 382-7556
1
2
Revised 5/13/05
Revised 4/10/06
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Area 5
Cass, Fulton, Howard, Miami, Tipton, Wabash
Area 5 Agency on Aging & Community Services
1801 Smith St., Suite 300
Logansport, IN 47947
(800) 654-9421
Area 6
Blackford, Delaware, Henry, Jay, Madison, Randolph, Grant
LifeStream Services, Inc.
PO Box 308
Yorktown, IN 47396-03081
(800) 589-1121
Area 7
Clay, Parke, Putnam, Sullivan, Vermillion, Vigo
West Central Indiana Economics Development District, Inc. (WCIEDD)
PO Box 359
Terre Haute, IN 47808-03592
(800) 489-1561
Area 8
Boone, Hancock, Hamilton, Hendricks, Johnson, Marion, Morgan, Shelby
Central Indiana Council on Aging and In-Home Solutions (CICOA)
4755 Kingsway Drive, Suite 200
Indianapolis, IN 46205-15603
(800) 489-95504
Area 9
Fayette, Franklin, Rush, Union, Wayne
In-Home & Community Services Agency
520 S. 9th St., Suite 100
Richmond, IN 47374-62305
(800) 458-9345
Area 10
Monroe, Owen
Agency on Aging
7500 W. Reeves Rd.
Bloomington, IN 47404
(800) 844-1010
1
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Revised 4/10/06
4
Revised 5/13/05
5
Revised 4/10/06
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Area 11
Bartholomew, Brown, Decatur, Jackson, Jennings
Aging & Community Services of
South Central Indiana, Inc.
1531 13th St, Suite G-900
Columbus, IN 47201
866-644-6407
Area 12
Dearborn, Jefferson, Ohio, Ripley, Switzerland
LifeTime Resources, Inc.
13091 Benedict Drive
Dillsboro, IN 47018
1
(877) 897-0472
Area 13
Daviess, Dubois, Greene, Knox, Martin, Pike
Generations
1019 N. 4th St., PO Box 314
Vincennes, IN 47591
(800) 742-9002
Area 14
Clark, Floyd, Harrison, Scott
Lifespan Resources, Inc.
426 Bank Street, Suite 100. P.O. Box 995
New Albany, IN
47151-0995
(888) 948-83302
Area 15
Crawford, Lawrence, Orange, Washington
Hoosier Uplands
521 W. Main St.
Mitchell, IN 47446
(800) 333-2451
Area 16
Gibson, Perry, Posey,
Spencer, Vanderburgh, Warrick
South West Indiana Regional Council on Aging (SWIRCA)
16 W. Virginia, PO Box 3938
Evansville, IN 47737
(800) 253-2188
1
2
Revised 4/10/06
Revised 5/13/05
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2021 MAP OF THE 16 PLANNING AND SERVICE AREAS
CHART 2
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2022 AREA PLAN ON AGING
(a) Policy.
(1) As required by the Older Americans Act, to receive or continue AAA designation, an
AAA shall develop and submit an Area Plan to the FSSA DA. The Area Plan shall be for
a two, three, or four year period as determined by the FSSA DA, with adjustments to be
made on an annual basis.1
(2) An AAA Needs Assessment shall be completed and results provided to the
FSSA DA upon submission of a new area plan. AAA designation shall be
withdrawn if the FSSA DA finds that an Area Plan or plan amendment cannot be
approved. 2
(b) Authority.
United States Code, 42 USC 3026(a)(1)
(c) Procedure.
(1) The AAA’s assessment techniques shall be either a formal area-wide needs
assessment survey or an alternative which includes at least three of the following:
(A) review of available census data and other statistical indicators for the
PSA;
(B) interviews of key individuals who are knowledgeable about the
community, its population, the needs and patterns of services already
provided;
(C) community forums where objectives and needs are identified;
(D) the gathering of data through a survey of population sample; or
(E) any other valid research technique to acquire the necessary data.
(2) The AAA shall conduct at least one public hearing regarding the needs assessment
findings.
(3) The FSSA DA shall monitor, assess, and evaluate the implementation of the Area
Plan and provide the AAAs with technical assistance as required.
(4) The area plan shall not be implemented until final approval has been granted
by the FSSA DA.
(5) The area plan provisions for submission are to be used by all AAAs to request
direct delivery of service waiver approval.
1
Older Americans Act, Section 306(a)(1)
FSSA DA Operations Manual Section 3001.1 – Reasons for Withdrawal of the Designation of an Area
Agency on Aging
2
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2022.1 DIRECT PROVISION OF SERVICES
(a) Policy.
A separate Application for Waiver to Provide Direct Provision of Services form
shall be included for each service that the AAA or any other agency with the same
Board of Directors as the AAA, wishes to provide.
(b) Authority.
Older Americans Act, Section 306
Older Americans Act, Section 307
Code of Federal Regulations, 45 CFR 1321.35
Code of Federal Regulations, 45 CFR 1321.59
Code of Federal Regulations, 45 CFR 1321.65
Indiana Code, IC 12-10-1-6
United States Code, 42 USC 3026
(c) Procedure.
(1) The AAA shall include the following specific information in the Area Plan as
required by the OAA and the FSSA DA:
(A) OAA Waiver Exempt Services Form
The OAA Waiver Exempt Services Form shall be submitted at the same
time as the area plan submission and shall be updated and annually
submitted to the FSSA DA. For each direct service that the AAA wants to
provide, the AAA shall make a request by submission of a separate, fully
completed OAA Waiver Exempt Services Form. If a direct service waiver
approval is granted, it will be valid for one state fiscal year (7/1-6/30).
(B) Direct service waivers are not required for the provision of
Ombudsman, Case Management (if the AAA is already providing case
management services as of the date of the submission of the plan) or
Information and Assistance/Referral (I & A/R) services. However, the
requesting AAA must submit an OAA Waiver Exempt Services Form to the
FSSA DA for each of these services (for monitoring and information
purposes). The OAA Waiver Exempt Services form shall contain the
following:
(i) full name of the service;
(ii) valid signature of the executive director of the requesting AAA
and date of request (in blue ink);
(iii) grant funds listed; and
(iv) AAA staff to be involved.
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(C) Application for Waiver for Direct Provision of Service
(i) For Waivers to provide direct delivery of services other than for
Ombudsman, Case Management Services or Information and
Referral, the completed Application for Waiver for Direct Provision
of Service shall include information about the grant funds to be used
to provide direct provision of the service.
(ii) Title, number of staff working full–time, part-time and the percent
of time staff members use for administration of the service.
(iii) The AAA shall include an explanation to justify the use of funds
and staff to provide the service and a description of the activities
through which the AAA has tried to recruit and develop other
providers of the service.
(iv) The AAA shall submit the names and addresses of all potential
providers of the service to persons in the PSA. The list of providers
does not need to be limited to providers physically located in the
PSA.
(v) The AAA shall also fully describe past and proposed future
activities at recruiting or encouraging the development of other
service providers of the service, which include the following:
(I) proof of legal notices and/or classified advertisements that
ran in the major newspaper in each county of the PSA for at
least one day for two consecutive weeks, including Sunday,
(if a paper is issued), during the fiscal year. The
advertisement should list funding sources, dollar amounts,
and services to be provided;
(II) proposed activities for the period covered by the new
Area Plan aimed at recruiting or encouraging the
development of other provider(s) of the service; and
(III) other positive documentation showing that direct delivery
of service is necessary to assure the availability of services
to eligible older adults.
(2) Organizational Charts
(i) Organizational charts showing titles and positions located within
each unit of the AAA shall be included in the Area Plan. If the Area
Agency on Aging is located within a multi-purpose agency, the AAA
shall also attach an organizational chart that identifies all units
within the multi-purpose agency, including the single organizational
unit responsible for Older Americans Act activities.
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(3) Board of Directors
(i) A listing of the board of directors of the Area Agency on Aging,
including name of the President or Chairperson; his/her address and
place and day of the month of the board meetings shall be included.
All board members names shall be listed along with the county
represented, and the dates of the beginning and ending of their
terms.
(ii) Include a copy of annual board meeting schedule; list address of
board meeting locations, date of meetings and names of board
members.
(4) Advisory Council Information
(A) Information regarding the advisory council shall include:
(i) number of members;
(ii) number of members over 60 years - 50% of the advisory
council must be 60 years old or older (if not 50% over 60
years old, describe plans to gain participation from areas
without adequate representation);
(iii) number of Title III recipients;
(iv) number of elected public officials or their designee;
(v) number of representatives of health care providers
organizations (include a separate count of veteran’s health
care providers);
(vi) number of representatives of the nutrition project or
persons knowledgeable about the nutrition program;
(vii) number of representatives of the supportive services
provider organizations;
(viii) number of persons with leadership experience in the
private or volunteer sector;
(ix) number of persons who are members of a minority race
include percentage of minority older adults in the PSA (if no
minority members describe plan to gain participation of
minorities);
(x) percentage of all older adults in the PSA;
(xi) percentage of minority older adults of total members on
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the Advisory Council; and
(xii) number of older adults who reside in rural areas.1
(C) The AAA must specify how often the Advisory Council meets
and how the Advisory Council meetings are advertised.
(4) Target Population Information for the Area Plan.
(i) The Area Plan shall contain a description of how the AAA assures
preference to the target populations for each funding source. The
Area Plan shall include assurances regarding:
(I) adults age 60 years old or older with the greatest economic
and social need;
(II) older minority and low income minority individuals;
(III) older Individuals living in rural areas; and
(IV) older individuals who are Native Americans.
(5) Focal Point Information for the Area Plan.
(i) Focal Point information shall include:
(I) the Area Plan the process for selection of focal points.
(II) a list of all focal points including at least one focal point in
each county or a provision that information/services are
accessible to each county. If the AAA is unable to meet this
requirement, the AAA shall submit a detailed explanation of
the rationale for not having a focal point in each county and
how non-focal point counties have a direct access to
information and services.
(6) Quality Assurance Procedures for All AAA Activity.
(i) Quality assurance procedures for all services, providers and
management shall be part of the Area Plan and include a quality
assurance procedure for in-home services care plans per CHOICE
Guidelines. All quality assurance tools used during the duration of
the plan shall be submitted with the Area Plan. Include copies of
provider and client survey tools and date of completion of last
provider survey.
1
Older Americans Act, Section 306 (a)(6)(D)
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(7) Emergency Plan, Policy and Procedures.
(i) Describe the AAA’s emergency plan, policies and procedures,
and submit a copy of your agency’s emergency plan and all
associated material. The plan shall include not only an internal AAA
plan but also include a plan for client service continuation and interagency coordination.
(8) Inventory of Available Home and Community-Based Resources.
(A) Provide number of nursing facilities in the PSA, number of
assisted living facilities in the PSA, number of adult foster care
facilities in the PSA, number of adult day care facilities in the PSA,
number of RBA/ARCH facilities in the PSA, number of meal sites in
the PSA, number of senior centers in the PSA, number of case
managers in the PSA (including Area Agency and Independent),
number of transportation providers in the PSA, number of mental
health clinics in the PSA and indication of participation in the “You
Can” program.
(9) Conflict of Interest.
(A) The Area Plan shall provide assurances that funds received
under the OAA will not be used to pay any part of a cost (including
an administrative cost) incurred by the AAA to carry out a contract
or commercial relationship that is not carried out to implement the
OAA.
(B) If an AAA wishes to contract with a service provider that is
contrary to this section, either because an alternative service
provider is not available or because it is in the best interest of the
client, an AAA must request and be granted a waiver from the FSSA
DA. The AAA shall not contract with that service provider unless the
FSSA DA grants the waiver.
(10) Other Requirements.
(A) Also, the Area Plan shall include the following:
(i) SCSEP (Title V) Plan;
(ii) Rationale, goals, objectives, tasks, key indicators and
outcomes for:
(I) Management initiatives
(II) Program Development
(III) Protective Services
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(IV) Access Services
(V) In-Home Services
(VI) Advocacy
(VII) Community Services
(VIII) Legal Assistance
(IX) Disease Prevention/Health Promotion
(X) Senior Community Service Employment Program
(SCSEP)
(XI) Congregate meal site listings
(iii) Nutrition Services Information
(I) Waiver for frequency of nutrition services
(II) Case Manager Certification Process
(III) Assurances including:
(a) Regulatory Requirements
(b) General Assurances
(c) Equal Opportunity and Civil Rights
(d) Provision of Services
(16) Cost Allocation Plan
(a) The AAA shall list the general approach used in allocating costs to
particular grants and contracts, in compliance with OMB Circular A-122 –
“Cost Principles for Non- Profit organizations”. The list shall include the
following information:
(1) How the AAA charges all allowable direct costs.
(2) What the AAA uses as allowable joint or shared costs.
(3) How all other allowable general and administrative costs are
allocated.
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(b) Allocation of Joint Costs.
(1) The AAA shall submit a Cost Allocation Plan which includes a
summary of the AAAs methods and procedures used to allocate
costs to programs, grants, contracts and agreements during the
Area Plan period. The allocation of joint costs shall include a
summary of the methodology on how joint costs are allocated.
(c) Compensation for Personal Services.
(1) The AAA shall submit a list of compensation for personal
services to include the following information:
(A) How the salaries and wages of staff assigned and working
full time for a program are allocated to that program.
(B) How the salaries and wages of staff assigned and working
for more than one program are allocated based upon that
individual’s timesheet time allocation (with the supervisor’s
approval signature).
(d) Employee Benefits and Related Expenses.
(1) The AAA shall submit a list of Employee Benefits and Related
Expenses including FICA, FUTA, group insurance, Worker’s
Compensation, and Flexible Compensation. These costs are to be
allocated in the same manner as salaries and wages.
(e) Space Costs.
(1) An explanation of the methodology to determine space costs
shall be included as part of the Cost Allocation Plan.
(2) Space costs are to be allocated based upon usable square
footage. Costs include rent, electricity, gas, water and sewerage,
and cleaning services. A schedule is prepared at the beginning of
each year for each building which identifies the square footage
being used by each individual.
(3) A schedule which identifies the square footage being used by
each individual is to be prepared at the beginning of each year for
each building. The resulting square footage distributions are divided
by total square footage to arrive at percentage distributions for each
individual. Space costs will be allocated to each program based
upon time allocations of the individual occupying the space.
(f) Telephone and Postage.
(1) An explanation of the methodology to allocate telephone costs
shall be included as part of the Cost Allocation Plan.
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(g) Contracts for Services.
(1) An explanation of the methodology to determine space costs
shall be included as part of the Cost Allocation Plan.
(A) Insurance. (Cost for insurance will be allocated to
benefited programs based upon what is being insured and
the method used by the insurance company.)
(2) Professional Service Contracts.
(h) All other contracts.
(1) An explanation of the methodology used for other contracts
shall be included as part of the Cost Allocation Plan.
(i) Materials and Supplies.
(1) An explanation of the methodology used to allocate materials
and supply costs shall be included as part of the Cost Allocation
Plan.
(A) Supplies ordered for a specific program will be allocated
to that specific program.
(B) Commonly used office supplies shall be stored in specific
locations and made available to all agency employees.
(C) The AAA shall include an explanation of how supplies are
charged back to programs (requisition methods).
(D) Photocopying will be allocated based upon a specific
usage rate per copy (listed separately for black and white and
color copies).
(k) Travel and Transportation.
(1) Travel and transportation costs shall be allocated based on the
purpose of travel. All travel and transportations costs shall be
charged directly to the program for which the travel was incurred.
(l) Food Purchases.
(1) An explanation of the methodology used to allocate food
purchase costs shall be included as part of the Cost Allocation Plan.
OMB Circular A-122 applies to such purchases.
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(m) Other Expenditures.
(1) Other costs will be allocated by a base determined to be
appropriate to the cost.
(n) Capital Expenditures ($5000 or more).
(1) Capital expenditures are allocated according to the direct
program for which the expenditure is used. After receiving
appropriate written funding source approval, equipment will be
purchased in accordance with AAA bidding and purchasing
requirements. The cost will then be allocated to the program
ordering and using the equipment.
(2) When depreciation is recognized, it is recognized by the
standards of OMB Circular A -122. If more than one program uses
the equipment, then an allocation of the depreciation of the
purchase cost will be based upon the particular equipment, unless
all funding sources approve charging a share of the purchase cost
to their grant.
(o) Allocation of General and Administrative Expenses.
(1) Allocation of general and administrative costs is the relative
percentage of direct service labor hours within each program as
compared to the agency as a whole. All general and administrative
costs incurred by the agency are accumulated in a group of expense
accounts maintained in an indirect cost pool.
(o) Allocation of Medicaid Waiver Administration.
(1) List the methodology of how these units are determined as
billable units.
(p) Lists of Grants, Contracts, and Agreements.
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2022.2 SUBMISSION OF THE AREA PLAN
(a) Policy.
(1) Upon receipt of annual instructions from the FSSA DA, the AAA shall complete
and send an original of the complete Area Plan (copies not accepted). The Area
Plan shall be sent electronically and in written form to the Director of the FSSA
DA. The written form of the Area Plan shall contain appropriate original
signatures, including the signature of the AAA Director.
(2) The FSSA DA Director shall ensure the new Area Plan is distributed to
appropriate FSSA DA staff for review.
(b) Authority.
Older Americans Act, Section 306(a)
(c) Procedure.
(1) Following receipt of the Area Plan, FSSA DA staff shall review the Area Plan to
assure compliance with federal and state regulations.
(2) The FSSA DA Director shall send notification of necessary Area Plan revisions
electronically and in written form. The notification shall be addressed to the AAA
Director. The notification shall contain instructions and requirements regarding
needed changes, corrections, additions, adjustments, documentation, and a
deadline date for the AAA to submit the revisions, corrections and adjustments to
the Area Plan.
(3) The AAA shall complete all requirements and send back the revised Area Plan
to the FSSA DA within the required time period.
(4) The COA representative shall review each Area Plan with the FSSA DA and AAA
staff and make recommendations for approval or disapproval to the FSSA DA. The
FSSA DA shall maintain final authority on Area Plan approval. If the Area Plan is
found to meet all requirements, the COA shall consent to approval of the Area
Plan.
(6) Upon approval of the Area Plan, the FSSA DA shall issue a notification of the grant
award and/or contract prior to the beginning date of the funding period.
(7) The FSSA DA Director shall notify the AAA Director of the approval of the Area
Plan by means of a written letter.
(8) The FSSA DA shall maintain a paper and electronic version of the Area Plan on
file for the same time period that the Area Plan is in effect. As annual revisions to
the Area Plan are approved, the Area Plan shall be updated by the appropriate
FSSA DA staff. 1
1
Added 4/10/06
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2022.3 AAA POLICY REGARDING DIRECT PROVISION OF SERVICES
(a) Policy.
(1) Except where a waiver is granted by the FSSA DA, area agencies shall award
funds by grant or contract to community services provider agencies and
organizations. Identification of an AAA as a unit within a multi-purpose agency does not
constitute an independent corporate identity. In such agencies, a "contract" between the
AAA and a separate service-delivery provider within the same corporation structure will
be viewed as direct delivery of service by the AAA and will not be permitted without a
waiver approved by the FSSA DA. Service delivery by any AAA that has a corporate
relationship with a service provider in which one corporation maintains majority control of
the board of the other corporation will also be viewed as direct delivery of services and
will require waiver approval by the FSSA DA. The AAAs must adhere to all procurement
policies as found in the FSSA DA website.
(2) The FSSA DA shall consider approval for a direct delivery of services waiver after
analyzing the AAA’s area plan, direct delivery request form and associated
documentation.
(b) Authority.
Code of Federal Regulations, 45 CFR 1321.63(b)
(c) Procedure.
(1) The AAAs are encouraged to develop multiple providers before requesting a waiver
for direct delivery of services.
(2) Specific procedures will be found in Section 2022 - Area Plan on Aging.
(d) Cross Reference.
Section 2022 – Area Plan on Aging - FSSA DA Operations Manual.
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2022.4 AREA PLANS AND PUBLIC HEARINGS
(a) Policy.
Each AAA shall have and implement:
(1) hearings for needs assessments prior to submitting a new area plan to
the FSSA DA for review; and
(2) area-wide public hearings on the area plan prior to an area plan review.
Cross Reference.
Section 3000 – Hearings and Appeals Process - FSSA DA Operations Manual.
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2023 CONFLICT OF INTEREST
(a) Policy.
(1) Conflict of interest refers to ethical conduct in the workplace wherein the public
obligations and the private interests of an employee may be in conflict and could
influence the employee’s judgment. It is the State officer’s or employee’s duty to
determine if a potential conflict of interest exists, to avoid the conflict, if possible, or,
where applicable, to disclose a conflict.
(2) An FSSA DA employee or representative shall not solicit or accept compensation
other than that provided for by law for the performance of official duties. State
employees, including employees of the FSSA DA, are not permitted to accept any gifts,
meals, or similar items from vendors and lobbyists, if those vendors or lobbyists do
business with the Family and Social Services Administration (FSSA).
(3) No employee or representative of the FSSA DA or an AAA shall be subject to a
conflict of interest prohibited under the OAA.
(4) No employee or representative of the FSSA DA should use his or her position with
the FSSA DA or information acquired during employment with the FSSA DA in a manner
that may create a conflict or the appearance of a conflict, between the employee’s
personal interests and those of the FSSA DA or of the FSSA.
(5) All activities conducted as an employee of the FSSA DA should always place the
lawful and legitimate interests of the FSSA DA over personal gain.
(6) Absent written authorization by the FSSA DA, no employee shall be affiliated with
any buyer, purchasing agent, or provider of goods or services to the FSSA DA or FSSA.
Such affiliation generally is inconsistent with the employee’s capacity to deal with all
providers; to fairly and honestly service the public interest; and to discharge his or her
responsibility to the FSSA DA or FSSA.
(7) Conflict of Interest Situations
(i) Conflict of interest may exist in the following situations:
(I) employment in which relatives are involved in a supervisory-subordinate
relationship; or
(II) a business relationship wherein an employee stands to gain financially from
transactions, purchases, property, services, or any other type of contractual
relationship that would not "maintain the integrity and public purpose of services
provided”.
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(c) Authority.
Older Americans Act, Section 307(a)(11)(B)
Older Americans Act, Section 307 (a)(7)(B)(i)(ii)
Older Americans Act, Section 307(a)(7)(B)(i)(ii)(iii)
Indiana Code, 4-2-6-3
Indiana Code, 4-2-6-9
Indiana Code, 4-15-7-1
Indiana Code, 35-44-1-3
Indiana Administrative Code, 40 IAC 2-1-9
(d) Procedure.
(1) The Indiana Department of Administration (IDOA) may cancel any contract with any
AAA, without recourse by the AAA, if a conflict of interest situation arises and is not
satisfactorily resolved, within a reasonable amount of time.
(2) The IDOA will not exercise its right of cancellation, if the AAA obtains a written
opinion from the State Ethics Commission indicating that the conflict of interest has been
resolved and/or does not violate any statute or code, relating to conflict of interest or
ethical conduct.
(3) The IDOA may take action, including cancellation of the contract consistent with a
written, official opinion of the State Ethics Commission, regarding a possible conflict of
interest situation or ethical conduct violation.
(4) If an FSSA DA employee or an AAA employee or staff member has any reason to
believe there may be a conflict of interest, he or she should immediately disclose the
matter to an immediate supervisor or the ethics officer.
(5) An AAA may not contract for services with any entity that is owned or controlled by
any of the following:
(A) A member of the AAA's board of directors, or
(B) A member of the AAA staff; or
(C) A relative of any member of the AAA's board of directors, or executive staff,
including the executive director.
(6) The AAA shall disclose to the Indiana Department of Administration (IDOA) the
following:
(A) when an individual executing a grant for the AAA, awarded through the FSSA
DA becomes a State employee; or
(B) when an individual who has an interest of 3% or more of an entity receiving a
grant awarded through the FSSA DA, becomes a State employee; or
(C) when a spouse or unemancipated child of an individual that is executing a
grant for the AAA or has an interest of 3% or more of an entity receiving a grant
through the FSSA DA becomes a State employee.
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(7) If a person or entity provides case management services to an older adult or a
person with disabilities, then that person or entity shall not provide any other service
under this article to that particular individual or ay other individual under the Medicaid
Waivers unless a Waiver is received and approved by the FSSA DA.
(e) Cross Reference.
“Conflict of Interest” section of the contract agreement between the AAA and FSSA DA.
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2023.1 CONFLICT OF INTEREST RULES
CHART 3
460 IAC 1-5-10 CONFLICT OF INTEREST (ADULT GUARDIANSHIP SERVICES)
Sec. 10. (a) The provider shall avoid even the appearance of a conflict of interest or
impropriety when dealing with the needs of the recipient. Impropriety or conflict of
interest refers to a situation in which the provider has a personal or financial interest, or
both, that may be perceived as self-serving or adverse to the position or the best interest
of the recipient.
(c) The provider's adult guardianship services program volunteers shall be free from
conflict of interest.
(d) The provider's adult guardianship services program advisory committee shall have a
written plan for resolving conflicts of interest.
460 IAC 1-4-9 CONFLICTS OF INTEREST (CHOICE RULE)
Sec. 9. (a) The AAA shall not contract for CHOICE services with any service provider
that is owned or controlled by a member of the AAA's board of directors or a member of
the AAA's staff.(b) The AAA shall not contract for CHOICE services with any service
provider that is owned or controlled by a relative (father, mother, brother, sister, uncle,
aunt, husband, wife, son, daughter, son-in-law, daughter-in-law, grandmother,
grandfather, grandson, or granddaughter) of any member of the AAA's board of director
or executive staff, including the executive director.(c) An AAA that wishes to contract
with a service provider contrary to this section, due to the lack of an alternative provider
or because it is in the best interest of the participant, must request and be granted a
waiver from the division.
460 IAC 1-7-11 CONFLICT OF INTEREST; STATE OMBUDSMAN (LTC OMBUDSMAN)
AND STATE LEVEL OFFICE STAFF
Sec. 11. Any individual who has the following conflicts of interest, or any individual who
has an immediate family member with these conflicts of interest, shall not be appointed
as state ombudsman or to the staff of the state office:
(1) Having a financial interest in a long term care facility or a long term care service
within three (3) years before the date of appointment.
(2) Employment in a long term care facility within one (1) year before the date of
appointment.
(3) Current direct involvement in the licensing or certification of a long term care facility
or a provider of a long term care service.
(4) Current employment in, contractual arrangement with, or participation in the
management of a long term care facility.
(5) Current membership in a trade association of long term care facilities.
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460 IAC 1-7-12 CONFLICT OF INTEREST; BOARD MEMBERS, (OMBUDSMAN)
OFFICERS, AND EMPLOYEES OF LOCAL OMBUDSMAN ENTITIES
Sec. 12. (a) Board members of the local ombudsman entity who are not free from
conflicts of interest shall not participate in any discussion or vote on any matters
pertaining to the program, and such refusal shall be made a part of the minutes or other
official record of the local entity’s board of directors or other comparable governing body.
Such conflicts of interest include the following:
(1) Current direct involvement in the licensing or certification of a long term care facility
or a provider of a long term care service.
(2) Current employment in, contractual arrangement with, or participation in the
management of a long term care facility.
(3) A current financial interest in a long term care facility or a long term care service.
(4) Current membership in a trade association of long term care facilities.
(b) In order to receive and maintain designation or to be redesignated as a local
ombudsman entity, officers of those entities seeking to be designated or redesignated as
local ombudsman entities shall be free from conflicts of interest, which include the
following:
(1) Current direct involvement in the licensing or certification of a long term care facility
or a provider of a long term care service.
(2) Current employment in, contractual arrangement with, or participation in the
management of a long term care facility.
(3) A current financial interest in a long term care facility or a long term care service.
(4) Current membership in a trade association of long term care facilities.
(c) In order to receive designation, or redesignation, as a local ombudsman entity,
employees of those entities who supervise a local ombudsman shall be free from
conflicts of interest, which include the following:
(1) Current direct involvement in the licensing or certification of a long term care facility
or a provider of a long term care service.
(2) Current employment in, contractual arrangement with, or participation in the
management of a long term care facility.
(3) A current financial interest in a long term care facility or a long term care service.
(4) Current membership in a trade association of long term care facilities.
460 IAC 6-19-9 CONFLICT OF INTEREST (SUPPORTED LIVING CASE MANAGEMENT)
Sec. 9. If a person provides case management services to an individual, then that
person shall not provide any other service under this article to that particular individual.
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2024 NEPOTISM
(a) Policy.
(1) No person being related to any member of any state board or commission, or to
the head of any state office or department or institution, as father, mother, brother,
sister, uncle, aunt, a husband or wife, son or daughter, son-in-law or daughter-in-law,
niece or nephew, shall be eligible for any position in any such state board,
commission, office, or department or institution, as the case may be, nor shall any
such relative be entitled to receive any compensation for his or her services out of
any appropriation provided by law.
(2) No persons related as father, mother, brother, sister, husband, wife, son,
daughter, uncle, aunt, son-in-law, daughter-in-law, niece, or nephew may be placed
in a direct supervisory-subordinate relationship.
(3) This section shall not apply if such person has been employed in the same
position in such office or department or institution for at least twelve consecutive
months immediately preceding the appointment of his relative as a board member or
head of such office, department, or institution.
(4) To establish uniform guidelines within the FSSA DA, the hiring of family members
is restricted. Persons related to any member of any state board or commission or to
the head of any state office, department, or institution:
(A) shall not be eligible to hold any position within the same entity; and
(B) are not eligible to receive any compensation for services out of any
appropriation.
(5) The restrictions do not apply if the person has been employed in the same
position within the office, department, or institution for twelve consecutive months
immediately preceding the appointment of his or her relative as a board member or
head of such office, department, or institution.
(b) Authority.
Indiana Code, 4-15-7-1(d)
Indiana Code, 1-1-19-9
FSSA Policies and Procedures Manual –AD1-20
(c) Procedure.
Employees of the FSSA DA have the responsibility to contact their supervisor, the
FSSA Ethics Officer or the State Ethics Commission whenever there are questions
involving gifts from vendors.
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2025 ACCEPTANCE OF GIFTS
(a) Policy.
State employees, including employees of the FSSA DA, are not permitted to accept
any gifts, meals, or similar items from vendors and lobbyists if they do business with
the Family and Social Services Administration (FSSA).
(b) Authority.
FSSA Policies and Procedures Manual -AD1-20, and Older Americans Act, Section
306(a) (14).
(c) Procedure.
(1) Employees of the FSSA DA have the responsibility to contact their supervisor,
the FSSA Ethics Officer or the State Ethics Commission whenever there are
questions involving gifts from vendors.
(2) An AAA may not contract for services with any entity that is owned or controlled
by any of the following:
(A) A member of the AAA's board of directors, or
(B) A member of the AAA staff; or
(C) A relative of any member of the AAA's board of directors, or executive
staff, including the executive director.
(3) The AAA shall disclose to the Indiana Department of Administration (IDOA) the
following:
(A) when an individual executing a grant for the AAA, awarded through the
FSSA DA becomes a State employee; or
(B) when an individual who has an interest of 3% or more of an entity
receiving a grant awarded through the FSSA DA, becomes a State
employee; or
(C) when a spouse or unemancipated child of an individual that is executing a
grant for the AAA or has an interest of 3% or more of an entity receiving a
grant through the FSSA DA , becomes a State employee.
(D) If a person or entity provides case management services to an older adult
or a person with disabilities, then that person or entity shall not provide any
other service under this article to that particular individual or any other
individual under the medical Medicaid Waivers, unless a Waiver is received
and approved by the FSSA DA.
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2026 CONFIDENTIALITY
(a) Policy.
(1) Except as properly authorized by the FSSA DA or the FSSA, it shall be the
responsibility of all employees to maintain the confidentiality of all information not
required by law to be disclosable to the public including electronic mail, memorandums
and conversations.
(2) According to the FSSA Code of Conduct, all employees who suspect violations of the
letter or spirit of the Code of Conduct have an obligation to report their concerns to the
FSSA DA or the FSSA designated ethics officer. Employees may also relate their
suspicions or specific incidents to any member of the State Ethics Commission.
(3) No adverse action shall be taken or permitted against anyone for communicating
legitimate concerns to the appropriate persons. While an investigation will be facilitated
if the employee identifies himself or herself, the FSSA DA or FSSA will accept and
investigate matters submitted anonymously.
(b) Authority.
PL104-191
(c) Procedure.
(1) All employees and contractors under the jurisdiction of the State Ethics Commission
are expected to follow the rules outlined in the Indiana Code of Ethics for the Conduct of
State Business document and PL 104-191 – Health Insurance Portability and
Accountability of 1996 (HIPAA).
(2) All new employees shall complete training regarding State ethics requirements on the
first day of work following the beginning of a contract term or pursuant to an internal
requisition if, in the judgment of the Division Director or the FSSA Secretary, the
contractor will work more than thirty hours a week for more than twenty-six weeks during
any one year period.
(3) The AAA shall agree that all information, including but not limited to information
concerning older adults or person with disabilities, received by the AAA or a service
provider, in administering the terms and provisions of a contract agreement between the
FSSA DA and the AAA, shall be received and maintained in a confidential manner
corresponding with the condition set forth in the contract agreement and the
requirements of the Older Americans Act, the Indiana Code and any other applicable
laws and regulations.
(d) Cross Reference.
Section 7 - Health Insurance and Portability Act of 1996 (HIPAA) - FSSA DA Operations
Manual.
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2027 COORDINATION
(a) Policy.
(1) The FSSA DA shall provide a comprehensive and coordinated service system for
Indiana’s aging population, giving high priority to those individuals in greatest need. In
carrying out these duties, the FSSA DA shall coordinate service delivery with the AAAs.
(2) Also, the FSSA DA shall initiate, evaluate, and provide assistance for improving
programs in cooperation with all other state agencies having concerns or responsibilities
for older adults.
(b) Authority.
Indiana Code, 12-10-1-4
Indiana Code, 12-10-1-5
Indiana Code, 12-10-1-6
United State Code, 42 USC 3027(a)(17)
Code of Federal Regulations, 45 CFR 1321.7
Code of Federal Regulations, 45 CFR 1321.17(f)(8)
(c) Procedure.
(1) The FSSA DA will coordinate planning, identification, assessment of needs, and
services for older adults with disabilities, giving particular attention to persons with
severe disabilities, with the appropriate state agencies, to enhance services and develop
collaborative programs to meet the needs of older adults with disabilities.
(2) The FSSA DA shall ensure the maximum availability of services to older adults and
persons with disabilities through the following coordination and resource activities:
(A) coordination of the FSSA DA and the AAAs needs assessments;
(B) monitoring, oversight and statewide coordination in the
development and implementation of the Area Plans;
(C) development of the State Plan; and
(D) contracting with the AAAs to carry out assessment and plans needs and
goals.
(3) The AAA designated by the FSSA DA in each planning and service region shall
coordinate, in cooperation with other agencies or organizations in the area, region,
district, or county, all programs and activities providing health, recreational, educational,
or social services for older adults.
(4) Each AAA and its service providers shall coordinate planning and service delivery
with other agencies and organizations within the PSA.
(5) The FSSA DA shall complete the following procedures to ensure coordination of
services to older adults and persons with disabilities;
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(A) identify national and state programs which impact or could impact older
adults and persons with disabilities;
(B) participate in organizations developed for purposes of information
sharing, joint planning and service delivery;
(C) establish public/private coalitions to address the growing needs of older
adults;
(D) enter into cooperative agreements with state agencies and organizations in
order to clearly outline respective responsibilities and expected outcomes;
(E) extend opportunities for participation in the FSSA DA sponsored training to
state health and social service agencies and organizations that serve and/or
advocate for older adults; and
(F) extend opportunities for participation in the FSSA DA sponsored training to
businesses and organizations which improve the skills of the FSSA DA staff and
otherwise further the interests and needs of older adults and persons with
disabilities.
(6) The AAA shall do the following:
(A) initiate new services and pursue resource development at the local and area
levels.
(B) have a process in place that invites participation for the development and
implementation of the area plan and the CHOICE plan from a variety of sources,
including consumers, providers, advocacy groups, independent living centers,
hospitals, nursing homes, and the general public; and
(C) conduct evaluations, at least on an annual basis, of providers and projects
delivering services to older adults and persons with disabilities.
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2028 DIRECT DELIVERY OF SERVICES
(a) Policy.
(1) No supportive services, nutrition services, or in-home services will be directly
provided by the FSSA DA or an AAA, except where, in the judgment of the FSSA DA:
(A) provision of the service by the FSSA DA or an AAA is necessary to assure an
adequate supply of services;
(B) services are directly related to the FSSA DA or AAA administrative function;
or
(C) services of comparable quality can be provided more economically by the
FSSA DA or an AAA.
(2) Identification of an AAA as a unit within a multi-purpose agency does not constitute
an independent corporate identity. In such agencies, a "contract" between the AAA and
a separate service-delivery provider within the same corporation structure will be viewed
as direct delivery of service by the AAA and will not be permitted without a waiver
approved by the FSSA DA. Service delivery by any AAA that has a corporate
relationship with a service provider in which one corporation maintains majority control of
the board of the other corporation will also be viewed as direct delivery of services and
will require waiver approval by the FSSA DA. The AAAs are encouraged to develop
multiple providers before requesting a waiver for direct delivery of services.
(3) The AAAs must adhere to all procurement policies as found in the FSSA DA website.
(b) Authority.
Older Americans Act, Section 307
Code of Federal Regulations, 45CFR 1321.63
(c) Procedure.
Section 2023 – Area Plan on Aging – FSSA DA Operations Manual.
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2029 INFORMATION SHARING
(a) Policy.
(1) The FSSA DA shall promote community education regarding the problems of older
adults through institutes, publications, radio, television and the press, and establish and
maintain information and referral sources throughout Indiana when not provided by other
agencies.
(2) The FSSA DA shall serve as a clearinghouse for information on issues affecting
older adults and persons with disabilities.
(b) Authority.
Indiana Code, 12-10-1-4
(c) Procedure.
(1) The FSSA DA may gather and disperse information from national, state, and local
sources regarding problems and issues facing older adults and adults with disabilities,
through methods such as:
(A) communication materials such as brochures, information sheets, websites
external/internal links, help-lines, information and referral programs and other
materials and programs as indicated and appropriate;
(B) participation in state and local educational forums (conferences, training,
seminars) either by hosting or collaboration with key stakeholders;
(C) overseeing the information and referral programs within the AAAs based on
the State Plan and the individual AAA plan;
(D) presenting the annual Governor’s Conference on Aging and In-Home
Services;
(E) presenting and sponsoring events and displays at the senior citizen’s building
during the annual Indiana State Fair; and
(F) maintaining an accurate and informative website for the FSSA DA.
(2) The AAA shall dispense information through the following:
(A) community education via institutes, publications, radio, websites, television,
and the press;
(B) training for AAAs, service providers, special interest groups, and key
stakeholders in the community;
(C) workshops and special events for older adults and persons with
disabilities; as well as providers who serve these constituents; and
(D) contacts with individuals and specific stakeholder groups based on the type
of information to be shared and the specific aspect of educational delivery.
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2030 MARKETING MATERIALS
(a) Policy.
(1) Potential press releases or marketing materials, initiated by the FSSA DA, including
brochures, radio, television or printed advertisements or any other marketing or
informational documents shall be routed through the Office of Communications for
release to the public.
(b) Authority.
Indiana Code, 12-10-1-4(12)
(c) Procedure.
(1) The FSSA DA director will forward such materials to the communications liaison for
input, feedback, and approval. Responses will be made to the FSSA DA Director for
follow up. Timelines are based on level of urgency for the proposed materials.
(2) Materials developed by the Office of Communications that refer, address or respond
to issues, concerns, and topics that are age-specific/relevant material will be provided to
the FSSA DA Director for input and feedback. Response time will be based on the level
of urgency for proposed materials.
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2031 RETENTION OF RESOURCE RECORDS
(a) Policy.
(1) Administrative and some public information files shall be kept in the Library and
Resource Center. Certain types of records have a required time period of retention.
(2) Administrative records such as official minutes of any state agency, board,
commission meeting, or of any division; are to be kept for five years after the end of the
calendar year of the meeting.
(3) After the five years, the record is transferred to the Commission on Public Records,
State Archives Division. The office manager monitors the retention of these records and
is responsible for the transfer of these records to the Indiana Commission of Public
Records, Archives Division.
(b) Authority.
Indiana Code, 5-15-5.1-5(a)(9)
Indiana Code, 5-15-5.1-12
(c) Procedure.
(1) Administrative files could be used to respond to public inquiries on policies or
programs or miscellaneous agency projects.
(2) Public information files should be transferred to the COMMISSION ON PUBLIC
RECORDS, STATE ARCHIVES DIVISION, for evaluation, sampling or weeding
pursuant to archival principles, when the files become outdated or replaced. The office
manager monitors the retention of these records and is responsible for the transfer of
these records to the Indiana Commission of Public Records, Archives Division.
(Evaluation sampling is done by ICPR/Archives.) Public information files such as typical
administrative files could contain correspondence, publications, maps, drawings and
related records.
(d) Cross Reference.
Records Center Handbook for State Agency Staff –found on the Commission on Public
Records website www.in.gov/icpr.
FSSA DIVISION OF AGING Operations Manual
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2032 GOVERNOR’S CONFERENCE ON AGING
(a) Policy.
The FSSA DA shall plan and host the annual Indiana Governor's Conference on Aging
and In-Home Services.
(b) Authority.
Indiana Code, IC 12-10-1-4 (17)
(c) Procedure.
(1) Planning for the Indiana Governor's Conference shall commence approximately one
year prior to the event. Securing a date and venue shall be the first planning priority,
followed by the development of an event timeline.
(2) Conference planning work shall be developed and operated with a community based
planning committee that meets, at a minimum, nine times during the yearly planning
cycle. Meeting agendas, notes, and reports are recorded and kept in a conference
planning manual. The conference manual provides the conference planning timeline with
appropriate context and operational directions to be followed.
(3) The Governor’s office is notified initially when the date/time/location is determined.
Both electronic mail and formal letters are sent to the Governor’s office 6 months prior to
the actual conference date, with follow up at 2 months prior to the event. Drafts of the
welcome letter, and any key directions/talking points are requested 3 months prior to the
conference date. The Governor shall be formally invited upon securing the date and
location.
(4) The Indiana Governor’s Conference will be planned and conducted in accordance
with all relevant state codes and guidelines and reflect the goals of the FSSA DA and
the FSSA. The conference will also reflect relevant goals and objectives outlined in the
State plan, community stakeholder strategic objectives (as appropriate), as well as the
principles of sound geriatrics.
(5) The FSSA DA shall adhere to guidelines concerning, but not limited to, submissions
of budget and venue contracts. All efforts should be made to ensure that the conference
is fiscally self-sustaining.
FSSA DIVISION OF AGING Operations Manual
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2033 INDIANA STATE FAIR
(a) Policy.
The FSSA DA shall participate every year in the Indiana State Fair.
(b) Authority.
Indiana Code, 12-10-1-4(12)
(c) Procedure.
(1) The date of the Indiana State Fair is set by the State Fair Board of Directors.
(2) The FSSA DA has the use of an assigned state fair building during the fourteen day
run of the state fair. The FSSA DA state fair coordinator shall consult with the sixteen
AAA event coordinators when planning the yearly activities for the state fair event.
(3) If the FSSA DA has a sponsor for the annual state fair event, the name appearing on
the building accommodating the event may change, however, Senior Citizens Building
must always be part of the name.
(4) The events, decorations, and displays at the FSSA DA state fair event shall reflect
the goals of the FSSA, and the FSSA DA and shall provide information and services to
those persons that visit the senior citizens building. The state fair will pay for the use of
all other materials and services to maintain the building during the fourteen day event.
(5) The FSSA DA must pay for the use of the senior citizens building, using monies
made available by the FSSA DA or FSSA.
(6) The FSSA DA shall sell booth space at the senior citizens building to pay for use of
the state fair building.
(7) The FSSA DA state fair coordinator must submit a budget to the State Fair Fiscal
Department in a timely manner.
(8) An annual meeting shall be held after the State Fair is concluded.
(9) The AAA shall coordinate with the FSSA DA (when requested) in the planning and
presentation of the annual Indiana State Fair event.
FSSA DIVISION OF AGING Operations Manual
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2034 MONITORING AND ASSESSMENT
(a) Policy.
(1) Monitoring and assessment is an evaluation to identify whether the requirements of
current program laws, plans, policies, goals and objectives are being met, to determine
needs for technical assistance, and to identify particular needs for best-practice
recommendations.
(2) The FSSA DA shall review, assess, monitor, evaluate and comment on Federal,
State and local plans, budgets, regulations, programs, law, levies, hearings, policies, and
actions which affect or may affect older adults and recommend any changes in which the
FSSA DA considers to be appropriate.
(b) Authority.
United States Code, 42 USC 3027(a) (4)
Code of Federal Regulations, 45 CFR 1321.13
Code of Federal Regulations, 45 CFR 1321.7(c)
Code of Federal Regulations, 45 CFR 1321.53
Indiana Code, 12-10-1-4(7)
(c) Procedure.
(1) Monitoring activities shall be completed for each AAA, within the period of the AAA
Contract Agreement. Monitoring and Assessment activities may include the following:
(A) review of AAA area plans;
(B) on-site visits to the AAAs; and
(C) other data gathering activities, such as desktop review and electronic
review, completed for individual programs.
(2) Assigned FSSA DA staff shall coordinate monitoring and assessment activities with
program coordinators and specialists within other units in the FSSA DA.
(3) The FSSA DA shall perform the following monitoring and assessment activities:
(A) evaluate activities, services, and programs receiving funds under the State
Plan by reviewing claims for reimbursement, financial reports, program
performance reports, and other electronic and hard copy communications and
through on-site visits to the AAAs.
(B) utilize assessment instruments that will be made available to the AAA prior to
use by the FSSA DA.
(4) The following AAA or service provider activities will be monitored for compliance:
(A) fiscal management practices and procedures;
(B) AAA operation, including coordination with other service providers, area
FSSA DIVISION OF AGING Operations Manual
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plans, priority services to target populations, grants and contracts under the area
plan, and stewardship of the OAA;
(C) AAA administration policies and procedures;
(D) Senior Community Service Employment Program (SCSEP - Title V);
(E) in-home services and case management;
(F) information and assistance programs;
(G) nutrition services including meal-site assessments for congregate and
home-delivered meals;
(H) other service-specific assessments as appropriate; and
(I) implementation of policy.
2034.1 Monitoring Visit to the AAA
(1) The FSSA DA will prepare and forward a report to the AAA within thirty days from a
monitoring and assessment visit indicating accomplishments, program performance, and
any findings requiring corrective actions.
(2) Copies of the report shall also be sent to the appropriate unit supervisor and program
coordinator or specialist.
(3) The AAA must respond in writing, to the Executive Director of the FSSA DA within
thirty days of the receipt of the assessment report on any recommendation and/or
corrective action indicated. The AAA will be afforded an opportunity to explain in writing
or in a meeting, any aspect of the assessment with which the AAA disagrees or needs
clarified. At the discretion of the FSSA DA, the AAA may be required to submit a written
corrective action plan, within a specified timeframe, to the FSSA DA. The FSSA DA
shall monitor any submitted corrective action plan for compliance.
(4) If an AAA fails to submit a corrective action plan within the specified time frame or if
an AAA submits an incomplete or unsatisfactory corrective action plan, or if the AAA
does not take the appropriate corrective actions within a specified target date, the FSSA
DA may sanction the AAA through punitive measures which may include decertification
of the AAA.
(5) The AAA shall carry out the following:
(A) provide access to fiscal and program information necessary for state or
federal monitoring and assessment in both hard copy and electronic documents;
(B) respond within the requested time frame to problems addressed in written
reports or included in a corrective action plan; and
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(C) self monitor and assess activities, services, and programs funded under the
area plan, including those provided by an AAA under a direct delivery of services
waiver.
(D) develop monitoring and assessment instruments and written procedures for
carrying out monitoring and assessment functions;
(E) maintain documentation of all monitoring and assessments, technical
assistance, and corrective actions in the appropriate service-provider file;
(F) ensure that all of its service providers maintain adequate fiscal and
programmatic records as required for services funded through the AAA; and
(G) ensure that service providers submit fiscal and program reports to the AAA
as requested and permit the FSSA DA and AAA staff to examine service
documents and records as necessary to monitor or assess programs.
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2034.2 MONITORING AND ASSESSMENT REGARDING THE AMERICANS WITH
DISABILITIES ACT (ADA)
(a) Policy.
(1) The FSSA DA shall review AAA written policy to assure that AAA facilities are
in compliance with the Americans with Disabilities Act (ADA).1
(2) The AAAs shall comply with all ADA standards.
(3) All AAAs shall maintain a written policy concerning the use and evaluation of
all their buildings and buildings used by their clients relating to ADA compliance.
(b) Authority.
Public Law 101-336 (ADA)
United States Code 42, USC 126, Section 12181, 12182 and 12186
(c) Procedure.
The written policy must be maintained in the AAA’s formal policy manual.
(1) The written policy must address the following priorities:
(A) accessible approach and entrance;
(B) access to goods and services;
(C) access to rest rooms;
(D) any other measures necessary.2
1
Added 4/10/06
The Americans with Disabilities Act Checklist for Readily Achievable Barrier Removal (August 1995)
- Checklist for Existing Facilities - version2.1 recommends access to public buildings should be reevaluated annually.
2
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2035 NEEDS ASSESSMENT
(a) Policy.
(1) The FSSA DA shall perform the following duties:
(A) Evaluate programs, services and facilities for the aged and determine the
extent to which those programs, services, and facilities meet the needs of the
aged.
(B) Examine the needs of the aged and prepare programs and facilities to meet
those needs.
(b) Authority.
United States Code, 42 USC 3026(a)(1)
(c) Procedure.
(1) The FSSA DA shall do the following:
(A) conduct statewide needs assessments, every four years, in conjunction with
the FSSA DA State Plan to determine service gaps and needs; and
(B) assure that the AAAs conduct needs assessments, in conjunction with the
AAA area plan, to determine needs and location of services.
(2) The AAA shall conduct assessments to determine the service needs and priorities of
older adults and persons with disabilities within the PSA.
(3) To the greatest extent possible, findings of needs assessments shall determine the
method for delivering services.
(4) The AAA's assessment techniques may include the following methods:
(A) Reviewing census data for the particular area or areas of similar size and
population along with other statistical indicators of the community.
(B) Interviewing key informants who are knowledgeable about the community, its
people, their needs, and patterns of services already received.
(C) Gathering raw data through a survey of a population sample, completed by
the AAA board of directors or an objective third party.
(D) Any other valid research technique to acquire the necessary data.
(5) The AAA shall:
(A) in conjunction with the submission of each full new area plan, conduct a PSA
wide assessment which determines service needs, service deficiencies and
priorities of older adults and persons with disabilities within the PSA.
(B) the AAA’s assessment techniques shall be either a formal area-wide needs
FSSA DIVISION OF AGING Operations Manual
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assessment survey or an alternative which includes at least 3 of the following:
(i) review of available census data and other statistical indicators for the
PSA;
(ii) interviews of key individuals who are knowledgeable about the
community, its population, the needs, and patterns of services already
provided;
(iii) community forums where objectives and needs are identified;
(iv) the gathering of data through a survey of population sample;
(v) the AAA shall conduct at least 1 public hearing regarding the needs
assessment findings, and;
(vi) any other valid research technique to acquire the necessary data.
FSSA DIVISION OF AGING Operations Manual
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2036 PRIORITY SERVICES
(a) Policy.
Each area agency plan shall provide, through a comprehensive and coordinated service
system for supportive services, nutrition services and where appropriate for the
establishment, maintenance or construction of multipurpose senior centers, within the
planning and service area.
(b) Authority.
Older Americans Act, Section 306
(c) Procedure.
(1) The FSSA DA has specified a minimum percentage of the AAA Title III-B allotment to
be spent in each of the following priority services categories:
(A) Access services—40%
(B) In-home Services—15%
(C) Legal services—3%
(D) Ombudsman services—3%
(2) The FSSA DA shall review program reports, needs assessments, and expenditure
data to determine priority service needs. Required minimum expenditures for each
category of priority services will be shown in the State Plan and the area plan format.
Completed Area Plans will be reviewed to assure that amounts budgeted for priority
services will not fall below the required minimums.
(3) The AAA must address each category of priority services. Every AAA shall develop
an annual budget for its Area Plan that ensures that an adequate amount of its allotment
is expended for the delivery of the following types of services:
(A) access services including transportation; outreach, information and
assistance and case management services.
(B) in home services including supportive services for families of older adults who
are victims of Alzheimer’s disease and related disorders with neurological and
organic brain dysfunction; and
(C) legal assistance.
(4) The AAA shall require each service provider to report quarterly on services and
expenditures. The AAA must monitor and assess each service provider to ensure that
funding designated for priority services is being utilized accordingly.
FSSA DIVISION OF AGING Operations Manual
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2037 REPORTING REQUIREMENTS
(a) Policy.
(1) The plan shall provide that the State agency will make such reports, in such form,
and containing such information as the Assistant Secretary may require, and comply
with such requirements as the Assistant Secretary must impose to insure the
correctness of such reports.
(2) The FSSA DA will prepare reports with the information and in the form required by
the assistant secretary of the Administration on Aging (AoA) and will comply with all
requirements imposed by the assistant secretary to ensure the correctness of the
reports.
(3) At the request of the assistant secretary and for the purpose of monitoring
compliance with the act, including conducting an audit, the FSSA DA shall disclose all
sources and expenditures of funds the FSSA DA and AAAs receive or expend to provide
services for older adults.
(4) Required Reports from the FSSA Division of Aging.
(A) The FSSA DA is required to prepare and submit the following reports; see
appropriate citation for details.
(i) Report: INDIANA STATE PLAN FOR AGING AND IN-HOME SERVICES
UNDER THE OLDER AMERICANS ACT
Authority: OAA 307(a)
Submitted To: U.S. ADMINISTRATION ON AGING
Due: EVERY FOUR YEARS; NEXT ONE DUE September 1st, 2006 1
(ii) Report: CHOICE REPORT - "AND OTHER LONG TERM CARE HOME AND
COMMUNITY BASED PROGRAMS"
Authority: IC 12-10-10-11(a)
Submitted To: GENERAL ASSEMBLY, CHOICE BOARD
Due: ANNUALLY BEFORE OCTOBER 1 (Included as part of the Statewide INHome Services Annual Report)
(iii) Report: TITLE III MAINTENANCE OF EFFORT RE STATE EXPENDITURES
Authority: 45 CFR 1321.49
Submitted To: U.S. ADMINISTRATION ON AGING
Due: ANNUALLY BY JULY
(iv) Report: TITLE III NATIONAL AGING PROGRAM INFORMATION SYSTEM
REPORT (NAPIS)
Authority: OAA 307(a)(6)
Submitted To: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
(ADMINISTRATION ON AGING)
Due: ANNUALLY BY NOVEMBER 30
(v) Report: GOVERNOR’S TASK FORCE ON ALZHEIMER'S DISEASE AND
1
Changed 4/10/06
FSSA DIVISION OF AGING Operations Manual
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RELATED SENILE DEMENTIA ANNUAL REPORT
Authority: IC 12-10-4-5
Submitted To: GENERAL ASSEMBLY
Due: ANNUALLY BY NOVEMBER 1(Included as part of the Statewide IN-Home
Services Annual Report)
(vi) Report: TITLE V SENIOR COMMUNITY SERVICE EMPLOYMENT
PROGRAM ANNUAL PRE-APPLICATION FOR GRANT
Authority: 20 CFR Part 641.204
Submitted To: U.S. DEPARTMENT OF LABOR
Due: ANNUALLY BY APRIL (date depends on bulletin instructions from DOL)
(vii) Report: TITLE V SENIOR COMMUNITY SERVICE EMPLOYMENT
PROGRAM QUARTERLY PROGRESS REPORT
Authority: 29 CFR 97.40(b) or 29 CFR 95.51(b)
Submitted To: U.S. DEPARTMENT OF LABOR
Due: QUARTERLY (JANUARY 31, APRIL 30, JULY 31, OCTOBER 31)
(viii) Report: EQUITABLE DISTRIBUTION REPORT
Authority: 20 CFR Part 641.201(c), OAA 506(c) and (d)
Submitted To: U.S. DEPARTMENT OF LABOR
Due: ANNUALLY BY OCTOBER 1
(ix) Report: TITLE VII OMBUDSMAN STATISTICAL REPORT
Authority: OAA 712(h)
Submitted To: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
(ADMINISTRATION ON AGING)
Due: ANNUALLY BETWEEN FEBRUARY 1 TO APRIL I
(x) Report: ADULT PROTECTIVE SERVICES
Authority: IC 12-10-3-30
Submitted To: INDIANA LEGISLATURE GENERAL ASSEMBLY
Due: ANNUALLY BEFORE FEBRUARY 2
(xi) Report: ADULT GUARDIANSHIP SERVICES
Authority: IC 12-10-7
Submitted To: ANNUALLY TO THE FSSA DIVISION OF AGING FOR THE
FSSA DA ANNUAL REPORT
Due: ACCORDING TO CURRENT SCHEDULES FOR THE FSSA DA ANNUAL
REPORT
(xii) Report: MONEY MANAGEMENT1
Authority: MOU/ARTICLE IV, ITEM O
Submitted To: AARP
Due: SEMI-ANNUALLY AND ANNUALLY ON 1/31 AND 6/30
1
Deleted the word ‘quarterly’ on 4/10/06
FSSA DIVISION OF AGING Operations Manual
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(xiii) Report: OBRA PAS/PARR
Authority: 42 USC 1396r (e)(7)(iv)
Submitted To: CMS
Due: MONTHLY TO ISDH AND EDS
(xiv) Report: FAMILY CAREGIVER SUPPORT PROGRAM
Authority: OAA 371-376
Submitted to: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (AoA)
Due: QUARTERLY FROM AAAS AND DUE TO HSS ANNUALLY
ON JANUARY 31
Authority.
Older Americans Act, Section 307
Older Americans Act section 712
Indiana Code, 12-10-10-11 (a)
Indiana Code, 12-10-4-5
Indiana Code, 12-10-7
Indiana Code 12-10-3-30
Code of Federal Regulations, 20 CFR 97.40
Code of Federal Regulations, 45 CFR 1321.49
Code of Federal regulations, 20 CFR 641.201(c)
MOU/Article IV, Item O
United States Code, Section 42 USC 1396.r (e) (7) (iv)
FSSA DIVISION OF AGING Operations Manual
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2038 TARGET POPULATIONS
(a) Policy.
(1) The FSSA DA shall assure that preference will be given to providing services
to older adults with greatest economic need and older adults with social need
with particular attention to low-income minority adults and older adults residing in
rural areas and include proposed methods of carrying out the preference.
(b) Authority.
Older Americans Act, Section 206(a)
Older Americans Act, Section 305 (a)(2)(E)
Older Americans Act, Section 306(a)(3)(A)
Older Americans Act, Section 306 (a)(4)(B)
Older Americans Act, Section 307 (a) (4)
(c) Procedure.
(1) The FSSA DA shall assure that priority is given to serving those older adults with the
greatest economic and social needs, with particular attention to low-income minority older
adults and older adults living in rural areas. The FSSA DA will focus attention toward
target populations through the following methods:
(A) Organization
The FSSA DA shall divide the state into distinct PSAs after consideration of the
geographical distribution of older adults with the greatest economic and social
needs, giving particular attention to low-income, minority older adults.
(B) Administration
The FSSA DA shall conduct annual evaluations of and public hearings on activities
and projects carried out under the State Plan, including an evaluation of the
effectiveness of the FSSA DA in reaching older adults with the greatest economic
and social needs, giving particular attention to low-income minority older adults. In
conducting such evaluations and public hearings, the FSSA DA shall solicit the
views and experiences of entities that are knowledgeable about the needs and
concerns of low income minority older adults.
(C) Funding Formula
The FSSA DA shall develop and implement an intrastate funding that assures that
funds are available to target populations.
(D) State Plan
(i) The State Plan shall contain specific strategies for service delivery and systems
enhancement for targeted populations.
(ii) The plan shall provide assurances that the special needs of older individuals
residing in rural areas will be taken into consideration, and shall describe how
those needs have been met and describe how funds have been allocated to
meet those needs.
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(5) Area Plan
(A) Section 2022 – Area Plan on Aging – FSSA DA Operations Manual
(6) Other Methods
(A) The FSSA DA shall review area plans before approving them and will also
monitor their implementation. The FSSA DA shall provide technical assistance and
training as needed or requested.
(B) The AAAs will focus attention toward target populations using the following:
(i) Funding Formula
The AAA shall develop and implement an intra-area funding formula that
addresses target populations.
(ii) Advisory Council
The AAA's advisory council shall meet at least quarterly. The AAA shall
document any recommendations made by the advisory council concerning
matters about the AAA's target populations and assure those
recommendations are considered by the appropriate decision making
persons.
(III) Other Methods
Outreach services (Refer to Section 5123 - Outreach Services), the AAA
shall place special emphasis on reaching older adults with the greatest
economic or social needs, giving particular attention to low-income minority
older adults and older adults who reside in rural areas.
(7) Procedure Regarding CHOICE Service Funds
(A) Each AAA shall use at least 20% of CHOICE service dollars for
persons with disabilities under 60 years of age.
Cross Reference.
Section 5007.4 - Allocation of Funds – FSSA DA Operations Manual
Section 5007.4.1 - Funding Formulas – FSSA DA Operations Manual
Section 4021- Outreach Services - FSSA DA Operations Manual
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More Information can be found at:
Code of Federal Regulations,
1300 -1399
45 CFR 1321.13
45 CFR 1321.17
45 CFR 1321.19
45 CFR 1321.21
45 CFR.1321.23
45 CFR 1321.27
45 CFR 1321.29
45 CFR 1321.35
45 CFR 1321.53
United State Code
42 USC 3021 to 3700 - Public Health and Welfare
42 USC 3027(a) (2),
42 USC 3012(a)(26)
42 USC 3026(a) (1)
Indiana Code
4-15-7-1(d)
12-10-1-4 (4)
Older Americans Act of 1965, as amended in 2000
Sections 305(a), 307(a), 705, 712(a)(5)(c)
Conflict of Interest’ Section of the Contract Agreement
FSSA Policy and Procedures Manual AD1-20
Region V - Regional Memorandum
ROM-81-73 Subject: State Plans Based on Area Plans
Community and Home Options to Institutional Care for the Elderly and Persons with Disabilities
(CHOICE) – Guidelines and Procedures
Family and Social Services Administration Employee Orientation Manual
Governor’s Commission on Home and Community Based Services Fact Book – April 24, 2003
Indiana Medicaid Home and Community-Based Waiver Services - A Guide for Consumers Third
Edition, September, 2002
FSSA Division of Aging Operations Manual - Appendix 1 – State Plan Provisions
State Plan, Indiana, Fiscal Years 2004-2005
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Websites
Administration on Aging – www.aoa.gov
Access Indiana – www. IN.GOV
Indiana Association for Area Agencies on Aging – www.IAAAA.org
Indiana Department of Administration - www.in.gov/IDOA
FSSA Website (Intranet)
For ordering hard copies of federal documents - GPO Access - www.access.gpo.gov
FSSA DIVISION OF AGING Operations Manual
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SECTION 3
3000 HEARINGS AND APPEALS PROCESS
(INCLUDING WITHDRAWAL AND DE-DESIGNATION PROCEDURES OF
AREA AGENCIES ON AGING AND PLANNING AND SERVICE AREAS)
Table of Contents
3000 PUBLIC HEARINGS
3000.1 The FSSA DA Procedure Regarding Public Hearings
3000.2 Additional FSSA DA Actions that Require Public Hearings
3000.3 Appeal Process
3001 The FSSA DA Policy and Procedure Regarding the Withdrawal of an AAA
Designation
3001.1 Reasons for Withdrawal of the Designation of an Area Agency on
Aging (AAA)
3001.2 The FSSA DA Preparation for the Withdrawal of the Designation
of an AAA
3001.3 Withdrawal of an AAA Designation
3001.4 Administrative Review
3001.5 Appeals to the Assistant Secretary of the Administration on Aging
3001.6 Continuity of the Functions of the AAA within the PSA
3002 THE FSSA DA DESIGNATION OF AN ADDITIONAL PLANNING AND
SERVICE AREA (PSA)
3002.1 Appeal Procedure Regarding the Designation of an Additional PSA
or Change or Revision of the Boundaries of an Existing PSA
3003 The FSSA DA APPEALS PROCESS REGARDING AN ADVERSE
ACTION OTHER THAN THE WITHDRAWAL OF THE DESIGNATION OF AN
AAA OR THE ADDITION OR CHANGE OF THE BOUNDARIES OF A PSA
3003.1 Step 1: Documentation
3003.2 Step 2: Informal Review with the FSSA DA
3003.3 Step 3: Public Hearing
3003.4 Step 4: Administrative Review
3004 INVOLVEMENT OF AAAs, SERVICE PROVIDERS, OLDER ADULTS,
AND PERSONS WITH DISABILITIES
3005 FSSA DA APPEALS CHART
3006 CLIENT/APPLICANT APPEALS
3006.1 Notification of Client Rights
3006.2 Procedure for Providing Written Notice of Client Rights
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3006.3 FSSA DA Procedure Regarding Appeals and Hearings1
3007 THE FSSA DA APPEAL POLICY AND PROCEDURE FOR
CLIENTS/APPLICANTS APPLYING FOR OR RECEIVING SERVICES FOR
SSBG, CHOICE, AND TITLE III (EXCLUDING IPAS AND PASRR)
3007.1 Step 1: Informal Review with the Case Manager, the Case
Manager Supervisor, and/or an Appropriate Representative
3007.2 Step 2: Agency Review
3007.3 Step 3: Administrative Hearing
3007.4 Assistance Available to a Client/Applicant during the Appeal
Process
3007.5 Requests for Reconsideration and Appeal of Adverse Action
3008 RIGHTS OF CLIENTS/APPLICANTS APPLYING FOR OR RECEIVING
IPAS OR PASRR
3008.1 Process to Request Reconsideration of an Adverse Action
3008.2 Appeal Procedure for Clients/Applicants Applying For or
Receiving IPAS or PASRR Services
3008.3 Appeal Procedure for Title III Service Providers
3008.4 Appeal Process for Service Providers
3008.4.1 Step 1: Informal Review with the AAA
3008.4.2 Step 2: Agency Review
3008.4.3 Step 3: Appeal Hearings at the State Level
CHART 4 Older Americans Act, Section 305
CHART 5 FSSA DA Appeals Chart
CHART 6 Client /Applicant Appeals
CHART 7 AAA Appeals Process
For appeal process for individuals applying for or receiving services funded by the
Medicaid Home and Community-Based Waiver Program, please refer to the appropriate
Medicaid Waiver document.
1
Added 5/13/05
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3000 PUBLIC HEARINGS
(a) The FSSA DA will conduct periodic evaluations of, and public hearings on, activities
and projects carried out in the State, including evaluations of the effectiveness of
services provided to older adults with greatest economic need, greatest social need, or
disabilities, with particular attention to low-income minority individuals and older
individuals residing in rural areas. 1
(b) The FSSA DA shall;
(1) afford an opportunity for a hearing upon request, in accordance with
published procedures, to any area agency on aging submitting an area plan or
any provider of (or applicant to provide) services;
(2) issue guidelines applicable to grievance procedures required by United States
Code, Section 3026(a)(10); and
(3) shall take place as part of an action or proceeding or to solicit the views of
older adults when making evaluations of services or programs. 2
3000.1 THE FSSA DA PROCEDURE REGARDING PUBLIC HEARINGS
(a) The FSSA DA will conduct evaluations of and public hearings on activities and
projects carried out under the State Plan, including an evaluation of the effectiveness of
the FSSA DA in reaching older adults with the greatest economic need and older adults
with the greatest social need, with particular attention to low-income minority older
adults.
(b) The AAA shall conduct periodic evaluations of and public hearings on activities
carried out under the area plan, as well as an annual evaluation of the effectiveness of
outreach efforts that identify older adults and persons with disabilities who are eligible for
services.
(c) In conducting such evaluations and public hearings, the FSSA DA shall solicit the
views and experiences of entities that are knowledgeable about the needs and concerns
of low-income older adults.
3000.2 ADDITIONAL FSSA DA ACTIONS THAT REQUIRE PUBLIC HEARINGS
(a) The FSSA DA shall also conduct public hearings:
(1) as part of an action or proceeding:
(A) to revoke the designation of an AAA;
1
2
Older Americans Act, Section 305(b)(5)(C)
Code of Federal Regulations, 45 CFR 1321.61(a)(2)
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(B) to designate an additional PSA in the state;
(C) to divide the state into different PSAs;
(D) to otherwise affect the boundaries of the PSAs in the state; or
(E) to deny an application to become a PSA.
(F) if the FSSA DA finds that an AAA has failed to comply with federal or
state laws, including the area-plan requirements, regulations, or policies,
and the FSSA DA decides it may withhold a portion of Title III funds to the
AAA; or
(G) to obtain the views of older adults, AAAs, recipients of grants under
Title VI, and other interested persons and entities (along with other
means) regarding programs carried out under Title VII -Allotment for
Vulnerable Rights Protection Activities.
(2) Each AAA shall have and implement the following:
(A) Hearings for needs assessments prior to submitting its area plan to
the FSSA DA for review and
(B) area-wide public hearings on the area plan prior to an area plan
review.
(3) The AAA shall seek the advice of the AAA advisory council on aging relative
to conducting a public hearing.
(4) Each AAA shall give adequate notice to older adults, public officials, and
other interested parties of the times, dates, and locations of the public hearings.
(5) Each AAA shall hold a public hearing at a time and location that permits older
adults, public officials, and other interested parties reasonable opportunity to
participate. The facility must be accessible to persons with disabilities.
(6) Notice of a public hearing should be given in major newspapers having wide
distribution within the area thirty days prior to the holding of the public hearing. In
addition, copies of preplan materials will be available for general distribution at
the time of the public hearing announcement or shortly thereafter. The public
notice should indicate where and when to obtain the preplan materials.
(7) At the area plan public hearings, the AAA shall present in both oral and
written form pertinent information regarding the services it plans to provide
directly and furnish interested parties with an opportunity to testify.
(8) The manner in which an AAA presents this information to interested parties is
open to the AAA's discretion, as long as the area plan information is presented in
a readable form with adequate information provided to support an understanding
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of the agency's intentions and their implications for older adults and persons with
disabilities living in the area. No format is prescribed for these purposes;
however, all information requirements for area-plan submission to the state
agency must be included in the distributed materials.
(9) Information that must be available to the public as a supplement to the area
plan shall include the following:
(A) a profile of the conditions of older adults in the area and their need for
services. The profile should be more comprehensive than that provided in
the area plan and in a form more suitable for public consumption.
(B) a prioritization of the major issues facing older adults in the area and a
discussion of constraints and opportunities for problem resolution.
(C) a general summary of the proposed plan, a description of the process
used in plan development, and the process the agency plans to use for
refining the plan in the future.
(D) a general summary and description of the AAA's specific objectives
for providing services to older adults with greatest economic need and
older adults with greatest social need, including specific objectives for
providing services to low-income minority older adults residing in the
AAA's PSA.
(E) a general description of how service providers in the area are
organized to respond to the needs of older people, with particular
attention given to OAA programs.
(F) the identification of the area advisory council on aging membership by
name, affiliation, and county accompanied by a definition of the council's
roles, responsibilities, authorities, and the methods used in membership
selection.
(G) the identification of agency board membership and the county of each
member's residence.
3000.3 APPEAL PROCESS
The FSSA Division of Aging (FSSA DA) shall provide an appeal process for Area
Agencies on Aging (AAAs) or other affected parties if the FSSA DA initiates an action or
preceding that would result in the following(1) withdrawal of the designation of an AAA;
(2) designation of an additional planning and service area (PSA) or division of the
state into different PSAs or changes in the boundaries of a PSA; 1 or
1
Older Americans Act, Section 305 (b)(1)(4)(5)(C)(I)(II)(III)(IV)
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(3) actions that would adversely affect an AAA or affected parties, other than
those listed in items (1) and (2).
3001 THE FSSA DA POLICY AND PROCEDURE REGARDING THE WITHDRAWAL OF AN
AAA DESIGNATION
CHART 4
Older Americans Act, Section 305(b)(5)(C)(i)(I) The State agency shall establish and follow appropriate
procedures to provide due process… if the state agency initiates an action or proceeding to revoke the
designation of the Area Agency on Aging.
The FSSA DA shall continue to recognize the designation of the current sixteen AAA’s in
Indiana unless the FSSA DA finds reason to initiate withdrawal procedures for the
designation of any existing AAAs.
3001.1 REASONS FOR WITHDRAWAL OF THE DESIGNATION OF AN AREA AGENCY ON
AGING (AAA)
The FSSA DA shall withdraw the AAA designation, if after reasonable notice and
opportunity for a hearing, there is a finding concerning any of the following;
(1) an AAA does not meet the requirements of the OAA.
(2) an AAA area plan or plan amendment is not approved.
(3) there is substantial failure in the provisions or administration of an approved
area plan to comply with any provision of the OAA or of any policies or
procedures established and published by the FSSA DA.
(4) activities of the AAA are inconsistent with the statutory mission prescribed in
the OAA requirements or are in conflict with the requirement of the OAA that the
designated AAA function only as an Area Agency on Aging. 1
(5) the designated AAA voluntarily relinquishes designation.
3001.2 THE FSSA DA PREPARATION FOR THE WITHDRAWAL OF THE DESIGNATION OF
AN AAA
Prior to withdrawing the designation of an AAA, the FSSA DA shall conduct the following
activities:
(1) provide written notification of the proposed action affecting the AAA. The
written notification shall summarize the basis for the action or decision and shall
contain the following:
1
Code of Federal Regulations, 45 CFR 1321.35(a) (4)
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(A) the effective date of withdrawal of the designation of the AAA;
(B) an explanation of all reasons and causes for the withdrawal of the
designation of the AAA; and
(C) a provision that explains policy and procedures for an appeal of the
decision to the assistant secretary of the Administration on Aging (AoA).
(2) Mail the notice and all other appropriate documents pertaining to the action to
withdraw the designation of an AAA by means of the United State Postal Service,
using the www.usps.com tracking and confirmation option, to provide signature
confirmation via fax. Correspondence should be addressed and mailed to the
appropriate AAA Director and to the Chairman of the AAA’s governing board, at
least 90 days before the effective date of the decision to withdraw the
designation of an AAA.
(3) Notify the appropriate FSSA and the FSSA DA staff, at least 90 days before
the effective date of the decision to withdraw the designation of the AAA.
(4) Conduct a public hearing on the proposed decision, at least 30 days before
the effective date of the withdrawal of the designation of an AAA. (See Section
3000 - Public Hearings – 3000)
(5) Invite representatives of the affected AAAs, Title III and Title VII service
providers, and older adults residing in the PSA or who are affected by the
decision to attend and participate in the public hearing.
(6) Request written comments from the affected AAAs, Title III, Title V and Title
VII service providers, and older adults, residing in the affected PSA.
(7) Notify the affected AAA, in writing, of the decision, after the public hearing
and at least eighteen days 1 before the effective date of the withdrawal of
designation of the AAA. Mail a notification of the decision to the affected AAA by
means of the United States Postal Service, using www.usps.com the tracking
and confirmation option to provide signature confirmation, via fax.
(8) The original notification shall contain the address of the AAA’s central location
and shall be sent to the Director of the AAA and a copy of the notification shall be
sent to the Chairman of the AAA’s governing board. 2
3001.3 WITHDRAWAL OF AN AAA DESIGNATION
If the FSSA DA withdraws an AAA designation it shall take the following action:
(1) The FSSA DA shall notify the Assistant Secretary for the Administration on
Aging (AoA), Department of Health and Human Services, and all appropriate
1
2
Indiana Administrative Code, 4-21.5
Older Americans Act, Section 305 (b)(5)(C) (ii) (ll) (III (IV) (V)
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persons and entities of the action taken.
(2) The notification to the Assistant Secretary shall be sent by certified mail,
return receipt requested, registered mail, or overnight delivery, unless another
method is approved or requested by the AoA.
(3) If the FSSA DA withdraws the designation of an AAA, the FSSA DA shall
provide a written plan for the continuity of services in the affected PSA and will
do the following:
(A) discontinue reimbursement to the affected AAA;
(B) notify service providers to submit requests for reimbursements to the
FSSA DA or a designated interim contractor;
(C) place a legal notice or an advertisement in a newspaper of statewide
circulation advising that claims against the affected AAA related to the
OAA programs administered through the contract, shall be referred to the
FSSA DA or a designated interim contractor
(D) designate a new AAA for the affected PSA, in a timely manner;
(E) allow the affected AAA a chance to appeal the decision of the FSSA
DA, to the assistant secretary of the AoA; 1 and
(F) perform the responsibilities of the AAA or assign the responsibilities of
the AAA to another agency within the PSA, for up to 180 days after the
final decision to withdraw designation of an AAA, unless the FSSA DA
has received an extension period from the AoA.
3001. 4 ADMINISTRATIVE REVIEW
(a) If an AAA is dissatisfied with the decision received after the Public Hearing, the AAA
may appeal the decision by requesting an administrative review. The AAA shall make
the request for an administrative review in writing to the Director of FSSA DA within
eighteen days of the date of the decision sent after the public hearing. The request shall
include a statement regarding the issues the AAA wishes reviewed and shall be signed
and dated by the AAA Director.
(b) The request for an Administrative Review shall be sent from the FSSA DA, to the
Director of DDRS within eighteen days from the date of receipt. The Administrative
Review shall be conducted by an Administrative Law Judge (ALJ) or hearing officer
appointed by the DDRS director. The Administrative Review will be conducted in
accordance with Indiana Code 4-21.5.4.
(c) Payment for the cost of a hearing shall be considered an allowable expense for the
AAA under OMB A-87 and A-122. The cost must be reasonable and shall be paid from
1
Code of Federal Regulations, 45 CFR 1321.35 (a)
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the AAA's 10% allowable administrative expenses. The AAA may retain an attorney with
the exception that the cost of the attorney is paid by funds earmarked for administrative
costs.
(d) The AAA shall not recoup the administrative review, appeal hearing or attorney
expenses under funding allocated for program development and coordinated activities.
The AAA shall not use Title III-B, III-C, or III-D funds for hearing expenses or attorney
fees.
3001.5 APPEALS TO THE ASSISTANT SECRETARY OF THE ADMINISTRATION ON AGING
(AOA)
(a) The FSSA DA shall allow for an appeal to the Assistant Secretary of the
Administration on Aging (AoA), of an action concerning the withdrawal of the designation
of an AAA, designation of a new PSA, division of Indiana into different PSAs or changes
in the boundaries of any PSA, as listed in Section 3002.1 of this document, if the appeal
is made on the basis of the following:
(1) the facts and merits of the matter that is the subject of the action or
proceeding; or
(2) procedural grounds.1
(b) Procedures completed for an appeal to the assistant secretary of the AoA include the
following:
(1) the FSSA DA shall notify the AAA and all other affected parties and entities of
the right to appeal to the assistant secretary in all written notices of the proposed
action;
(2) the FSSA DA shall accept and process all written appeal requests from the
affected AAA or appropriate parties, within thirty days of the effective date of the
action to withdraw the designation of the AAA;
(3) the written request for an appeal must contain the following(A) the decision for which the appeal is being made;
(B) legal name, address and telephone number of the
appellant(s); and
(C) documented information regarding how the action will affect the
appellant.
(4) The written request shall be addressed to the Director of the DDRS.
(5) The FSSA DA shall forward appeal requests and all supporting
1
Older Americans Act, 305 (b)(5)(C) (iii)(I) and (ll)
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documentation to the assistant secretary of the AoA within 18 days of receipt.
(6) If the assistant secretary sets aside a decision of the FSSA DA to revoke the
designation of an AAA, the FSSA DA shall nullify the revocation. 1
3001.6 CONTINUITY OF THE FUNCTIONS OF THE AAA WITHIN THE PSA
(a) If an AAA’s designation has been withdrawn, and it is necessary to ensure continuity
of the services in a PSA, the FSSA DA may, for a period of 180 days after it has given
final notice of withdrawal of the designation, perform the responsibilities of the AAA or
assign the responsibilities of the AAA to another appropriate agency within the PSA. 2
(b) The assistant secretary of the AoA may extend the 180-day period for the FSSA DA
to perform the duties of an AAA, for the affected PSA, if the FSSA DA does the
following;
(1) notifies the assistant secretary of the AoA in writing of its action; and
(2) requests an extension and demonstrates to the satisfaction of the assistant
secretary of the AoA, a need for the extension. 3
3002 THE FSSA DA DESIGNATION OF AN ADDITIONAL PLANNING AND SERVICE AREA
(PSA)
(a) The FSSA DA shall recognize the designation of the current PSAs and their current
boundaries, in Indiana unless the FSSA DA finds reason to initiate designation of an
additional PSA or needs to make changes in the boundaries of a PSA, for any reason.
(b) In determining an additional PSA or revising or otherwise affecting the boundaries of
a PSA, the FSSA DA shall consider the following(1) the geographical distribution of older adults in Indiana;
(2) the incidence of the need for supportive services, nutrition services, multipurpose senior centers, and legal assistance;
(3) the distribution of older adults who have the greatest economic need, with
particular attention to low income minority older adults and older adults residing
in rural areas in the service area;
(4) the distribution of older adults who have the greatest social need, with
particular attention to low income older adults, and older adults residing in rural
areas in the service area;
1
2
3
Older Americans Act, 305 (b)(5)(C)(iv)
Code of Federal Regulations, 45 CFR 1321.35 (c)(2)
Code of Federal Regulations, 45 CFR 1321.35 (d)
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(5) the distribution of older adults who are American Indians residing in the
service area;
(6) the distribution or resources available to provide such services or centers;
(7) the boundaries of existing areas within the state which are drawn for the PSA
of supportive services programs;
(8) the location of general purpose local government within Indiana; and
(9) any other relevant factors.
(c) The FSSA DA may designate as a PSA the following;
(1) any unit of general purpose local government which has a population of
100,000 or more; 1 (The Older Americans Act guidelines also include Indian
Reservations as entities entitled to make application for PSA designation.
Currently, Indiana contains no Indian Reservations.)
(2) any region within Indiana recognized for purposes of area wide planning
which includes one or more such units of general purpose local government
when the FSSA DA determines that the designation of such regional PSA is
necessary and enhances the effective administration of programs authorized
under Title III of the OAA;
(3) areas which were designated for the planning or administration of supportive
services programs; or
(4) the FSSA DA may include in any designated PSAs such additional areas to
the unit of general purpose local government or region so designated as the state
agency determines to be necessary and enhances the effective administration of
programs authorized under Title III of the OAA.
3002.1 APPEAL PROCEDURE REGARDING THE DESIGNATION OF AN ADDITIONAL PSA
OR CHANGE OR REVISION OF THE BOUNDARIES OF AN EXISTING PSA
(a) The FSSA DA shall provide written notice of the proposed action or proceeding
affecting PSA boundaries to existing PSAs and to any other affected parties. Such
notification includes clear documentation of the need for the proposed action.
(b) The FSSA DA shall conduct a public hearing on the proposed action or proceeding.
(c) The FSSA DA shall invite the participation of the affected AAA, Title III service
providers and older adults to the public hearing.
(d) The FSSA DA shall request written comments from the affected AAAs, Title III
1
Older Americans Act, Section 305(b)(1)
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service providers and older adults.
(e) The FSSA DA shall provide an opportunity for appeal to any applicant denied
PSA designation after the public hearing who submits a written request for an appeal
hearing, within 30 days of the notice of denial of designation. The appeal procedures
shall include a process to appeal the decision to the assistant secretary of the AoA, if the
applicant follows the FSSA DA prescribed procedures for requesting an appeal.
3003 THE FSSA DA APPEALS PROCESS REGARDING AN ADVERSE ACTION OTHER
THAN THE WITHDRAWAL OF THE DESIGNATION OF AN AAA OR THE ADDITION OR
CHANGE OF THE BOUNDARIES OF A PSA
3003.1 STEP 1: D OCUMENTATION
The FSSA DA may use the following documentation to verify the need to initiate an
adverse action or proceeding, other than the withdrawal of a designation of an AAA or a
PSA:
(1) The AAA plan and/or amendments;
(2) Service agreements between area agencies and service providers;
(3) Population demographics including but not limited to economic and social
data;
(4) Memorandums and letters;
(5) Monitoring and assessment reports; and
(6) Any other documentation that specifically corroborates the FSSA DA reasons
for taking such action or proceeding.
3003.2 STEP 2: INFORMAL REVIEW
WITH THE
FSSA DA
(a) The AAA must first discuss any questions, concerns, or problems regarding an
adverse action with a representative of the FSSA DA. This informal review will take
place at the offices of the FSSA DA. Within eighteen days of the date of the informal
meeting, the FSSA DA representative must notify the AAA in writing of the decision
reached on the issues raised at the informal review. The FSSA DA representative must
also inform the AAA that an appeal of the decision made at the informal review may be
completed by submitting a written appeal request to the Director of the FSSA DA.
(b) The FSSA DA shall provide a written notice of action or proceeding to the affected
AAA's executive director, the AAA's service providers, and any other appropriate
persons or organizations, by certified mail at least thirty days in advance of the effective
date of the action or proceeding. The process for requesting an appeal of the decision
shall be included in the written notice of action.
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3003.3 STEP 3: PUBLIC HEARING
If the FSSA DA initiates an action, the FSSA DA shall provide an opportunity for a public
hearing, if requested by an AAA or any other entity directly affected. See Section 3000
for more information regarding a Public Hearing.
3003.4 STEP 4: ADMINISTRATIVE REVIEW
(a) If an AAA is dissatisfied with the decision received after the public hearing, the AAA
may appeal the decision by requesting an administrative review. The AAA shall make
the request for an administrative review in writing to the Director of the FSSA DA within
eighteen days of the date of the decision sent after the public hearing. The
Administrative Review will be conducted in accordance with Indiana Code 4-21.5.4.
(b) The request for an Administrative Review shall be sent from the FSSA DA, to the
Director of DDRS. The Administrative Review shall be conducted by an Administrative
Law Judge (ALJ) or hearing officer appointed by the DDRS director.
(c) Payment for the cost of a hearing shall be considered an allowable expense for the
AAA under OMB A-87 and A-122. The cost must be reasonable and shall be paid from
the AAA's 10% allowable administrative expenses. The AAA may retain an attorney with
the exception that the cost of the attorney is paid by funds earmarked for administrative
costs. (See 4001.5 for more information)
(d) The AAA shall not recoup the appeal hearing or attorney expenses under funding
allocated for program development and coordinated activities. The AAA shall not use
Title III-B, III-C, or III-D funds for hearing expenses or attorney fees.
3004 INVOLVEMENT OF AAAS, SERVICE PROVIDERS, OLDER ADULTS, AND PERSONS
WITH DISABILITIES
The FSSA DA shall involve the AAA, service providers, older adults, and persons with
disabilities in the appeal process by;
(1) providing the AAA with an opportunity for a public hearing at
a location accessible to older adults, persons with disabilities, and service
providers;
(2) publishing the notice of a public hearing in a newspaper of statewide
circulation, and providing access to the content of materials prior to the hearing;
and
(3) making the written decision and/or summary of the results of the public
hearing available for copying to service providers or other interested parties or
persons upon their request.
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3005 FSSA DA APPEALS CHART
CHART 5
Withdrawal of Designation
the Designation of an
of an AAA
Additional
PSA
Division of or
Changes in the
Boundaries of
a PSA
Denial of an
Application
to become a
PSA
Other Adverse
Actions
Affecting an
AAA
1. Document the
need for the action.
Send written
notification of plans
to withdraw the AAA
designation, to the
affected AAA, AoA
and DDRS.
1. Document the
need for the action.
Send written
notification of the
action to designate
an additional PSA,
to the affected
AAA, or other
appropriate entity,
the AoA and
DDRS.
1. Document
the reason for
denial.
Send written
notification of
the denial of the
application for
designation of a
PSA, to DDRS
and the affected
entities. Include
notice of public
hearing option.
1. Document the
need for the action.
Send written
notification of the
adverse action to
the AAA or
appropriate entity.
2. If requested
by an affected
entity, hold a
Public Hearing
inviting
appropriate
entities,
individuals, and
older adults.
Issue the final
decision on the
proposed
action.
3. If requested by
3. If requested
3. If requested by 3. Formally
the affected AAA,
by an affected
an affected entity, send notice to
DDRS will hold an
entity, DDRS will DDRS will hold an appropriate
Administrative
hold an
Administrative
entities
Review with an
Administrative
Review with an
including the
Administrative Law Review with an Administrative Law process
Judge (ALJ)
Administrative
Judge (ALJ)
for an appeal of
assigned by the
Law Judge (ALJ) assigned by the
the decision to
DDRS Director.
assigned by the DDRS Director.
the AoA.
DDRS Director.
4. Send formal
4. Send formal
4. Send formal
notice to the
notice to
notice to
affected AAA
appropriate
appropriate entities
explaining the
entities outlining outlining appeal
appeal process for appeal process process for an
an appeal of the
for an appeal of appeal of the
decision to the AoA. the decision to
decision to the
the AoA.
AoA.
2. Hold an Informal
Review with the
AAA and/or the
affected entity.
Issue the final
decision on the
proposed action.
1. Document the
need for the
action. Send
written
notification of
the action to
designate
an additional
PSA, to an
affected AAA or
other
appropriate
entity, AoA and
DDRS.
2 Hold a Public
2 Hold a Public
Hearing inviting
Hearing inviting
representatives of
representatives
the affected AAA,
of the affected
Title III and Title VII entity, and older
providers, and older adults. Issue the
adults. Issue the
final decision on
final decision on the the proposed
proposed action.
action.
Indiana Code 4-21.5
2. Hold a Public
Hearing inviting
representatives of
the affected entity
and older adults
Issue the final
decision on the
proposed action.
3. If requested by
an affected entity,
hold a Public
Hearing inviting
representatives of
the affected AAA,
and other
appropriate entities.
4. If requested by
AAA, an
Administrative
Review with an
Administrative Law
Judge (ALJ),
assigned by the
DDRS Director.
Older Americans Act, OAA Section 305(b)(5)(C)(i)
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3006 CLIENT/APPLICANT APPEALS
CHART 6 – RIGHTS FOR FRAIL OLDER INDIVIDUALS
Older Americans Act, Section 314 (2) Rights Relating to In-Home Services for Frail Older Individuals
The Assistant Secretary shall require entities that provide in-home services under this title to promote the
rights of each older individual who receives such services. Such rights include the following….
(2) The right to voice a grievance with respect to such service that is or fails to be so provided, without
discrimination or reprisal as a result of voicing such grievance.
3006.1 NOTIFICATION OF CLIENT RIGHTS
All Title III, SSBG and CHOICE applicants and clients must be notified, in writing, of their
rights to appeal decisions. The explanation of appeal rights shall be provided to each older
adult or person with disabilities, in a manner that is easy to understand.
3006.2 PROCEDURE FOR PROVIDING WRITTEN NOTICE OF CLIENT RIGHTS
(a) Written notice of client rights shall contain language found in Appendix III.
The preferred format is also found in Appendix III.
(b) The Area Agency on Aging’s name and address should be included on the written
notice. The written notice can be printed on the Area Agency’s letterhead if the
letterhead includes the Area Agency’s name and address.
(c) The font size used for the written notice of client rights shall be at 12 point or larger.
(d) Ink color for the written notice of client rights shall always be black.
(e) Paper color must be white.1
3006.3 FSSA DA PROCEDURE REGARDING APPEALS AND HEARINGS
(a) If an appeal request comes to any FSSA DA staff person, other than the Director, the
staff person should immediately notify the FSSA DA Director and/or the appropriate
FSSA legal staff person. 2
3007 FSSA DA APPEAL POLICY AND PROCEDURE FOR CLIENTS/APPLICANTS
APPLYING FOR OR RECEIVING SERVICES FOR SSBG, CHOICE AND TITLE III
(EXCLUDING IPAS, PASRR)
(a) A client/applicant has the right to appeal decisions regarding eligibility and services.
In the case of a client/applicant who lacks the capacity to make a knowing and informed
decision regarding the client/applicant's own care, the client/applicant’s representative
may appear on the client/applicant's behalf throughout the appeals process.
1
2
Added 5/13/05
Added 5/13/05
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(b) Policy decisions or decisions of general applicability regarding services, including a
decision by an AAA to suspend taking applications, are not subject to appeal.
(c) The AAA case manager is responsible for answering questions and attempting to
resolve any problems or complaints before the client/applicant resorts to the appeals
process. To create a complete record for appeal, the case manager is also responsible
for documenting in the case file, all dates, verifying documentation, and written
descriptions of complaints and actions taken.
3007.1 STEP 1: INFORMAL REVIEW WITH THE CASE MANAGER, THE CASE MANAGER
SUPERVISOR, AND/OR AN APPROPRIATE REPRESENTATIVE
(a) The case manager‘s supervisor shall conduct an Informal Review with the
client/applicant, the client/applicant's representative (if one is selected) and the
client/applicant’s case manager to first discuss any questions, concerns, or problems
regarding services.
(b)This informal meeting may take place either at the AAA or at the client/applicant's
home or at a mutually acceptable location
(c) Within 5 days of the date of the informal meeting, the case manager supervisor shall
inform the client/applicant in writing:
(1) of the decision reached on the issues raised at the meeting; and
(2) that the client/applicant may request in writing, an agency review to the AAA's
executive director or designee within eighteen days of the date of the decision.
3007.2 STEP 2: AGENCY REVIEW
(a) The AAA review process begins when a client/applicant, within eighteen days of the
date of the decision, requests an agency review, following Step One. The AAA director
or designee will conduct the Agency Review. The client/applicant, the client/applicant's
representative (if one is selected), and the case manager or the case manager's
supervisor shall attend the review. The Agency Review may take place at either the AAA
or at the client/applicant’s home or at a mutually acceptable location.
(b) The client/applicant will be given the opportunity to testify, present supporting
materials, explain the client/applicant's reasons for disagreement with the action or
decision, and present an appropriate alternative. The case manager or the case
manager supervisor may testify and explain the reasons for the de cision or action taken.
(c) Following the review, the executive director or the designee conducting the review
shall consider the comments of the client/applicant, the client/applicant’s representative
or the client/applicant's advocate (if any), and the case manager, or the case manager's
supervisor.
(d) Within five days, the AAA's executive director or designee shall prepare the AAA's
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final decision in writing that will include findings of fact and the specific reason for the
decision. The decision shall inform the client/applicant of the client/applicant's right to
have an administrative hearing under Step 3 if the client/applicant is dissatisfied with the
AAA's final decision.
The client/applicant and advocate, if any, shall each be sent a copy of the decision by
registered or certified mail, return receipt requested.
3007.3 STEP 3: ADMINISTRATIVE HEARING
(a) If a client/applicant is dissatisfied with the decision reached at the agency review, the
client/applicant may appeal the decision by requesting an administrative hearing. The
client/applicant or the client/applicant's representative shall make the request for an
administrative hearing in writing to the Director of the FSSA DA within 18 days of the
date of the decision from the agency review. The request shall include a statement
regarding the issues the client/applicant wishes reviewed and shall be signed and dated.
(b) Administrative hearings shall be conducted by an Administrative Law Judge (ALJ) or
hearing officer appointed by the DDRS director. The ALJ shall, at least 5 days in
advance of the hearing, notify all involved persons by registered or certified mail, return
receipt requested, of the date, time, and location of the hearing. The AAA shall forward
all written case documentation to the Administrative Law Judge prior to the hearing. The
hearing will be conducted in accordance with Indiana Code 4-21.5.4.
(c) Testimony will be taken under oath or affirmation, and the proceedings will be tape
recorded. The client/applicant, the client/applicant's advocate, any other witnesses that a
party chooses to present, and the case manager or the case manager supervisor will
each be given an opportunity to place written material into evidence, present additional
written or oral statements, and ask questions of any party. If the client/applicant wishes
to have a transcript of the hearing, DDRS will transcribe the tape at the client/applicant's
expense.
(d) DDRS may waive this cost in exceptional circumstances. Immediately following the
hearing but not later than 5 days, the Administrative Law Judge shall prepare the
proposed decision that will include a report of the findings of fact and the reasons for the
decision based on those findings of fact. This proposed decision shall be forwarded to
the DDRS director.
(e) A copy of the proposed decision shall be sent to the AAA, the client/applicant, and
the client/applicant's advocate, if any, by registered or certified mail, return receipt
requested. The DDRS director shall affirm, modify, or dissolve the Administrative Law
Judge's proposed decision. The AAA, the client/applicant, and the client/applicant's
advocate shall be notified of the director's final order by registered or certified mail,
return receipt requested.
(f) If a client/applicant appeals a decision that terminates any service that is already
being provided, the service in question may continue until the appeal is resolved.
However, services that would be harmful to the client/applicant or which violate state or
federal law or regulations and internal policies of DDRS or the FSSA DA, will not be
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continued during the appeal process.
3007.4 ASSISTANCE AVAILABLE TO A CLIENT/APPLICANT DURING THE APPEAL
PROCESS
(a) A client/applicant may bring to the informal review, agency review, and administrative
hearing, any person the client/applicant wishes to be present, including legal counsel.
FSSA DA shall not pay for legal counsel or for any other expenses incurred for a
client/applicant during the Informal Review, Agency Review, the Administrative Hearing
or any part of the appeal process.
(b) Upon request, interpreter services will be made available to assist the deaf or NonEnglish speaking persons, and reader services will be made available to assist the
visually impaired. However, if the client/applicant requires these services for participation
in the agency review or administrative hearing, the client/applicant shall discuss the
arrangements with the case manager in enough time for the case manager to make the
appropriate arrangements, before the scheduled AAA review. The AAA shall make every
effort to provide these assistive services to the client/applicant.
3007.5 R EQUESTS FOR RECONSIDERATION AND APPEAL OF ADVERSE ACTION
At any time during Step 1, Step 2 and Step 3, the request for reconsideration of an
appeal of an adverse action may be made, by the client/applicant, in writing at the same
time. If the reconsideration decision reverses the initial finding, the appeal request
should be canceled. If the original determination is upheld, the client/applicant will decide
whether to continue with the appeal request.
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3008 RIGHTS OF CLIENTS/APPLICANTS APPLYING FOR OR RECEIVING IPAS OR
PASRR
(a) A client/applicant has the right to appeal and request a fair hearing in accordance
with the Medicaid Fair Hearing Process when the client/applicant disagrees with an IPAS
and/or a PASRR finding (e.g., when placement in a nursing facility is determined to be
inappropriate or the Medicaid per diem reimbursement is denied as a result of the
IPAS/PASRR program).
(b) During the course of an appeal, a client/applicant has the right to request a
reconsideration of an adverse decision if there is additional documentation pertinent to
the reason for denial which was not initially presented.
3008.1 PROCESS TO REQUEST RECONSIDERATION OF AN ADVERSE ACTION
(a) For Pre-Admission Screening (PAS), the reconsideration request and submission of
additional documentation is presented through the Indiana Pre-Admission Screening
agency. The Indiana Pre-Admission Screening agency will resubmit the entire PAS case
record to the state, enclosing and identifying the new documentation. The case record
should be clearly marked as a "Request for PAS Determination Reconsideration."
(b) For Pre-Admission Screening Resident Review (PASRR), a similar process is
followed. For Resident Review, the request and additional documentation is submitted
via the local Community Mental Health Center.
3008.2 APPEAL PROCEDURE FOR CLIENTS/APPLICANTS APPLYING FOR OR
RECEIVING IPAS OR PASRR SERVICES
(a) If the client/applicant wishes to appeal, a letter must be sent with the
client/applicant’s signature to:
Indiana Family and Social Services Administration
Division of Family and Children
Hearings and Appeals
402 West Washington Street
Room W-392
Indianapolis, Indiana
46204
(b) The letter must contain the client/applicant’s address and telephone number. A copy
of the decision or a written statement explaining the decision should be attached to the
letter. If the client/applicant is unable to write the letter, the client/applicant may have
someone assist in the request for an appeal.
(c) The client/applicant will be notified in writing by the Hearings and Appeals Office, of
the date, time and place of the hearing. Prior to, or at the hearing, the client/applicant will
have the right to examine the entire contents of the case record at the PAS agency.
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(d) The client/applicant may represent themselves at the hearing or authorize a
representative such as an attorney, a relative, a friend, or other spokesperson to do so.
At the hearing, the client/applicant will have full opportunity to bring witnesses, establish
all pertinent facts, and circumstances, advance any arguments without interference, and
question or refute any testimony or evidence presented.
(e) For additional information regarding rights for clients/applicants applying for or
receiving IPAS services or PASRR services, refer to state form 707 (R4/4-94)/form 4B.
3008.3 APPEAL PROCEDURE FOR TITLE III SERVICE PROVIDERS
(a) The AAA shall grant an opportunity for appeal to grantee or contractor when Older
Americans Act funds are withdrawn or when a grant or contract is suspended or
terminated prior to the end of an approved budget year.
(b) Each AAA shall have and implement written appeal Procedures to resolve disputes
with service providers. Written appeal Procedures should be included in all service
provider contracts with the AAA, by January, 2006.
(c) Written appeal Procedures shall include the following:
(1) Notification of the appeal process included when the AAA takes adverse
action against a service provider.
(2) Complete information regarding Procedures for appeals at the state level.
3008.4 APPEAL PROCESS FOR SERVICE PROVIDERS
Service Providers must complete the following steps before requesting an appeal of an
adverse action at the state level:
3008.4.1 STEP 1: INFORMAL REVIEW
WITH THE
AAA
(a) The Service Provider must first discuss any questions, concerns or problems
regarding an adverse action with a representative of the AAA. The Informal Review will
take place at the AAA.
(b) The AAA representative shall prepare a written document for the Agency Review
outlining the action being disputed and the data on which the action was based. A copy
of this written document shall be made available to the service provider prior to the
Agency Review.
(c) Within five days of the date of the Informal Review, the AAA representative shall
provide the service provider a written notice of the decision reached on the issues raised
at the Informal Review.
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(d) The written notice shall be sent by certified mail, return receipt requested. The AAA
representative must also inform the Service provider that an appeal of the decision made
at the Informal Review may be submitted in writing to the executive director of the AAA.
3008.4.2 STEP 2: AGENCY REVIEW
(a) The Service Provider’s request for an Agency Review of the AAA decision must be
made in writing and submitted to the AAA, within eighteen days of the date of the
decision made at the Informal Review. The written request shall include a detailed
explanation of the service provider’s grievance.
(b) The executive director or designee is to conduct the AAA review at the AAA office.
(c) The AAA shall complete the following:
(1) schedule the Agency Review and notify the service provider of the date, time
and location of the Agency Review, within eighteen days of the receipt of the
request for an Agency Review;
(2) prepare a written document for the Agency Review outlining the action being
disputed and the data on which the action was based. A copy of this written
document shall be made available to the service provider, at least eighteen days
prior to the Agency Review; and
(3) give the service provider the opportunity to testify, present supporting
materials, explain the reason for the disagreement with the action or decision,
and state what would be an acceptable alternative.
(d) Following the Agency Review, the Executive Director or Designee conducting the
Agency Review will consider the comments and written documentation provided by the
service provider.
(e) Within five days from date of the Agency Review, the executive director or designee
will prepare and send a written notice of the final decision to the service provider. The
written notice of the final decision will be sent to the service provider by certified mail,
return receipt requested.
(f) The final decision will include the findings of fact, the specific reason for the decision,
and information concerning the service provider’s right to appeal the decision at the state
level, if dissatisfied with the AAA’s final decision.
3008.4.3 STEP 3: APPEAL HEARINGS AT THE STATE LEVEL (DDRS)
(a) If a service provider is dissatisfied with the decision reached at the agency review,
the service provider may appeal the decision by requesting a hearing at the state level
(DDRS).
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(b) Before seeking an appeal at the state level (DDRS), the service provider must have
adhered to and complied with the AAA’s established policy and Procedures on the
appeal process for:
(1) service providers who are denied funding;
(2) service providers whose subgrant, contract, or agreement has been
terminated; and
(3) other decisions that adversely affect a service provider.
(c) The service provider must make a written request for an appeal hearing to the
Director of the FSSA DA within eighteen days of the date of the Agency Review final
decision. The FSSA DA Director shall transmit the appeal request to the DDRS Director
in a timely manner.
(d) The request shall include a statement regarding the issues the service provider
wishes to be reviewed and must be signed and dated by the service provider. Appeal
Hearing requests shall be addressed to:
Director
FSSA DIVISION OF AGING
402 W. Washington Street
P.O. Box 7083 – MS21
Indianapolis, Indiana
46207-7083
(e) Appeal hearings will be conducted by an Administrative Law Judge (ALJ), designated
by the Director of DDRS. The hearing procedures used by DDRS shall be held in
accordance with Indiana Code 4-21.5.
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3009 AAA APPEAL PROCESS
CHART 7
Client/Applicant
Appeal of an Adverse
Action Taken by an
AAA
Rights of Client/
Service Provider Appeal
Applicant Applying For of an Adverse Action
or Receiving PreTaken by an AAA
Admission Screening
Services (IPAS) or PreAdmission Screening
and Resident Review
Services (PASRR)
1. If appropriately requested
by the client/applicant, hold
an Informal Review
conducted by the Case
Manager Supervisor at the
AAA or the client’s home or a
mutually acceptable location.
The Case Manager
Supervisor issues a written
notice of the decision within 5
days of the Informal Review.
The written notice details the
final decision and contains
information about further
appeal Procedures.
2. If appropriately requested
by the client/applicant, hold
an Agency Review,
conducted by the AAA
director or designee. The
AAA director issues a written
notice of the decision within 5
days of the Agency Review.
The written notice details the
final decision and contains
information about appeal
procedures.
3. If appropriately requested
by the client/ applicant, the
DDRS will hold an
Administrative Hearing with
an Administrative Law Judge
(ALJ) assigned by the DDRS
Director.
1. The client/applicant shall
submit a written request for an
appeal reconsideration of an
adverse action to the
appropriate Pre-Admission
Screening Agency.
1. If appropriately requested by
an effected entity, hold an
Informal Review conducted by a
representative of the AAA.
The AAA representative issues a
written notice of the decision
within 5 days of the Informal
Review. The written notice
details the final decision and
contains information about
further appeal procedures.
2. If appropriately requested
by the client/applicant, the
State will conduct an appeal
hearing.
2. If appropriately requested by
an affected entity, hold an
Agency Review, conducted by
the AAA director or designee.
The AAA director issues a
written notice of the decision
within 5 days of the Informal
Review. The written notice
details the final decision and
contains information about
appeal Procedures.
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3. If appropriately requested by
an affected entity, DDRS will
hold an Administrative Review
with an Administrative Law
Judge (ALJ) assigned by the
DDRS Director.
69
PART 2
SECTION 4
SERVICE DEFINITIONS
Table of Contents
4000 SERVICE DEFINITIONS
4001 ADAPTIVE AIDS AND DEVICES
4001.1 Allowable Adaptive Aids and Devices
4001.2 Adaptive Aids and Devices Not Allowed
4001.3 Funding Sources for Adaptive Aids and Devices
4001.4 The FSSA DA Policy and Procedures Regarding Adaptive Aids
and Devices
4001.5 AAA Policy and Procedures Concerning Adaptive Aids and
Devices
4001.6 Service Provider Responsibilities Concerning Adaptive Aids and
Devices
4001.7 Unit of Service
4002 OTHER SERVICES FUNDED BY CHOICE
4002.1 Services Not Allowed
4002.2 Funding Sources for Other Services
4002.3 The FSSA DA Policy and Procedures Regarding Other Services
4002.4 AAA Policy and Procedures Concerning Other Services
4002.5 Service Provider Responsibilities Specific to CHOICE Funding
4002.6 Unit of Service
4003 ADULT DAY SERVICES
4003.1 Allowable Activities
4003.2 Activities Not Allowed
4003.3 Funding Sources Administered by the FSSA DA for Adult Cay
Care Services
4003.4 The FSSA DA Policy and Procedures Regarding Adult Day Care
Services Providers
4003.5 AAA Policy and Procedures Regarding Adult Day Care Services
4003.6 Service Provider Responsibilities Concerning Adult Day Care
Services
4003.7 Day Care Meal
4003.8 Day Care Transportation
4003.9 Unit of Service
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4004 ADULT GUARDIANSHIP SERVICES
4004.1 Funding Sources
4004.2 The FSSA DA Policy and Procedures Regarding Guardianship
Services
4004.3 Service Provider Responsibilities Concerning Adult Guardianship
Services
4004.4 Allowable Adult Guardianship Services
4004.5 Activities Not Allowed
4005 ADULT PROTECTIVE SERVICES
4005.1 Definition of Endangered Adult
4005.2 Exceptions to Definition of Endangered Adult
4005.3 Allowable Activities
4005.4 Funding Sources for Adult Protective Custody
4005.5 Unit of Service
4006 ALZHEIMER’S DISEASE AND RELATED SENILE DEMENTIA (AD/RSD)
PROGRAMS
4006.1 Funding Sources for AD/RSD
4006.2 The FSSA DA Policy Regarding AD/RSD Services
4006.3 The FSSA DA Procedures Regarding Alzheimer’s/Dementia
Special Care Unit Disclosure Form (State Form 48896)
4006.4 Consultation
4006.5 Service Provider Responsibilities and Procedures Regarding
AD/RSD Services
4007 ATTENDANT CARE SERVICES
4007.1 Allowable Activities
4007.2 Activities Not Allowed
4007.3 Funding Sources for Attendant Care Services
4007.4 The FSSA DA Policy and Procedures Regarding Attendant Care
Services
4007.5 AAA Policy and Procedures Regarding Attendant Care Services
4007.6 Service Provider Responsibilities Concerning Attendant Care
Services
4007.7 Unit of Service
4008 CASE MANAGEMENT SERVICES
4008.1 Independent Case Managers
4008.2 Case Management Allowable Activities
4008.3 Services Not Allowed Under Case Management
4008.3.1 Services Not Allowed to be Supplied by Independent
Case Managers
4008.3.2 Entities Not Allowed to Conduct Case Management
Services
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4008.4 Funding Sources for Case Management Services
4008.5 The FSSA DA Policy and Procedures Regarding Case
Management Services
4008.6 AAA Policy and Procedures Regarding Case Management
Services
4008.7 Case Manager Qualifications
4008.7.1 Minimum Qualifications for Individual Case Managers
4008.8 The FSSA DA Policy and Procedures Regarding Certification of
Case Managers
4008.9 The FSSA DA Policy and Procedures De-certification Procedures
for Case Managers Employed by AAA or by Independent Case
Management Agencies
4008.10 AAA Policy and Procedures Concerning Certification of Case
Managers
4008.11 AAA Policy and Procedures Concerning De-certification of Case
Managers
4008.12 Service Standards for Case Management Services
4008.12.1 Information Concerning an Older Adult or Person With a
Disability
4008.13 Unit of Service
4009 CONTINUING EDUCATION SERVICES
4009.1 Funding Sources for Continuing Education Services
4009.2 The FSSA DA Policy and Procedures Regarding Continuing
Education Services
4009.3 The AAA Policy and Procedures Regarding Continuing Education
Services
4010 DISEASE PREVENTION AND HEALTH PROMOTION SERVICES
4010.1 Target Population
4010.2 Funding Sources
4010.3 Allowable Disease Prevention and Health Promotion Services
Activities
4010.4 Unit of Service
4011 FAMILY CAREGIVER SUPPORT PROGRAM
4011.1 Funding Sources for the Family Caregiver Support Program
4011.2 Populations Served by the Family Caregiver Support Program
4011.3 Access Assistance
4011.4 Information for Caregivers
4011.5 Counseling
4011.6 Respite
4011.7 Supplemental Services
4011.8 The FSSA DA Policy Regarding the Family Caregiver Support
Program
4011.9 The FSSA DA Procedures Regarding the Family Caregiver
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Support Program
4011.10 AAA Policy and Procedures Regarding the Family Caregiver
Support Program
4011.11 Reports
4011.12 Unit of Service
4012 HOME HEALTH SERVICES
4012.1 Allowable Home Health Services
4012.2 Home Health Services Not Allowed
4012.3 Funding Sources for Home Health Services
4012.4 The FSSA DA Policy and Procedures Regarding Home Health
Services
4012.5 AAA Policy and Procedures Concerning Home Health Services
4012.6 Service Provider Responsibilities Concerning Home Health
Services
4012.7 Unit of Service
4013 HOMEMAKER SERVICES
4013.1 Allowable Homemaker Services
4013.2 Activities Not Allowed
4013.3 Funding Sources for Homemaker Services
4013.4 The FSSA DA Policy and Procedures Regarding Homemaker
Services
4013.5 AAA Policy and Procedures Concerning Homemaker Services
4013.6 Service Provider Responsibilities Concerning Homemaker
Services
4013.7 Unit of Service
4014 HOME REPAIR/MAINTENANCE SERVICES
4014.1 Allowable Home Repair/Maintenance Activities
4014.2 Activities Not Allowed
4014.3 Funding Sources for Home Repair/Maintenance Services
4014.4 The FSSA DA Policy and Procedures Regarding Home
Repair/ Maintenance Services
4014.5 AAA Policy and Procedures Regarding Home
Repair/ Maintenance Services
4014.6 Service Provider Responsibilities Concerning Home Repair/
Maintenance Services
4014.7 Unit of Service
4015 INDIANA PRE-ADMISSION SCREENING PROGRAM (IPAS)
4015.1 Funding for Indiana's Pre-Admission Screening Program
4015.2 Eligibility Requirements for Indiana's Pre-Admission Screening
Program
4015.3 The FSSA DA Policy and Procedures Regarding Indiana's
Pre-Admission Screening Program
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4015.4 AAA Duties Regarding Indiana's Pre-Admission Screening
Program
4015.5 AAA Procedures Concerning Indiana's Pre-Admission Screening
Program
4015.6 IPAS Final Determination
4015.7 Appeals and Fair Hearings
4016 INFORMATION AND ASSISTANCE SERVICES (I&A)
4016.1 Allowable Information and Assistance Services Activities
4016.2 Funding Sources for Information and Assistance Services
4016.3 The FSSA DA Policy and Procedures Regarding Information and
Assistance Services
4016.4 AAA Policy and Procedures Regarding Information and
Assistance Services
4016.5 Unit of Service
4017 LEGAL ASSISTANCE SERVICES
4017.1 Allowable Legal Assistance Activities
4017.2 Activities Not Allowed
4017.3 Funding Sources for Legal Assistance Services
4017.4 The FSSA DA Policy and Procedures Regarding Legal
Assistance Services
4017.5 AAA Policy and Procedures Concerning Legal Assistance
Services
4017.6 Service Provider Procedures
4018 ENVIRONMENTAL MODIFICATIONS SERVICES
4018.1 Allowable Environmental Modifications Services
4018.2 Activities Not Allowed
4018.3 Funding Sources for Environmental Modifications Services
4018.4 The FSSA DA Policy and Procedures Regarding Environmental
Modifications Services
4018.5 AAA and Case Manager Policy and Procedures Regarding
Environmental Modifications Services
4018.6 Documentation Standards
4018.7 Provider Qualifications
4018.8 Unit of Service
4019 MONEY MANAGEMENT SERVICES PROGRAM
4019.1 Activities of the Money Management Program
4019.2 Representative Payee
4019.3 Bill Payer
4019.4 Bill Payer Monitor
4019.5 Activities Not Allowed
4019.6 Money Management Services Program Safeguards
4019.7 Reporting
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4019.8 Program Size
4019.9 Income and Liquid Assets
4019.10 Funding Sources for the Money Management Services Program
4019.11 Local Sponsor Eligibility
4019.12 Recommendations for Assisting Clients Above the Income and
Asset Limits
4019.13 The FSSA DA Policy Regarding the Money Management
Services Program
4019.14 State Advisory Council
4019.15 AARP/National Sponsor Procedures
4019.16 The FSSA DA Procedures Regarding the Money Management
Services Program
4019.17 The FSSA DA Procedures Regarding Monitoring of the Money
Management Services Program
4019.18 Local Sponsor Responsibilities Regarding Money Management
Services
4020 LONG TERM CARE OMBUDSMAN
4020.1 Allowable Activities
4020.2 Unit of Service
4021 OUTREACH SERVICES
4021.1 Allowable Outreach Services
4021.2 Funding Sources for Outreach Services
4021.3 The FSSA DA Policy and Procedures Regarding Outreach
Services
4021.4 AAA Policy and Procedures Concerning Outreach Services
4021.5 Unit of Service
4022 PERSONAL ASSISTANCE SERVICES (Funded by Medicaid Waiver Only)
4023 PRE-ADMISSION SCREENING/RESIDENT REVIEW (PASRR)
4023.1 Funding Sources for PASRR
4023.2 Eligibility and Participation Requirements for PASRR
4023.3 Participation in the IPAS Program
4023.4 Determination of Criteria
4023.4.1 Level I
4023.4.2 Level II
4023.5 PASRR -Two Part Program
4023.5.1 Pre-admission Screening
4023.5.2 Resident Review
4023.6 Responsible Entities in the Assessment Process
4023.7 PASRR Final Determination
4023.8 Appeals and Fair Hearings
4024 RESIDENTIAL CARE ASSISTANCE PROGRAM (RCAP)
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4025 RESPITE CARE
4025.1 Allowable Services Covered Under Respite Care Services
4025.2 Activities Not Allowed
4025.3 Funding Sources for Respite Care Services
4025.4 The FSSA DA Policy and Procedures Regarding Respite Care
Services
4025.5 AAA Policy and Procedures Concerning Respite Care Services
4025.6 Service Provider Responsibilities Concerning Respite Care
Services
4025.7 Unit of Service
4026 SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM
(See Section 9)
4027 SENIOR CENTERS
4027.1 Allowable Activities
4027.2 Activities Not Allowed
4027.3 Funding Sources Specific for Senior Centers
4027.4 The FSSA DA Policy and Procedures Regarding Senior Centers
4027.5 AAA Policy and Procedures Regarding Senior Centers and Focal
Points
4028 THERAPY SERVICES
4028.1 Allowable Therapy Service Activities
4028.2 Funding Sources for Therapy Services
4028.3 The FSSA DA Policy and Procedures Regarding Therapy
Services
4028.4 AAA Policy and Procedures Concerning Therapy Services
4028.5 Service Provider Procedures Concerning Therapy Services
4028.6 Unit of Service
4029 TRANSPORTATION SERVICES
4029.1 Allowable Transportation Services
4029.2 Activities Not Allowed
4029.3 Funding Sources Specific for Transportation Services
4029.4 The FSSA DA Policy and Procedures Regarding Transportation
Services
4029.5 AAA Policy and Procedures Regarding Transportation Services
4029.6 Documentation and Service Standards
4029.7 Service Provider Procedures Regarding Transportation Services
4030 VOLUNTEER SERVICES
4030.1 Funding Services for Volunteer Services
4030.2 The FSSA DA Policy and Procedures Regarding Volunteer
Services
4030.3 AAA Policy and Procedures Concerning Volunteer Services
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4031 REQUESTS FOR AUTHORIZATION OF SERVICES (RFA)
4031.1 AAA Procedures Regarding Request for Authorization of
Services
4031.2 The FSSA DA Procedure Regarding the Request for
Authorization of Services
4032 TRANSFER OF CLIENTS
4032.1 AAA Procedures Regarding Transfer of Clients
CHART 8
FAMILY CAREGIVER – REPORT DUE DATES
CHART 9
45 CFR 1321.53 (b) (i)
INFORMATION AND ASSISTANCE
CHART 10
CONTENT OF STATE PLAN
CHART 11
PASRR LAWS
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4000 S ERVICE DEFINITIONS
4001 ADAPTIVE AIDS AND DEVICES
Adaptive aids and devices are those devices, controls, appliances, and/or supplies
determined necessary for older adults or persons with disabilities to increase their ability
to function in a home and community-based setting, with independence and physical
safety.
4001.1 ALLOWABLE ADAPTIVE AIDS AND DEVICES
Allowable adaptive aids and devices include:
(1) communication aids and devices;
(A) Personal Emergency Response System (PERS)
(2) Other communication aids such as:
(A) direct selection communicators;
(B) alphanumeric communicators;
(C) scanning communicators;
(D) encoding communicators;
(E) speech amplifier; and
(F) electronic speech aids/devices.
(3) Adaptive aids and devices:
(A) standing boards/frames;
(B) adaptive switches/devices;
(C) meal preparation and dining aids/devices/appliances;
(D) specially adaptive locks; and
(4) Other adaptive aids and devices.
4001.2 ADAPTIVE AIDS AND DEVICES NOT ALLOWED
(a) Services which duplicate any other service, provided under the client's plan of care
are not allowed.
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(b) Adaptive Aids or devices needed solely for the convenience of the client or caregiver
are not allowed.
4001.3 FUNDING SOURCES FOR ADAPTIVE AIDS AND DEVICES
Funding sources are Title III, CHOICE, and SSBG.
4001.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING ADAPTIVE AIDS AND
DEVICES
The FSSA DA shall monitor and assess AAAs on the provision of Adaptive Aids and
Devices. 1
4001.5 AAA POLICY AND PROCEDURES CONCERNING ADAPTIVE AIDS AND DEVICES
The AAA shall determine client eligibility for Adaptive Aids and Devices and make
referrals to a service provider. The AAA shall monitor and assess service providers on
the provision of Adaptive Aids and Devices Services. 2
4001.6 SERVICE PROVIDER RESPONSIBILITIES CONCERNING ADAPTIVE AIDS AND
DEVICES
(a) Each service provider must meet all applicable federal, state, and county
requirements.
(b) Required documentation from the service provider includes:
(1) the installation date of any adaptive aid or device, assistive technology, or
other equipment; and
(2) the maintenance date of any adaptive aid or device, assistive technology or
other equipment.
(c) A change made to any adaptive aid or device, assistive technology, or other
equipment, including any alteration, correction, or replacement.
4001.7 UNIT OF SERVICE
A unit of service equals one approved Adaptive Aid or Device.
1
2
Changed 5/13/05
Changed 5/13/05
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4002 O THER SERVICES FUNDED BY CHOICE
(a) "Other Services" are those services necessary to prevent clients from losing their
independence which are not traditionally listed as allowable services to be funded by
CHOICE or any other source.
(b) Some services still may not be considered appropriate for CHOICE funding. The
FSSA DA requires that the case manager supervisor or an AAA official, contact the
appropriate FSSA DA staff person before proceeding with a request for funding
approval.
4002.1 SERVICES NOT ALLOWED
Any service other than those services that are necessary to prevent older adults and
persons with disabilities from losing their independence, are not allowed.
4002.2 FUNDING SOURCES FOR OTHER SERVICES
CHOICE is the funding of last resort for in-home and community-based services. If any
older adult or person with disabilities applying for or receiving services through CHOICE
funding is eligible for similar services from funding sources other than CHOICE, those
funding sources must be utilized prior to or in place of CHOICE funding.
4002.3 T HE FSSA DA POLICY AND PROCEDURES REGARDING OTHER SERVICES
The FSSA DA is responsible for the evaluation and approval of requests for other
services necessary to prevent institutionalization submitted by the AAAs, costing more
than $4,999.99. The FSSA DA also shall monitor and assess AAAs on the provision of
such other services.
4002.4 AAA POLICY AND PROCEDURES CONCERNING OTHER SERVICES
(a) AAAs must submit a plan of care for each client. Also, a Request for Approval to
Authorize Services (RFA) form must be submitted for authorization, to the FSSA DA for
each service cost that is over $4,999.99.
(b) When the AAA has established a documented history of consistent FSSA DA
approval and successful use of this service, a waiver of FSSA DA prior approval process
may be requested.
4002.5 SERVICE PROVIDER RESPONSIBILITIES SPECIFIC TO CHOICE FUNDING
Each AAA has the responsibility to arrange for the provision of individually needed
CHOICE services through local service providers, including the arrangements of fees for
service contracts.
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4002.6 UNIT OF SERVICE
A unit of service equals one hour of approved service or one device or supply.
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4003 ADULT DAY SERVICES
(a) Adult Day Services are structured community based programs that provide a variety
of health, social, recreational, and related supportive services for older adults and
persons with disabilities in a protective setting during daytime and early evening hours.
(b) This service is designed to meet the needs of eligible persons through an
individualized service plan including personal care and supervision, medical care,
transportation to and from the site, and therapeutic and recreational activities. Adult Day
Services also includes the provision of meals and snacks, as appropriate.
(c) Adult Day Services assess the needs of participating individuals and offer services to
meet those needs. Adult Day Services are provided at 3 different, designated levels of
services.1
(d) The three levels of Adult Day Services include:
(1) Basic Adult Day Services (Level 1) which include the following:
(A) monitoring and/or supervision of all Activities of Daily Living (ADLs)
which are defined as dressing, bathing, grooming, eating, walking, and
toileting with hands on assistance provided as needed;
(B) comprehensive, therapeutic activities;
(C) assurance health assessment and intermittent monitoring of health
status;
(D) monitoring of medication/or medication administration; and
(E) the ability to provide appropriate structure and supervision for those
with mild cognitive impairment.
(2) Enhanced Adult Day Services (Level 2) which include the following:
(A) assuring that Basic (Level 1) service requirements are met;
(B) providing hands-on assistance with 2 or more ADLs or hands-on
assistance with bathing or other personal care;
(C) health assessment with regular monitoring or intervention with health
status;
(D) dispensing or supervision of the dispensing of medications to
participants;
1
State of Indiana Medicaid Waiver Standards and Guidelines, Adult Day Services, June 2001
For a copy of the State of Indiana Medicaid Waiver Standards and Guidelines – Adult Day Services - June
2001, contact the Agency Oversight Unit of the Division of Aging at 317-233-0800. The Adult Day Services
may also be electronically accessed from the INsite program.
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(E) psychosocial needs assessment and addressing needs including
counseling for participants and caregivers; and
(F) provision of appropriate therapeutic structure, supervision and
intervention for those with mild to moderate cognitive impairments.
(3) Intensive (Level 3) which includes the following:
(A) meeting Basic (Level 1) and Enhanced (Level 2) service
requirements;
(B) hands on assistance or supervision with all ADLs and personal care;
(C) one or more direct health intervention(s) as required;
(D) rehabilitation and restorative services including Physical Therapy,
Speech Therapy, Occupational Therapies, coordinated or available;
(E) providing therapeutic intervention to address dynamic psychosocial
needs such as depression or family issues effecting care; and
(F) providing therapeutic interventions for those participants with
moderate to severe cognitive impairments.
4003.1 ALLOWABLE ACTIVITIES
(a) Supervision and assistance, when needed, with Activities of Daily Living (ADL) and
supervision of personal hygiene and personal care as determined in level of service
assessment.
(b) Provision of individual and group social, health related, and recreational activities
provided at the Adult Day Service site. Recreational activities should be activities that
are included in a place of treatment related to specific therapeutic goals which can
include a group exercise program and preventive health screening such as blood
pressure checks and discussion groups.
(c) Activities that may be provided outside the program site, during service hours, if
accompanied by a staff member, those activities may include:
(1) two shopping trips per month (per client), when taken in a group;
(2) medically related trips, when necessary, as documented in the care plan;
(3) a maximum of four specialized field trips each per month designed for client
groups, such as attendance at concerts, plays, films, museums, or special
events; and
(4) One nutritionally balanced meal per day (and a nutritional snack if the client is
present for more than three hours).
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4003.2 ACTIVITIES NOT ALLOWED
Funding sources for adult day services will cover only those activities described as
Allowable Activities in this service.
4003.3 FUNDING SOURCES ADMINISTERED BY THE FSSA DA FOR ADULT DAY CARE
SERVICES
Funding sources are:
(1) SSBG
(2) CHOICE
(3) Older Hoosier Funds
(4) Title III
(5) Program Income
4003.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING ADULT DAY CARE
SERVICES PROVIDERS
(a) The FSSA DA is responsible for the approval of all service providers of Adult Day
Services.
(b) After a prospective service provider indicates a desire to provide adult day services,
the FSSA DA will send an application packet to the service provider that will include a
survey tool to be completed by the service provider. The requirements for certification
are also included.
(c) The service provider will return the completed application and survey along with any
other requested documentation to the FSSA DA.
(d) The FSSA DA or the AAA will arrange a time to inspect the facility and will speak
with the owner/administrator on site. An informal summary of findings of the inspection
will occur on site. The FSSA DA will follow-up with a letter sent to the prospective
service provider, to confirm any changes (if applicable) that need to be completed by the
prospective service provider, to make the facility in compliance with Adult Day Services
requirements.
(e) When the facility is in compliance with all requirements, the FSSA DA will send a
provider agreement, W-9, a certification letter, and the county survey indicating which
counties will be served.
(f) When the provider agreement and other forms are returned and are found to be
complete, the documents will be reviewed and forwarded to Electronic Data Systems
(EDS), as appropriate. EDS will issue a provider number and enroll the service provider
on the EDS system.
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4003.5 AAA POLICY AND PROCEDURES REGARDING ADULT DAY SERVICES
The AAA shall contract with a service provider for providing Adult Day Services. The
local AAA shall contract, negotiate service rates (for programs other than the waiver
program), determine client eligibility for adult day services, and refer eligible clients to a
certified service provider.
4003.6 SERVICE PROVIDER RESPONSIBILITIES CONCERNING ADULT DAY SERVICES
(a) Adult Day Services providers must comply with all requirements listed in the Indiana
Medicaid Adult Day Services Standards and Guidelines, including the following:
(1) administrative structure requirements;
(2) administrative responsibilities;
(3) staff requirements;
(4) facility and grounds requirements;
(5) service requirements;
(6) emergency preparedness documentation requirements;
(7) service file documentation requirements;
(8) activities requirements;
(9) food service procedures;
(10) meal requirements;
(11) nutrition component requirements;
(12) transportation service requirements; and
(13) vehicle requirements.
(b) In addition, the Adult Day Service provider shall provide Adult Day Services that are
in compliance with all federal, state, and local policies and regulations.
4003.7 DAY CARE MEAL
(a) The day care meal is a nutritionally balanced meal provided to the client at least once
a day and a nutritionally balanced snack, if the client is present for more than 3 hours at
the adult day services site.
(b) Individual meals and snacks must be nutritionally balanced and each meal must
provide a minimum of 1/3 of the current daily recommended dietary allowance (RDA)
specified appropriate for the client's age by the Food and Nutrition Board of the National
Academy of Sciences, National Research Council.
4003.8 DAY CARE TRANSPORTATION
(a) The provision of transportation to and from an Adult Day Services site and to and
from special field trips may be part of the Adult Day Services.
(b) The Adult Day Service provider shall agree to provide the service as required and to
handle billing for services directly with the fiscal agent. In addition to any funding specific
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requirements, the Adult Day Service provider must obtain certification by FSSA DA if
approval is sought for the waiver program. The Adult Day Service provider must comply
with the above stated sets of requirements.
4003.9 UNIT OF SERVICE
(a) Older adults or persons with disabilities attend Adult Day Services on a planned
basis. A minimum of 3 hours to a maximum of 12 hours shall be allowed.
(b) There are 2 units of service allowed under Adult Day Care Services. The 2 units are
1/2 day rate and 1/4 hour rate. The 1/2 day rate covers from 3 hours up to 5 hours. A full
day is considered from 5 to 8 hours. The 1/4 hour rate is to be used for all hours over 8
and up to 12.
(1) Examples:
(A) If a client needs 3 hours of service, it is recorded on the Plan of
Care/Cost Comparison Budget (POC/CCB) as 1 unit of service.
(B) If a client needs 4 hours of service, it is recorded on the POC/BBC as
1 unit at the 1/2 day rate.
(C) If a client needs 5 hours of service, it is recorded on the POC/BBC as
2 units at the 1/2 day rate.
(D) If a client needs 8 hours of service, it is recorded on the POC/BBC as
2 units at the 1/2 day rate.
(E) If a client needs 9 hours of service, it is recorded on the POC/BBC as
2 units at the 1/2 day rate and 4 units at the 1/4 hour rate.
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4004 ADULT GUARDIANSHIP SERVICES
(a) Adult Guardianship Services (AGS) provides incapacitated adults, who are unable to
care for themselves properly or manage their own affairs without assistance due to
certain incapacities or developmental disabilities, with the least restrictive type of
guardianship or related service. 1
(b) Adult Guardianship Services provide individuals with the following:
(1) help in dealing with legal issues and problems;
(2) understanding and maintaining their:
(A) rights;
(B) exercise of choice; and
(C) benefits from available services.
(3) assistance in resolving disputes regarding clauses (A) through (B).
(c) The program also promotes the need for lifetime planning through understanding and
use of advance directives.
4004.1 FUNDING SOURCES
Adult Guardianship Services are funded by state and local funds.
4004.2 THE FSSA DA POLICY AND PROCEDURES REGARDING ADULT
GUARDIANSHIP SERVICES
(a) The FSSA DA shall contract in writing for the provision of guardianship services as
required in each service provision region with a nonprofit corporation qualified to receive
tax deductible contributions under Section 170 of the internal revenue code and located
in the region.2
(b) The FSSA DA shall provide the following:
(1) technical assistance to local service providers;
(2) a standardized format for reporting and budget;
(3) assessment and monitoring of the provider program and the contract terms
and conditions; and
1
2
Indiana Code, 12-10-7-5
Indiana Code, 12-10-7-8
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(4) development and coordination of guardianship programs to all interested
parties.
4004.3 SERVICE PROVIDER RESPONSIBILITIES CONCERNING ADULT GUARDIANSHIP
SERVICES
(a) The service provider shall do the following:
(1) assess each referred person to determine eligibility for guardianship or
alternative services;
(2) assure active participation of the Adult Guardianship Services committee in
determining the necessity of a guardianship or alternative service and the
appropriate, least restrictive type of service necessary for each assessed person;
(3) assume full responsibility for incapacitated persons for whom the service
provider is appointed guardian as set forth in IC 29-3-1-1 (in particular IC 29-3-81 through IC 29-3-8-8) and any other applicable provisions of law and by the
terms of any court order;
(4) maintain a file for each protected person that documents all action taken;
(5) keep records and make such reports as required by the FSSA DA and/or the
court; and
(6) monitor and evaluate the activities of all programs on an ongoing basis.
(b) Each service provider is subject to periodic audit of the guardianship services
program by the state board of accounts. The service provider shall arrange for a
financial and compliance audit of the funds provided by the state. Audits are to be
conducted by an independent public or certified public accountant and performed in
accordance with the Indiana state board of accounts publication entitled "Guidelines for
Examination of Entities Receiving Assistance from Governmental Sources".
4004.4 ALLOWABLE ADULT GUARDIANSHIP SERVICES
Adult Guardianship Services may include:
(1) management of activities associated with the grant;
(2) identification and determination of eligibility of potential individuals;
(3) formulations and adoption of individualized service plans that assure the least
restrictive type of guardianship or alternative services;
(4) annual reassessment of each protected person;
(5) training and supervision of staff, both paid and volunteer;
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(6) reporting and other procedures required by the FSSA DA and the courts; and
(7) travel associated with assessment of individuals, arranging or providing
services, and providing/obtaining training for staff and volunteers.
4004.5 ACTIVITIES NOT ALLOWED
(a) Except for guardianship and alternative services or other duties as set forth under
allowable services, the provider will not provide a service directly to a protected person,
unless a waiver has been obtained from the FSSA DA for those agencies that are the
only provider for services needed by the protected person.
(b) The provider cannot subcontract for the provision of guardianship or in any way
delegate responsibility for any guardianship or alternative service provided under the
FSSA DA grant.
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4005 ADULT PROTECTIVE SERVICES
(a) Adult Protective Services (APS) investigates allegations of endangerment of adults.
When allegations are substantiated, arranges for the least restrictive form of intervention
necessary to relieve the endangerment.
(b) Adult Protective Services is contracted from the FSSA DA, for each county with:
(1) the Prosecuting Attorney; or
(2) the Prosecuting Attorney that performs part of the services and a government
entity qualified to perform the remainder of the required services.
(c) If the Prosecuting Attorney decides not to enter into a contract, a governmental entity
qualified to provide the services required may be contracted. 1
4005.1 DEFINITION OF ENDANGERED ADULT
An adult is considered “endangered” if the individual is:
(1) at least 18 years old; and
(2) incapable by reason of mental illness, mental retardation, dementia, habitual
drunkenness, excessive use of drugs, or other physical or mental incapacity, of
managing or directing the management of the individual’s property or providing or
directing the provision of self-care; and harmed or threatened with harm as a
result of neglect, battery or exploitation of the individual’s personal services or
property.2
4005.2 EXCEPTIONS TO DEFINITION OF ENDANGERED ADULT
An individual is NOT an Endangered Adult solely:
(1) for the reason that the individual is being provided spiritual treatment in
accordance with a recognized religious method of healing, instead of specified
medical treatment if the individual would not be considered to be an endangered
adult if the individual were receiving the medical treatment; or
(2) on the basis of being physically unable to provide self care when appropriate
care is being provided. 3
1
2
3
Indiana Code, 12-10-3-7
Indiana Code, 12-10-3-2
Indiana Code, 12-10-3-8
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4005.3 ALLOWABLE ACTIVITIES
(a) If the Adult Protective Services Unit has reason to believe that an individual is an
endangered adult, the adult protective services unit shall investigate the complaint or
cause the complaint to be investigated by law enforcement or other agency and make a
determination as to whether the individual reported is an endangered adult.
(b) Allowable Adult Protective Services include:
(1) receiving reports of alleged endangered adults;
(2) investigating to determine whether a report can be substantiated;
(3) referring persons determined not to be endangered to needed services;
(4) evaluating the needs of a person determined to be endangered;
(5) developing protective plans of care;
(6) coordinating with and training of personnel in AAAs, banks, hospitals, law
enforcement, legal services, long term care ombudsman programs, and other
appropriate agencies and organizations;
(7) monitoring of service provision or arrangement for monitoring;
(8) making court appearances;
(9) making formal presentations of information for the purpose of making the
public more aware of the program;
(10) preparing documents or researching information that supports any other
allowable activity;
(11) performing other activities ordered by the court;
(12) performing activities that promote the prevention of adult abuse;
(13) coordinating and training of volunteers to assist with allowable activities; and
(14) attending workshops/in-service training related to adult abuse or prevention
of adult abuse. 1
1
Indiana Code 12-10-4-4
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4005.4 FUNDING SOURCES FOR ADULT PROTECTIVE SERVICES
Adult Protective Services is provided with funding through State (75%) and Local Funds
(25%).
4005.5 UNIT OF SERVICE
One hour of staff time spent performing allowable activities.
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4006 ALZHEIMER’S DISEASE AND RELATED SENILE DEMENTIA (AD/RSD)
PROGRAMS
(a) AD/RSD programs and projects are primarily conducted through contracted service
providers. Service providers carry out specifications of projects and programs as
developed by the FSSA DA in cooperation with the Indiana Governor's Task Force on
Alzheimer's Disease and Related Senile Dementia (GTF) (Refer to Section 1112Alzheimer's Disease and Related Senile Dementia Task Force.)
(b) Programs and projects vary depending upon the needs of the target population and
the Indiana GTF.
4006.1 FUNDING SOURCES FOR AD/RSD
Special state appropriation funds are designated for programs and projects specifically
pertaining to AD/RSD. Federal grants as awarded to Indiana for activities associated
with AD/RSD, are also funding sources for AD/RSD.
4006.2 T HE FSSA DA POLICY REGARDING AD/RSD SERVICES
(a) The FSSA DA is responsible for the administration of funding for programs, projects,
grants, meetings, special events, services, documents, and disseminations associated
with the operation of the GTF and all related projects.
(b) The FSSA DA shall apply for federal funds that may be available to Indiana for
activities associated with AD/RSD.
(c) The FSSA DA shall require all facilities in Indiana that are licensed under or subject
to Indiana Code 16-28 to submit, on an annual basis, a disclosure form.
(d) After receiving the completed Alzheimer’s/Dementia Special Care Unit disclosure
forms, the FSSA DA shall perform the following activities:
(1) make the completed Alzheimer’s/Dementia Special Care Unit disclosure
forms available to any individual upon request;
(2) publish all the disclosure forms before February of each year in a single
publication to disseminate to the public upon request; and
(3) coordinate with the Indiana State Department of Health to assure that all
licensed facilities with special care units submit completed Alzheimer’s/Dementia
Special Care Unit disclosure forms on an annual basis.
(e) The FSSA DA shall establish pilot programs for the provision of respite care and
other supportive services, including home care services, for individuals with AD/RSD
and their families and caretakers. The purpose of a respite care program is to do the
following:
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(1) provide relief to the family or caretaker of an individual with AD/RSD from the
stresses and responsibilities attendant to the individual's care; and
(2) prevent or reduce the incidence of inappropriate institutional care of
individuals with AD/RSD and enable individuals with disabilities to remain in their
homes as long as possible.1
4006.3 T HE FSSA DA PROCEDURES REGARDING ALZHEIMER’S/ DEMENTIA SPECIAL
CARE UNIT DISCLOSURE FORM (STATE FORM 48896)
The FSSA DA shall complete the following procedures, on an annual basis:
(1) collect and assemble the completed forms in a "by county" format;
(2) compile the forms into a single document before the first day of February of
each year;
(3) send a copy of the compilation to Alzheimer Association offices;
(4) send copies of appropriate county information to local Ombudsmen; and
(5) send a copy of the compilation to anyone who requests the information. A
section from the compilation may be sent, if a request is for information regarding
a specific county or region.
4006.4 CONSULTATION
The FSSA DA shall consult with an Alzheimer's Disease or Related Senile Dementia
support organization and other appropriate organizations in the development and
evaluation of:
(1) care or treatment training programs or respite care pilot programs; and
(2) other long term care initiatives. 2
4006.5 SERVICE PROVIDER RESPONSIBILITIES AND PROCEDURES REGARDING
AD/RSD SERVICES
(a) Service providers are responsible for fulfilling the terms and conditions of their
contracts in accordance with the related project proposals submitted to the FSSA DA.
(b) Health facilities shall submit the completed Alzheimer’s/Dementia Special Care Unit
disclosure form, provided by the FSSA DA in December of each year. Also the health
1
2
Indiana Code 12-10-4-2
Indiana Code 12-10-4-3
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facility shall make the form available to any individual seeking information on services for
an individual with Alzheimer’s disease or related disorder. 1
4007 ATTENDANT CARE SERVICES
Attendant Care Services primarily involve "hands-on" assistance for older adults and
persons with disabilities who have physical needs. These services are provided in order
to allow older adults or persons with disabilities to remain in their own home and to carry
out functions of daily living, self-care, and mobility.
4007.1 ALLOWABLE ACTIVITIES
Attendant Care Services may include:
(1) Incidental homemaker activities, which are not furnished in the absence of
other attendant care services, that are essential to the client's health care needs
to prevent or postpone institutionalization. Activities directly related to a client's
medical needs, furnished in conjunction with but subordinate to direct patient
care, are described in the Homemaker Service - Section 4013.
(2) Assistance, as specified in the plan of care, which may include the following:
(A) Attendant Care
(i) Bathing (tub, shower)
(ii) Partial bath, hands, face, back, bottom
(iii) Oral hygiene
(iv) Hair care
(v) Shaving
(vi) Intact skin care
(vii) Dressing client
(viii) Clipping hair
(ix) Application of cosmetics
(x) Hand and foot care
(B) Mobility
(i) Proper body mechanics
(ii) Transfer between bed and chair
(iii) Ambulation (not including assistive devices)
(C) Nutrition
(i) Meal planning, preparation, and clean up
(D) Elimination
(i) Assisting with bedpan, bedside commode, toilet
(ii) Incontinent or involuntary care
(iii) Emptying urine collection and colostomy bags
(E) Safety
(i) Use of the principles of health and safety in relation to self and
1
Indiana Code 12-10-5.5-4
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client
(ii) Identify and eliminate safety hazards
(iii) Practice health protection and cleanliness by appropriate
techniques of handwashing, waste disposal, and household tasks
(F) Other
(i) Reminding client to self-administer medication
(ii) Reality orientation and sensory stimulation
(3) Escorting client to medical appointments.
(4) Assistance with correspondence and bill paying.
4007.2 ACTIVITIES NOT ALLOWED
(a) Activities not allowed:
(1) occupied bed changes;
(2) bearing full weight of client during transfer;
(3) supervision of dispensing of medication by client or dispensing of medication
for client;
(4) skin care on broken skin;
(5) passive range of motion exercises;
(6) assistance with crutch ambulation;
(7) bedbaths;
(8) other activities that must be performed by a licensed health care professional;
and
(9) nail care of diabetic clients.
(b) Attendant Care Services will not be provided to medically unstable clients as a
substitute for care provided by a registered nurse, licensed practical nurse, licensed
physician, or other health professional.
4007.3 FUNDING SOURCES FOR ATTENDANT CARE SERVICES
Funding for Attendant Care Services comes from various sources including SSBG, Title
III, CHOICE, and local funds.
4007.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING ATTENDANT CARE
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SERVICES
The FSSA DA shall ensure that the AAAs have appropriate quality assurance
methodology in place and shall conduct quality control reviews on a regular basis.
4007.5 AAA POLICY AND PROCEDURES REGARDING ATTENDANT CARE SERVICES
The AAA shall determine client eligibility and shall refer clients to an appropriate service
provider, negotiate rates and memorandum of agreements, and institute quality
assurance methods and reviews regarding attendant care services.
4007.6 SERVICE PROVIDER RESPONSIBILITIES CONCERNING ATTENDANT SERVICES
The service provider shall agree to provide the service as required and to handle billing
directly to the fiscal agent.
4007.7
UNIT OF SERVICE
A unit of service equals 1 hour of allowable activities.
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4008 C ASE MANAGEMENT SERVICES
Case Management Services attempt to link clients to all needed services and to ensure
that clients continue to receive and benefit from these services. Currently in Indiana, all
16 AAAs have been granted waivers and are allowed to provide direct delivery of Case
Management Services.
4008.1 INDEPENDENT CASE MANAGERS
(a) Case management services can be provided to older adults and persons with
disabilities by private, independent case-management companies or by individual
case managers outside of the AAAs, if the personnel providing the casemanagement services meet the minimum qualifications for individual case
managers.
(b) All case managers must be certified through the local Area Agency on Aging.
(c) Individual case managers must be able to supply a grade of case management
services that is equal to that of a case manager employed by an AAA. Most
services provided by the AAA case managers can also be supplied by
independent case managers. 1
4008.2 CASE MANAGEMENT ALLOWABLE ACTIVITIES
Allowable case management activities shall include:
(1) Assessments of eligible clients to determine eligibility for services, functional
impairment level, and corresponding in-home and community services needed by the
client.
(2) Development of care plans to meet client needs.
(3) Implementation of the care plans, linking client with needed services, regardless of
the funding source.
(4) Assessment and care planning for discharge from institutionalization.
(5) Annual reassessments of clients needs.
(6) Periodic updates of care plans.
(7) Monitoring of the quality of home care community services provided to the client.
(8) Determination of and monitoring the cost effectiveness of the provisions of in-home
and community services.
(9) Information and assistance services.
1
Moved from Part 1, Section 1 - 4/10/06
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(10) Enhancement or termination of services based on need.
4008.3 SERVICES NOT ALLOWED UNDER CASE MANAGEMENT
Activities not listed above are not considered allowable under case management and are
not reimbursable.
4008.3.1 SERVICES NOT ALLOWED TO BE SUPPLIED BY INDEPENDENT CASE
MANAGERS
Services that may NOT be supplied by independent case managers or
independent case management companies are as follows:
(1) initial applications for Medicaid Waivers; and
(2) CHOICE funded services.1
4008.3.2 ENTITIES NOT ALLOWED TO CONDUCT CASE MANAGEMENT
SERVICES
Case Management may not be conducted by the following:
(1) any organization, entity, or individual that also delivers other in-home and
community-based services; or
(2) any organization, entity, or individual related 2 by common ownership 3 or
control to any other organization, entity, or individual who also delivers other inhome and community-based services, unless the organization is an AAA that has
been granted permission by the FSSA DA to provide direct services to clients.
4008.4 FUNDING SOURCES FOR CASE MANAGEMENT SERVICES
Funding sources for Case Management Services provided through the AAAs are SSBG,
CHOICE, Title III, Older Hoosier Funds, and local funds.
1
Moved from Part 1, Section 1023 - 4/10/06
Related means associated or affiliated with, or having the ability to control, or be controlled by.
3
Common Ownership exists when an individual, individuals, or any level entity possess
ownership or equity of at least five percent in the provider as well as the institution or organization serving
the provider. Control exists where an individual or an organization has the power or ability directly or
indirectly to influence or direct the actions or policies of an organization or institution, whether or not actually
exercised.
2
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4008.5 T HE FSSA DA POLICY AND PROCEDURES REGARDING CASE MANAGEMENT
SERVICES
The FSSA DA shall monitor and assess case management and help complete case
management certification.
4008.6 AAA POLICY AND PROCEDURES REGARDING CASE MANAGEMENT SERVICES
(a) AAAs shall determine case manager certification in compliance with rules established
by the FSSA DA. Case management may not be conducted by any agency or individual
that also delivers other services, unless the agency has been granted a waiver by the
FSSA DA to provide direct delivery of other services in addition to case management.
(b) The entity providing Case Management Services has the responsibility to do the
following:
(1) ensure the selection of qualified staff;
(2) provide and arrange for orientation and initial training for case management
staff;
(3) provide and arrange for ongoing in-service training for case management
staff;
(4) perform record keeping and data collection activities;
(5) provide community education regarding the case management system;
(6) establish working relationships with existing service providers;
(7) provide ongoing supervision of case managers;
(8) ensure administrative and support services for the case management system;
(9) ensure confidentiality of client information; and
(10) develop and expand resources for providing community care services,
where feasible.
(d) A provider of case management services shall ensure that the older adult or person
with disabilities who is a client, and the client’s legal representative, if applicable; and all
other providers serving the older adult or person with disabilities client, regardless of
whether the services provided are funded by CHOICE, Title III or SSBG, shall have
copies of relevant documentation, including information on client rights, client care plan,
how to file complaints with the FSSA DA, and requesting appeals concerning issues and
disputes relating to the services provided to the client.
(e) If meals (home-delivered or congregate) is the only service obtained by an
individual, and if complete case management services are not provided, the AAA
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must have established written policies and procedures concerning who is
responsible for administering, evaluating, and providing appropriate intervention
related to nutrition assessment findings.1
4008.7 CASE MANAGER QUALIFICATIONS
(a) The qualifications of a prospective case manager (resume, work experience,
education, and training) are to be submitted to the appropriate AAA.
(b) Certification is completed prior to the individual's employment.
4008.7.1 MINIMUM QUALIFICATIONS FOR INDIVIDUAL CASE MANAGERS
(a) All case management services provided must comply with the “Case
Management Standards” found in the Indiana Home and Community-Based
Services Medicaid Waiver Provider Manual.
(b) An applicant shall have the minimum educational/experience criteria, which
includes:
(1) a Bachelor’s Degree in social work, psychology, sociology,
counseling, gerontology, or nursing; or
(2) a Registered Nurse with one year experience in human services; or
(3) a Bachelor’s Degree in any other field with a minimum of 2 years fulltime, direct service experience with the older adults or persons with
disabilities. This experience must include assessment, care plan
development, and monitoring; or
(4) a Master’s Degree in a related field may substitute for the required
experience.
(c) All case managers must attend the Division of Disability, and
Rehabilitative Services’ (DDRS) “Case Management Orientation” within the
first six months of employment with an AAA or employment as an
independent case manager.2 Case Manager Orientation Training is
exclusive to new Case Managers. Case Managers who have already
attended Case Manager Orientation Training shall not be invited to attend a
second time.3
(d) All case managers must annually obtain at least 20 hours of training
regarding Case Management Services.
1
Added 4/10/06
Changed 4/10/06
3
Added 4/10/06
2
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(e) If the FSSA DA identifies a systemic problem with a provider’s services, the
provider shall obtain training on the topics recommended by the FSSA DA.
4008.8 THE FSSA DA POLICY AND PROCEDURES REGARDING CERTIFICATION OF
CASE MANAGERS
The FSSA DA shall establish case manager qualifications and monitor and assess Case
Management Services. To provide Case Management Services, an applicant shall be
approved by DDRS or its designee (AAAs).
4008.9 T HE FSSA DA POLICY AND PROCEDURES FOR DE-CERTIFICATION OF CASE
MANAGERS EMPLOYED BY AAA OR BY INDEPENDENT CASE MANAGEMENT AGENCIES
(a) A case manager employed by an AAA or by an independent case management
agency will be de-certified (de-activated) as of the case manager’s last date of
employment. When a case manager is being terminated or resigns, the independent
case management agency shall notify the AAA that completed the original case
management certification,1 of the termination or resignation. (A case manager should
NOT be de-certified for a temporary absence, such as for maternity, medical, or family
leave.)
(b) De-certification of an independent, non-agency case manager will remain the
responsibility of the FSSA DA. If an AAA suspects that an independent, non-agency
case manager may be providing poor quality or fraudulent services, the AAA should
notify the Bureau of Quality Improvement Services (BQIS) immediately, so the potential
problem can be investigated thoroughly.
(c) The FSSA DA shall establish case manager’s qualifications and monitor case
manager certifications conducted by AAAs.
4008.10 AAA POLICY AND PROCEDURES CONCERNING CERTIFICATION OF CASE
MANAGERS
(a) The AAAs shall make determinations regarding case management certification based
on the following:
(1) the applicant's resume and college transcript.
(2) information and documentation contained in the certification request sent by
the AAA to FSSA DA.
(3) collateral information submitted at the discretion of the AAA or entity.
1
Changed 4/10/06
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(b) The AAA reviews the material and a decision is made based upon the submitted
documentation. The decision is sent to the candidate with a copy to the FSSA DA.
The AAA maintains the submitted documentation. Candidates are informed of the
appeals process. The original of the certification is submitted to the Medicaid fiscal agent
for enrollment.
(c) Copies of case manager certification for all programs should be submitted to:
Division of Aging
P.O. Box 7083
Provider Specialist, Medicaid Waiver Unit
Indianapolis, Indiana 46207-7083
4008.11 AAA POLICY AND PROCEDURES CONCERNING DE-CERTIFICATION OF CASE
MANAGERS
To keep records at the FSSA DA and the Electronic Data Systems (EDS) current, the
AAA shall take the following actions when a case manager leaves employment with an
AAA or with an independent case management agency:
(1) The AAA representative who is authorized to certify case managers shall write
a short memo on agency letterhead explaining that the case manager is being decertified and requesting that this case manager‘s number be terminated.
(2) The memo shall include:
(A) the case manager’s name;
(B) the case manager’s 9-digit waiver provider number;
(C) the case manager’s last date of employment;
(D) the agency’s name;
(E) the agency’s address; and
(F) the agency’s 9-digit waiver provider number.
(3) The original and one copy of the memo should be sent to:
MS 21
Provider Relations Specialist
Division of Aging
P.O. Box 7083
Indianapolis, Ind. 46207-7083
(4) A copy of the memo should be retained in the case manager’s file at the AAA.
Records should be maintained a minimum of three years after a case manager is
de-certified, in case of future audits.
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4008.12 INFORMATION CONCERNING AN OLDER ADULT OR A PERSON WITH A
DISABILITY
A provider of case management services shall have the following information about an
older adult or person with a disability receiving case management services from the
provider:
(1) The wants and needs of the individual, including the health, safety, behavioral
needs and wishes for self-directed care of an individual.
(2) The array of services available to an individual.
(3) The availability of funding for an individual.
4008.13 UNIT OF SERVICE
A unit of case management service equals one-fourth hour (15 minutes) of allowable
activities.
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4009 CONTINUING EDUCATION SERVICES
(a) Continuing Education Services is the compilation and distribution of information on
institutions of higher education within each PSA concerning courses of study offered to
older adults and the policies related to fees charged to older adults.
(b) Continuing education information shall be made available to older adults at focal
points, senior centers, congregate nutrition sites, and other appropriate locations.
4009.1 FUNDING SOURCES FOR CONTINUING EDUCATION SERVICES
Funding sources are Title III, Older Hoosier Funds, and local funds.
4009.2 THE FSSA DA POLICY AND PROCEDURES REGARDING CONTINUING
EDUCATION SERVICES
The FSSA DA shall require the AAAs within the PSAs to compile available information
on institutions of higher education concerning courses of study offered to older adults
and the policies related to fees charged to older adults. The FSSA DA shall:
(1) provide for continuing education planning in the "Goals and Objectives"
section of the area plan;
(2) review completed area plans for evidence that planning for the compilation of
the Continuing Education information has been completed; and
(3) monitor each AAA to assure that the continuing education information has
been compiled and distributed appropriately.
4009.3 THE AAA POLICY AND PROCEDURES REGARDING CONTINUING EDUCATION
SERVICES
(a) Each AAA shall compile information on available continuing education opportunities
at institutions of higher education within their respective PSAs.
(b) The AAA will compile information, which will include the following:
(1) the courses of study offered to older adults by those institutions;
(2) the policies of those institutions with respect to the enrollment of older adults
with little or no payment of tuition on a space available basis or on another
special basis; and
(3) other information that is appropriate.
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(c) Based on the results of the compilation, each AAA shall summarize the information
and make it available to older adults at focal points, senior centers, meal sites, and other
appropriate places.1
1
Older Americans Act, 306(a)(6)(O)(ii)
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4010 D ISEASE PREVENTION AND HEALTH PROMOTION SERVICES
(a) Disease Prevention and Health Promotion Services provide information and
support to older individuals with the intent to assist them in avoiding illness and
improving health status.1
(b) Services are provided at multipurpose senior community centers, congregate
meal sites, home-delivered meals programs, senior high-rises, retirement
communities or other appropriate sites.2
4010.1 T ARGET POPULATION
Persons over age 60 who are medically underserved or who have the greatest
economic need for such services.3
4010.2 FUNDING SOURCES
Disease Prevention and Health Promotion Services are funded through the Older
Americans Act.
4010. 3 ALLOWABLE DISEASE PREVENTION AND HEALTH PROMOTION SERVICES
ACTIVITIES
Allowable activities include:
health screening programs;
physical fitness programs;
exercise classes;
nutrition education programs; and
informational programs on diagnosis, prevention, treatment,
rehabilitation of age-related diseases and chronic conditions; and
medication management programs.
4010.4 UNIT OF SERVICE
A unit of service equals one hour of allowable activity.
1
Added 4/10/06
Older Americans Act, Section 361(a)
3
Older Americans Act, Section 361(b)
2
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4011 FAMILY CAREGIVER SUPPORT PROGRAM
The Family Caregiver Support Program provides multi-faceted systems of support
services for family caregivers, including access information; assistance; individual
counseling, support groups and training; respite; and supplemental services.
4011.1 F UNDING SOURCES FOR THE FAMILY CAREGIVER SUPPORT PROGRAM
(a) The funding source for the Family Caregiver Support Program is Title III-E of the
Older Americans Act (OAA). 1
(b) No more than 10% of Title III-E expenditures can be used for supportive services to
relative caregivers (grandparents age 60 or older and relatives age 60 or older) of
children age 18 or younger. 2
(c) No more than 20% of Title III-E may be used for supplemental services.
4011.2 POPULATIONS SERVED BY THE FAMILY CAREGIVER SUPPORT PROGRAM
(a) Populations served by the Family Caregiver Support Program include adult family
caregivers, or another individual who is an informal provider of in-home and community
care for the following older adults:
(1) The care recipient defined as an older adult, 60 years of age and older; and
(2) The care recipient defined as an adult, 60 years of age or older, has two or
more activities of daily living (ADL) limitations, or a cognitive impairment, or
functional dependency for the caregiver, to be eligible for respite or supplemental
services.
(b) Populations served include grandparents or step-grandparents, 60 years or older (or
relative caregivers by blood or marriage) of children 18 years and younger who:
(1) live with the child;
(2) are the primary caregivers of the child because biological or adoptive parents
are unable or unwilling to serve as the primary caregivers of the child; or
(3) have a legal relationship to the child, such legal custody or guardianship, or
are raising the child informally.
(c) Priority for services shall be given to older adults with greatest social and economic
need (with particular attention to low-income older adults and older adults providing care
and support to persons with mental retardation and related developmental disabilities (as
defined in Section 102 of the Developmental Disabilities Assistance and Bill of Rights
Act, 42 USC 6001).
1
2
Older Americans Act, Section 303 (e) (1) and (2)
Older Americans Act, Section 304 (d) (1) (A)
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(d) Per the Administration on Aging, Title III-E permits payments to older adults, age 60
years and older, who are caring for children 18 years and younger, for support services
that include the following:
4011.3 ACCESS ASSISTANCE
This service assists caregivers in obtaining access to the services and resources that
are available within their communities.
4011.4 INFORMATION FOR CAREGIVERS
This is a service for caregivers that provides the public and individuals with information
on resources and services available to the individuals within their communities.
4011. 5 C OUNSELING
Counseling is provided to caregivers to assist them in making decisions and solving
problems relating to their caregiver roles. This includes counseling to individuals,
support groups, and caregiver training (for individual caregivers and families).
4011.6 R ESPITE
Respite services offer temporary, substitute supports or living arrangements for care
recipients in order to provide a brief period of relief or rest for caregivers. Respite care
includes the following:
(1) in home respite; (personal care, homemaker, and other in-home respite);
(2) respite provided by attendance of the care recipient at a senior center or other
non-residential program; and
(3) institutional respite provided by placing the resident in an institutional setting
such as a nursing home for a short period of time as a respite service for the
caregiver or, (for grandparents caring for the children,) summer camps. 1
4011.7 SUPPLEMENTAL SERVICES
(a) These services are provided on a limited basis to complement the care provided by
caregivers.
(b) Examples of supplemental services include, but are not limited to, home
modifications, assistive technologies, emergency response systems, and incontinence
supplies.
1
Older Americans Act, Section 373(a) (1) through (5)
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(c) Supplemental services are meant to be flexible enhancements to caregiver support
programs and are for the benefit of caregivers.
4011.8 The FSSA DA POLICY REGARDING THE FAMILY CAREGIVER SUPPORT
PROGRAM
The FSSA DA shall develop and coordinate a statewide Family Caregiver Support
Program that will be administered through the 16 AAAs.
4011.9 T HE FSSA DA PROCEDURES REGARDING THE FAMILY CAREGIVER SUPPORT
PROGRAM
(a) The FSSA DA shall grant funds to each AAA for the Family Caregiver Support
Program as part of the Area Plan.
(b) The FSSA DA shall collect information from the AAA’s data records, including
information on program services, in a standardized format relating to the Family
Caregiver Support Program.
(c) Data will be furnished to the AoA who will monitor program compliance and evaluate
and compare the effectiveness of the state program.
(d) The FSSA DA shall provide guidance and technical assistance to the AAAs.
(e) The FSSA DA shall establish procedures for fiscal and programmatic reporting.
4011.10 AAA POLICY AND PROCEDURES REGARDING THE FAMILY CAREGIVER
SUPPORT PROGRAM
(a) The AAA shall maintain and publicize the Family Caregiver Support Program to
ensure that caregivers have to access to quality information and support services.
(b) The AAA shall update the Family Caregiver Support Program Section of the A area P
plan with measurable goals and objectives.
(c) The AAA may place a cap on the amount of National Family Caregiver Support
Program respite dollars used per year.
4011.11 R EPORTS
(a) The AAA will submit quarterly data collection reports to the FSSA DA on the
approved form, in a timely manner during the program year.
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CHART 8
FAMILY CAREGIVER - REPORT DUE DATES
Family Caregiver- Report Due Dates
October 30th (first quarter - July 1- September 30)
January 30th (second quarter - October 1 - December 31)
April 30th (third quarter - January 1 - March 31)
July 30th (fourth quarter- April 1 - June 30)1
(b) The AAA will submit to the FSSA DA by September 1, the beginning of the annual
National Family Caregiver Month, a report on scheduled activities and plans for the
November National Family Caregiver Month.
(c) The AAA will submit annual updates to the FSSA DA Best Practices of the Indiana’s
Family Caregiver Support Program. The reporting period for the Best Practices update is
October 1 to September 30.
(d)The updated Best Practices document will be released annually in November in
conjunction with National Family Caregiver Month.
4011.12 U NIT OF SERVICE
Service units include the following:
(1) Information services – (1 Activity)
A service for caregivers that provides the individuals with current information on
resources and services available to the individuals within their communities.
(Note: service units for information services are for activities directed to
large audiences of current or potential caregivers such as disseminating
publications, conducting media campaigns, and other similar activities).
(2) Access assistance- (1 contact)
A service that assists caregivers in obtaining access to the services and
resources that are available within their communities. To the maximum extent
practicable, it ensures that the individuals receive the services needed by
establishing adequate follow-up procedures (Note: Information and assistance
to caregivers is an access service, i.e. a service that: A) provides
individuals with information on services available within the communities;
B) links individuals to the services and opportunities that are available
within the communities; C) to the maximum extent practicable, establishes
follow-up procedures. Internet website “hits” are to be counted only if
information is requested and supplied).
1
Changed 5/13/05
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(3) Counseling - (1 session)
Counseling to caregivers to assist them in making decisions and solving
problems relating to their caregiver roles. This includes counseling to individuals,
support groups, and caregiver training of individual caregivers and families.
(4) Respite - (1 hour)
Services which offer temporary, substitute supports or living arrangements for
care recipients in order to provide a brief period of relief or rest for caregivers.
(Respite Care includes: 1) In-home respite (personal care, homemaker and
other in-home respite); 2) respite provided by attendance of the care
recipient at a senior center or other nonresidential program; 3) institutional
respite provided by placing the care recipient in an institutional setting
such as a nursing home for a short period of time as a respite service for
the caregiver, and (for grandparents caring for children) summer camps. If
the specific service units purchased via a direct payment (cash or voucher)
can be tracked or estimated, report those service unit hours. If not, a unit
of service in a direct payment is one payment.
(5) Supplemental services (Services provided on a limited basis to complement
the care provided by caregivers. Examples of supplemental services include,
but are not limited to, home modifications, assistive technologies,
emergency response systems and incontinence supplies.
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4012 HOME HEALTH SERVICES
Home health services and supplies include all health monitoring activities performed in
the home, supervision of medication, and dressing changes.
4012.1 ALLOWABLE HOME HEALTH SERVICES
Allowable Services and Supplies include:
(1) bath assistance;
(2) foot care;
(3) home health aide services;
(4) medication set up;
(5) occupational therapy;
(6) physical therapy;
(7) private duty nursing;
(8) skilled nursing; and
(9) speech therapy.
4012.2 HOME HEALTH SERVICES NOT ALLOWED
Services other than those listed above are not allowable under home health services
and supplies.
4012.3 FUNDING SOURCES FOR HOME HEALTH SERVICES
Funding sources for home health services and supplies are Title III, SSBG, and
CHOICE.
4012.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING HOME HEALTH
SERVICES
The FSSA DA shall monitor and assess AAAs on the provision of Home Health
Services.1
1
Changed 5/13/05
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4012.5 AAA POLICY AND PROCEDURES CONCERNING HOME HEALTH SERVICES
The case manager shall determine client eligibility and shall refer clients to a certified
service provider, negotiate rates and agreements, and institute quality assurance
methods and reviews regarding home health services. The AAA shall monitor and
assess service providers on the provision of Home Health Services.1
4012.6 SERVICE PROVIDER RESPONSIBILITIES CONCERNING HOME HEALTH
SERVICES
Each service provider must meet all applicable federal, state, county, and local
requirements.
4012.7 UNIT OF SERVICE
A unit of service equals one hour of allowable activity.
1
Changed 5/13/05
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4013 H OMEMAKER SERVICES
Homemaker services offer direct and practical assistance with household tasks and
related activities. Homemaker services assist the older adult or person with disabilities
who has experienced a loss in the ability to perform the instrumental activities of daily
living to remain in a clean, safe, healthy home environment. Homemaker services are
provided when the client is unable to meet these needs or when an informal caregiver is
unable to meet these needs for the client.
4013.1 ALLOWABLE HOMEMAKER SERVICES
(a) Homemaker services provides for housekeeping tasks which may include:
(1) dusting and straightening furniture;
(2) cleaning floors and rugs by wet/dry mop and vacuum sweeping;
(3) cleaning the kitchen, including washing dishes, pots, and pans; cleaning the
outside of appliances and counters and cupboards; cleaning ovens and
defrosting and cleaning refrigerators;
(4) maintaining a clean bathroom, including cleaning the tub, shower, sink, toilet
bowl, and medicine cabinet; emptying and cleaning commode chair/urinal;
(5) laundering clothes in the home or Laundromat, including washing, drying,
folding, putting away, ironing, and basic mending and repair;
(6) changing linen and making beds;
(7) washing insides of windows;
(8) removing trash from the home;
(9) choosing appropriate procedures, equipment, and supplies; improvising when
there are limited supplies, keeping equipment clean and in its proper place; and
(10) yard clean up, including lawn mowing, raking, and snow removal.
(A) Homemaker services may provide assistance with meals/nutrition that
may include:
(I) shopping, including planning and putting food away; and
(ii) Making meals, including special diets under the supervision of
a registered dietitian or health professional.
(b) Homemaker services may include completing the following essential chores or
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errands:
(1) grocery shopping;
(2) household supply shopping;
(3) prescription pick up;
(4) food stamp pick up; and
(5) assistance with correspondence and bill paying.
4013.2 ACTIVITIES NOT ALLOWED
(a) Services requiring hands-on personal care or any activity that must be
provided by a licensed health professional care service are not allowed.
(b) Homemaker services that benefit household members only.
4013.3 FUNDING SOURCES FOR HOMEMAKER SERVICES
Funding sources are Title III, SSBG, CHOICE, Older Hoosier Funds, and other local
funds.
4013.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING HOMEMAKER
SERVICES
The FSSA DA shall monitor and assess AAAs on the provision of Homemaker Services.
4013.5 AAA POLICY AND PROCEDURES CONCERNING HOMEMAKER SERVICES
The AAA shall determine client eligibility for Homemaker Services and make referrals to
a service provider. The AAA shall monitor and assess service providers on the provision
of homemaker services.
4013.6 SERVICE PROVIDER RESPONSIBILITIES CONCERNING HOMEMAKER SERVICES
The service provider shall agree to provide homemaker services as required by the
FSSA DA. The service provider shall handle billing directly through the fiscal agent.
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4013.7 UNIT OF SERVICE
A unit of homemaker service equals one hour of allowable activity.
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4014 HOME REPAIR/MAINTENANCE SERVICES
(a) Home Repair/Maintenance and minor home repair services are planned and
monitored maintenance and minor repair activities essential to health and safety.
(b) Home Repair may be made to an owner or renter occupied single-family dwelling.
The intent of the service shall be to make the dwelling habitable and shall not be done to
improve the appearance of the property.
(c) Service activities shall be performed in order of priority. Conditions that are life
threatening and/or pose a health or safety hazard to the older adult or person with
disabilities will be allowed.
4014.1 ALLOWABLE HOME REPAIR/MAINTENANCE ACTIVITIES
(a) The Home Repair and Maintenance Services program dollars shall be used only for
repairs that directly correct and/or prevent health and/or safety hazards.
(b) Home Repair/Maintenance and minor home repair activities may include:
(1) plumbing, heating, and electrical malfunction repair or replacement;
(2) storm door, window, and screen repairs;
(3) gutter and roof patching;
(4) heavy cleaning; and
(5) broken step repairs.
(c) Health and safety alterations may include installation of:
(1) handrails;
(2) ramps;
(3) deadbolts;
(4) fire extinguisher;
(5) smoke detectors;
(6) locks; and
(7) window bars.
(d) Ground maintenance services may include limited lawn mowing, snow removal, and
minimal hard cleanup to assure safe entrance and departure from the premises.
(e) Time spent in assessing the job, obtaining the supplies, performing planned
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activities, and cleaning up.
(f) Travel time between work sites.
4014.2 ACTIVITIES NOT ALLOWED
Service providers will not be paid for such activities as:
(1) billing for more than the actual time of each staff person delivering services,
even when more than one client is simultaneously benefiting from the service;
and
(2) billing for home repair services which cannot be documented as avoiding a
clear and present health/safety hazard. Services may not be provided for
aesthetic purposes only.
4014.3 FUNDING SOURCES FOR HOME REPAIR/MAINTENANCE SERVICES
Home Repair/Maintenance Services are available through Title III, CHOICE, SSBG,
Older Hoosier Funds, and local funds.
4014.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING HOME REPAIR
/MAINTENANCE SERVICES
The FSSA DA shall periodically monitor and assess the AAA Home Repair/Maintenance
Services program and fiscal management. The FSSA DA shall refer home repair
requests for older adults and persons with disabilities to the appropriate AAA.
4014.5 AAA POLICY AND PROCEDURES REGARDING HOME REPAIR/MAINTENANCE
SERVICES
(a) If the Home Repair/Maintenance Services program is determined to be a viable
program at the AAA level, the AAA shall contract a service provider to make available
the appropriate Home Repair/Maintenance Services to any eligible older adult or person
with disabilities living within the PSA.
(b) The AAA shall determine client eligibility for Home Repair/Maintenance Services and
refer the client to a service provider.
4014.6 SERVICE PROVIDER RESPONSIBILITIES CONCERNING HOME REPAIR
/MAINTENANCE SERVICES
Each service provider must meet all applicable federal, state, and county requirements.
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4014.7 UNIT OF SERVICE
A unit of service equals one hour of allowable activity.
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4015 INDIANA PRE- ADMISSION SCREENING PROGRAM (IPAS)
(a) The primary purpose of the IPAS program is to have an assessment process to
determine an individual's needs in order to prevent the premature or unnecessary
placement of an individual in a nursing facility (NF) if the individual's needs can be more
appropriately met through the provision of home and community-based services.
(b) Pre-Admission screening is required for every applicant, regardless of age, income,
or resources, seeking admission to a NF in Indiana. IPAS provides an opportunity for the
supervision of long term care services in a location that is conducive to the physical and
the psychological well-being of the individual while also functioning as an effective
mechanism of health care cost containment.
(c) The objectives of the IPAS program are as follows:
(1) to identify older adults or persons with disabilities who are at risk of
institutionalization and meet the state's criteria for NF placement;
(2) to provide a comprehensive assessment of an individual's needs;
(3) to ascertain if alternative services are available in the community that would
be more appropriate than care in a NF at not more than the cost of placement in
a NF; and
(4) to deny permission to enter a NF when the above criteria are not met.
However, the individual may elect to enter a NF if the individual:
(A) is willing to forego eligibility for Medicaid reimbursement for NF per
diem costs for a period of up to 1 year from the date of admission to a NF;
and
(B) has not triggered a Level II Screen.
4015.1 FUNDING FOR INDIANA'S PRE-ADMISSION SCREENING PROGRAM
Pre-Admission Screening is 100% funded by the State of Indiana except:
(1) when reimbursement is provided for Medicaid and/or PASRR recipients
through the Medicaid Program; and
(2) when no other federal funding source (such as SSBG) is available.
In 1989, an additional step was added to the Pre-Admission
Screening process to identify individuals with a mental illness (MI)
or mental retardation/ developmental disability (MR/DD) condition. This step is
known as the Pre-Admission Screening/ Resident Review (PASRR). Although
IPAS is interrelated and coordinated with PASRR, the two are separate
programs. PASRR is a federally funded program and works with the State IPAS
program.
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4015.2 ELIGIBILITY REQUIREMENTS FOR INDIANA'S PRE-ADMISSION SCREENING
PROGRAM
Every person seeking admittance to an Indiana NF is eligible and must participate in the
IPAS program. There is no cost to the individual for IPAS services.
4015.3 T HE FSSA DA POLICY AND PROCEDURES REGARDING INDIANA'S PREADMISSION SCREENING PROGRAM
The FSSA DA shall administer the IPAS program by notifying IPAS agencies of changes
regarding state laws and rules, issuing directives concerning the IPAS process, and
acting to correct any IPAS processing problems encountered by the IPAS agencies.
4015.4 AAA DUTIES REGARDING INDIANA'S PRE-ADMISSION SCREENING PROGRAM
(a) The FSSA DA has designated the 16 AAAs as the IPAS agencies responsible for
administering the IPAS program in Indiana.
(b) As an IPAS agency, the AAA shall do the following:
(1) seek cooperation from other public and private agencies in the community
which offer services to older adults and persons with disabilities;
(2) provide information and education to the general public regarding availability
of the IPAS program;
(3) accept IPAS referrals from individuals, families, human service professionals,
and health facility personnel;
(4) assess health and psychosocial needs of referred individuals and identify
services needed to maintain the individuals in the least restrictive environment;
(5) identify available non-institutional services to meet the care needs of older
adults and persons with disabilities who have been referred;
(6) compute the cost effectiveness of non-institutional care versus NF services;
(7) upon receipt of a completed application, schedule the IPAS activities to be
completed within the designated time;
(8) determine the composition of the IPAS screening team;
(9) appoint the individual's physician to the IPAS screening team at the time of
each assessment. In the event that the individual is unable to specify an
attending physician, the IPAS agency may assist the individual in locating a
physician who shall be named as a member of the IPAS screening team1; and
1
Indiana Administrative Code, 460 IAC 1-1-7
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(10) subject to approval by DDRS, authorize Indiana hospital discharge planners
who may act as IPAS designees to authorize certain temporary NF admissions.
4015.5 AAA PROCEDURES CONCERNING INDIANA'S PRE-ADMISSION SCREENING
PROGRAM
The AAA, serving as the IPAS agency, will provide the following:
(1) an assessment of needs to applicants who are, at the time of evaluation,
inpatients in hospitals located in counties included in the PSA served by the AAA;
(2) an assessment of needs to applicants who have been admitted, under PAS
assessor approval, to a NF located in a county included in the PSA served by the
AAA;
(3) an IPAS manager, employed by the AAA, who has a thorough understanding
of the objectives, policy, and procedures of the IPAS program and services and
can function effectively in a leadership position with the IPAS team. The IPAS
area manager shall ensure the accomplishment of the IPAS process by providing
necessary direction and technical assistance; and
(4) an IPAS assessor, employed by the AAA, who has demonstrated
competence in the activities associated with personal care assessment of
functionally impaired individuals and care plan development.
4015.6 IPAS FINAL DETERMINATION
Final determination of appropriateness for NF admission is based on a review of
completed IPAS case documentation and the application of the Medicaid criteria for
need for NF level of services. The IPAS agency makes the final determination for private
pay only applicants. Medicaid eligibility determinations and those cases that the IPAS
agency cannot decide are submitted to OMPP for final determination. PASRR cases are
referred to the State PASRR unit with a team recommendation. The IPAS only final
determination is issued on State Form 707 Form 4B.
4015.7 APPEALS AND FAIR HEARINGS
Individuals who receive an adverse decision may appeal and request a fair hearing.
Under Indiana law, all IPAS appeals are processed through the Medicaid appeals
system.
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4016 INFORMATION AND ASSISTANCE SERVICES (I&A)
CHART 9
Older Americans Act, 321 (a)(3) …services designed to encourage and assist older
individuals to use facilities and services (including information and assistance services)
available to them, including language translation services to assist older individuals with
limited-English speaking ability to obtain services under this title. 1
45 CFR 1321.53(b) (1) a comprehensive and coordinated community based system described
in paragraph (a) of this section shall: Have a visible focal point of contact where anyone can go
or call for help, information or referral on any aging issue…
(a) Information and Assistance (I&A) Services shall ensure access, outreach linkage,
and follow-up procedures for older adults and persons with disabilities and other
interested persons to all available benefits and services including the following:
(1) all public/private financial benefits;
(2) housing;
(3) transportation;
(4) nutrition;
(5) Protective Services;
(6) In-Home Services/Case Management;
(7) Community/Social Services;
(8) Legal Services;
(9) Health Related Issues;
(10) Long Term Care; and
(11) Education and Training.
(b) Particular emphasis on linking all available services must be given to isolated older
persons and older persons with Alzheimer's Disease or Related Disorders (AD/RSD),
and to older adults 2 with the greatest economic/social need, particularly low-income
minority older adults, older adults residing in rural areas, and older adults with limited
English-speaking ability.
1
2
Added 4/10/06
Revised 5/13/05
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4016.1 ALLOWABLE INFORMATION AND ASSISTANCE SERVICES ACTIVITIES
Allowable Information and Assistance Services include:
(1) providing answers to questions and/or data about available services, their
location, and service eligibility requirements;
(2) assisting a client to receive a needed service, either by making a contact with
a client or by providing clients with information regarding the location of a service
provider; and
(3) follow-up contacts (as needed in special cases) made with a client or a
service provider to determine if the needed service was provided or what
additional services may still be needed.
4016.2 FUNDING SOURCES FOR INFORMATION AND ASSISTANCE SERVICES
Funding sources include:
(1) Title III;
(2) Older Hoosier Funds;
(3) SSBG; and
(4) Local Funds.
4016.3 T HE FSSA DA POLICY AND PROCEDURES REGARDING INFORMATION AND
ASSISTANCE SERVICES
(a) The FSSA DA shall establish and maintain a statewide coordinated I&A services
system that is available to all older adults, persons with disabilities, and interested
persons.
(b) This system will comprise both the state and AAA I&A service programs which shall
be coordinated with other appropriate agencies and organizations.
(c)The FSSA DA shall:
(1) refer I&A requests from older adults and persons with disabilities whenever
possible to the appropriate AAA;
(2) coordinate the I&A system with those of other state government divisions and
agencies in order to develop a comprehensive and coordinated I&A system
throughout Indiana;
(3) require each AAA to develop, maintain, and publicize an I&A system that is
available to all older adults in the PSA;
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(4) monitor and assess each AAA's I&A system for both program and fiscal
management on a periodic basis; and
(5) the program consultant shall provide a written summary report of the
monitoring visit within 60 days from the date of the visit.
(A) A monitoring summary report shall be produced and shall also
include:
(1) a letter to AAA, or other written report detailing findings and
corrective actions;
(2) copies of letter to staff supervisor and Division of Aging
director; and others as instructed or necessary;
(3) text and sections which contain footnotes as appropriate and
necessary to completely credit and maintain integrity in written
information. The report should furthermore contain a description of
the deficiencies and should recommend corrective actions which
are linked to and /or based on state and federal regulatory and
legal policies, established sound business practices, and in
conformity with the AAA’s performances based contract system;
and, other necessary feedback as determined by FSSA DA.
Suggestions may be included as well;
(4) may create a summary table with salient review elements
linked to program areas with outcomes and timelines for
correction and implementation; and
(5) maintain information concerning referral and other services,
such as state and federal agencies out of the realm of the AAA,
available to all interested persons.
4016.4 AAA POLICY AND PROCEDURES REGARDING INFORMATION AND ASSISTANCE
SERVICES
(a) The AAA shall maintain and publicize an I&A service program that links older adults
and persons with disabilities to the appropriate provider of services.
(b) The AAA shall provide coordination of the I&A service program with other
organizations in the PSA, other AAAs, and the FSSA DA. Each AAA shall ensure that
the I&A program will:
(1) be available to all older adults and persons with disabilities in each
county of the PSA;
(2) have toll free telephone and walk-in access;
(3) have sufficient and qualified staff and/or volunteers to handle all
procedures;
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(4) compile and maintain a resource directory either electronically or as a
hard copy which contains accurate and up-to-date information on services
available, including provider names, addresses, telephone numbers, cost
of the services, if appropriate, and the type of clients served;
(5) have bilingual service personnel in areas where there are
concentrations of non-English speaking persons;
(6) have defined procedures for intake, record keeping, referral, and
follow-up;
(7) conduct publicity and outreach activities that target those persons in
greatest economic and/or social need, including low-income minority
older adults;
(8) provide training for paid and volunteer staff designed to improve the
quality and quantity of service; and
(9) provide 24 hour coverage that could include such measures as a back
up phone number, answering machine, or area wide coordination with the
911 emergency system.
(c) The AAA shall have thirty days from the date of any program or fiscal monitoring or
any other request for information or action, to prepare a response which shall describe
specific actions linked to solutions to cited deficiencies and shall also acknowledge and
respond to the recommended corrective actions and suggestions outlined by FSSA DA.
(d) The FSSA DA maintains the discretion to impose additional corrective measures,
including sanctions and/or penalties for late reports; up to and including with holding of
payment or claims reimbursements until such corrective actions have been met and
sound functioning is restored, or the matter has been officially closed.
4016.5 UNIT OF SERVICE
A single unit of service equals the following:
(1) One call received from a client;
(2) One call made on behalf of a client;
(3) One mailing, e-mail, fax, or delivery per specific address;
(4) One contact at an organized event; (i.e. Health Fairs, Conferences); and
(5) a speaking engagement would equal 1 unit per person present during the
speaking engagement. Example – 40 people present would equal 40 units of
service.
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4017 L EGAL ASSISTANCE SERVICES
The legal assistance program provides individuals who are at least 60 years of age with
help in dealing with legal issues and problems. The goal of the program is to assist older
adults with understanding and maintaining their rights; to assist older adults in
exercising their choices; to help older adults benefit from available services; and to
resolve disputes. The program also promotes the need for lifetime planning through the
understanding and the use of advance directives.
4017.1 ALLOWABLE LEGAL ASSISTANCE ACTIVITIES
(a) Allowable activities must include assistance in the areas of:
(1) income
(2) health care
(3) long-term care
(4) nutrition
(5) housing
(6) utilities
(7) protective services
(8) defense of guardianship
(9) abuse
(10) neglect
(11) age discrimination
(b) Allowable activities may also include:
(1) communicating with a governmental agency for the purpose of obtaining
information, clarification, or interpretation of the agency's rules, regulations,
practices, or policies;
(2) informing a client about a new or proposed statute, executive order, or
administrative regulation;
(3) responding to a client's request for advice only with respect to the client’s own
communications to officials unless otherwise prohibited by the OAA, Title III
regulations or other applicable law. This provision does not authorize publication
of lobbying materials or training of individuals on lobbying techniques or the
composition of a communication for the individual's use;
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(4) making direct contact with the AAA for any purpose;
(5) providing a client with administrative representation in adjudicatory or
rulemaking proceedings or negotiations, directly affecting that individual's legal
rights in a particular case, claim or application;
(6) communicating with an elected official for the sole purpose of bringing a
client’s legal problem to the attention of that official;
(7) responding to the request of a public official or body for testimony, legal
advice or other statements on legislation or other issues related to aging;
provided that no such action will be taken without first obtaining the written
approval of the responsible AAA; and
(8) a legal assistance provider asking about the individual’s financial
circumstances as a part of the process of providing legal advice, counseling and
representation, or for the purpose of identifying additional resources and benefits
for which an older adult may be eligible.
(c) In addition, the AAA shall award funds to legal assistance provider(s) that shall:
(1) have staff with expertise in specific areas of law affecting older adults in
economic or social need, for example, public benefits, institutionalization and
alternatives to institutionalization;
(2) demonstrate the capacity to provide effective administrative and judicial
representation in the areas of law affecting older adults with economic or social
need;
(3) demonstrate the capacity to provide support to other advocacy efforts, for
example, the long-term care ombudsman program;
(4) demonstrate the capacity to provide legal services to institutionalized,
isolated, and homebound older adults effectively; and
(5) demonstrate the capacity to provide legal assistance in the principal
language spoken by individuals in areas where a significant number of clients
do not speak English as their principal language. 1
4017.2 ACTIVITIES NOT ALLOWED
(a) Excluded activities include:
(1) any requirement for an older adult to disclose information about income or
resources as a condition for providing legal assistance;
1
Code of Federal Regulations, 45 CFR 1321.71(c)
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(2) legal representation in a fee generating case unless other adequate
representation is unavailable or there is an emergency requiring immediate legal
action. All providers shall establish procedures for the referral of fee generating
cases;
(3) making OAA funds available to be used for lobbying activities, including but
not limited to activities intended to influence any decision or activity by any nonjudicial Federal, State or local individual or body;
(4) engaging in any political activity while performing legal assistance activities
which are supported with Title III funding;
(5) contributions made by a provider, employee of the provider, or staff attorney
from Older Americans Act funds, personnel or equipment to any political party or
association or to the campaign of any candidate for public or party office; or for
use in advocating or opposing any ballot measure, initiative, or referendum; and
(6) intentionally identifying the Title III program or provide, with any partisan or
nonpartisan political activity, or with the campaign of any candidate for public or
party office. 1
(b) While carrying out legal assistance activities and while using resources provided
under Title III, no provider or its employees shall:
(1) participate in any public demonstration, picketing, boycott, or strike, except as
permitted by law in connection with the employee's own employment situation;
(2) encourage, direct, or coerce others to engage in such activities; or
(3) at any time engage in or encourage others to engage in any illegal activity; or
make any intentional identification of programs funded under the OAA or
recipient with any political activity.2
4017.3 FUNDING SOURCES FOR LEGAL ASSISTANCE SERVICES
Funding sources include Title III Funds, Older Hoosier Funds, and local funds.
4017.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING LEGAL ASSISTANCE
SERVICES
(a) The duties of a Legal Assistance Developer include;
(1) guiding the development and enhancement of legal assistance programs for
older adults throughout the state;
1
2
Code of Federal Regulations 45 CFR 1321.71(c)
Code of Federal Regulations 45 CFR 1321.71(j)
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(2) coordinating the provision of legal assistance throughout the state;
(3) providing technical assistance, training, and other supportive functions to
AAAs, legal assistance providers, and other entities as appropriate; and
(4) developing statewide standards for the delivery of legal assistance.
(b) The FSSA DA shall determine the minimum percentage of each AAA's Title III-B
allotment that must be expended for legal assistance. When setting minimum
percentages (3%), reasonable efforts will be made to maintain existing levels of funding.
(c) The FSSA DA shall review area plans to assure that dollars budgeted for Legal
Services meet or exceed minimum (3%) required amounts.
(d) The FSSA DA shall monitor area plan implementation and expenditures.
(e) The FSSA DA shall identify vulnerable elder rights activities and coordinate those
activities with other organizations, state agencies, and legal assistance providers.
(f) The FSSA DA shall develop working agreements with other state and federal
agencies, departments, and other entities.
(g) The FSSA DA shall assure periodic assessments of the status of elder rights in the
state.
4017.5 AAA POLICY AND PROCEDURES CONCERNING LEGAL ASSISTANCE SERVICES
(a) The AAA shall budget, at a minimum, the percentage of the Title III-B allocation
designated by the FSSA DA for Legal Assistance Services making reasonable efforts to
maintain existing levels of funding. (AAAs shall spend no less than 3% of the Title III-B
allocation and shall not spend less on Legal Assistance Services than was spent in
program year 2000.)1
(b) The AAA shall maintain expenditure information in a clear manner consistent with
generally accepted accounting principles, and shall provide information to FSSA DA
immediately upon request.
(c) The AAA shall enter contractual agreements with providers of legal assistance who
can demonstrate the experience or capacity to deliver legal assistance.
(d) The AAA shall assure that any provider selected is the entity best able to meet the
following requirements:
(1) Demonstrate the capacity to provide effective administrative and judicial
representation in the areas of law affecting older adults with economic or social
need and shall:
1
Older Americans Act, Section 307 (a)(2)(C)
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(2) Demonstrate the capacity to provide support to other advocacy efforts such
as the ombudsman and the adult protective services programs;
(3) Demonstrate the capacity to provide services effectively to older adults and
persons with disabilities and to older adults who are institutionalized, isolated,
and homebound;
(4) Demonstrate the capacity to provide services in the principal language
spoken by individuals of the area; and
(5) Assure that other legal activities will not be a conflict of interest or interfere
with their professional contracted responsibilities.
(e) The AAA shall assure that older adults are not required to disclose information
regarding resources or income as a condition for receiving legal assistance. The legal
assistance provider may ask about a client’s financial circumstances only as part of the
process of providing services.
(f) The AAA shall not incur legal services expenditures unless there is a valid contract
with a legal services provider.
(g) The FSSA DA reserves the right to monitor, at any time, the legal services contracts
and activities of any AAA. The AAA shall promptly comply with such a review by
providing FSSA DA with information, upon request.
(h) The AAA shall assure that the provider has a system for gathering and preparing
information for reporting about legal issues and unmet needs for assistance, including
benefits, services, exercising choice, maintaining rights, and solving disputes.
(i) The AAA shall assure that the provider collects and reports information about
community education presentations.
(j) Fee generating cases will not be a covered service unless other adequate
representation is not available and an emergency exists that requires immediate legal
action.
(k) The AAA must assure that no legal assistance money will be made available to any
political party, for any political campaign, or for advocating or opposing any ballot
measure, initiative, or referendum.
(l) Pursuant to 45 CFR 1321.71, the AAA must assure that no funds will be used for:
(1) lobbying activities;
(2) public demonstrations, picketing, boycott, or strike, or encouragement of
others to participate in such actions;
(3) any illegal activity;
(4) any intentional identification of any participant or program funded under the
act with any political activity; or
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(5) paying dues, to any organization, other than a bar association (may not
exceed $100 per year). 1
4017.6 SERVICE PROVIDER PROCEDURES
Each Legal Assistance Services provider shall do the following:
(1) offer direct services provided by an attorney and/or non-lawyer advocate
under the direct supervision of an attorney as permitted by state law.
(2) administer a program designed to provide assistance to older adults with
greatest social or economic need;
(3) assure that the Legal Assistance Services provided will be in addition to any
Legal Assistance Services for older adults being furnished with funds from
sources other than Title III B; and
(4) agree that all Legal Assistance Services provided are coordinated with legal
services corporations and other agencies providing legal assistance in the
community to avoid unnecessary duplication of services provided by other
sources;
(5) restrict activity to these allowable service components:
(A) intake;
(B) advice;
(C) counsel;
(D) representation;
(E) mediation/negotiation;
(F) outreach, community education;
(G) research;
(H) document preparation; and
(G) referral.
(6) make referrals appropriately to other Legal Assistance Service providers in
the PSA, pro bono or reduced fee attorneys for the delivery of legal assistance
related to the priority service and issue areas and other services which cannot be
delivered by the provider;
1
Code of Federal Regulations, 45 CFR 1321.71(j) and (k)
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(7) be responsible for identifying conflicts of interests and other interference with
professional responsibilities under the act;
(8) with the consent of the older person, or his or her representative, bring
conditions or circumstances that place the older adult, or the household of the
older person, in imminent danger to the attention of appropriate officials for
follow-up;
(9) Assist participants in taking advantage of benefits under other programs;
(10) work closely with the AAA on the development of the legal assistance
section and other appropriate sections of the area plan;
(11) establish written procedures for:
(A) intake;
(B) accepting and denying cases;
(C) grievances and appeals;
(D) individual satisfaction or dissatisfaction with services;
(E) identifying conflicts of interest;
(F) referring cases with a conflict of interest;
(G) referring denied cases;
(H) referring fee generated cases;
(I) referrals to other agencies for nonlegal problems;
(J) protecting the integrity of the legal assistance program where other
service(s) are housed in the same agency, e.g., Ombudsman;
(K) gathering and preparing information for reporting about legal issues
and unmet needs for assistance, including benefits, services, exercising
choice, maintaining rights, and solving disputes;
(L) individual contributions; and
(M) confidentiality.
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4018 E NVIRONMENTAL MODIFICATIONS SERVICES
(a) Environmental Modifications Services are those physical adaptations to the home,
required by the individual's plan of care, which are necessary to ensure that an older
adult or person with disabilities, can function with greater independence in the home,
have safe access to the home, and without which, the older adult or person with
disabilities would require institutionalization. Environmental Modifications must have an
adaptive purpose that specifically improves the older adult or person with disabilities
ability to live independently.
(b) Environmental Modifications may be made to an owner or renter occupied singlefamily dwelling. The intent of the service shall be to make the dwelling habitable and
shall not be completed to improve the appearance of the property.
(c) CHOICE still uses the term “Minor Home Modifications” to define this service under
CHOICE guidelines. See CHOICE Guidelines and Procedures–Attachment B –
Definitions.
4018.1 ALLOWABLE ENVIRONMENTAL MODIFICATIONS SERVICES
(a) Allowable Environmental Modifications include:
(1) installation of ramps;
(2) installation of porch or stair lifts (hydraulic, manual, or other electric lifts);
(3) widening of doors;
(4) hand railings;
(5) automatic or manual door openers/door bells;
(6) bathroom/kitchen modifications;
(A) roll-in showers;
(B) sinks;
(C) bath tubs;
(D) water faucet controls;
(E) plumbing (plumbing cut outs, toilet/sink adaptation);
(F) turn around space;
(G) work tables/work surfaces;
(H) cabinetry/shelving; and
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(I) installation of grab bars/handrails -other than those approved under the
Medicaid state plan for toilets, tubs or showers.
(7) Adaptations to ensure health and safety are:
(A) fire safety adaptations;
(B) voice activated, light activated, motion activated, and electrical
devices;
(C) medically necessary air filtering devices;
(D) medically necessary heating/cooling adaptation;
(E) electrical wiring to accommodate other modifications or equipment
installation;
(G) generators; and
(H) other necessary environmental modifications.
4018.2 ACTIVITIES NOT ALLOWED
(a) Excluded Environmental Modifications are adaptations or improvements to the home
that is of general utility and not of direct medical or remedial benefit to the older adult or
person with disabilities.
(b) Activities that are not allowed include:
(1) central air conditioning;
(2) roof repair;
(3) carpeting;
(4) repairs not included in the approved plan of care;
(5) repairs not approved;
(6) improvements and adaptations that exceed the lifetime cap allowed by the
funding source; and
(7) Environmental Modifications completed solely for the convenience of the
older adult or person with disabilities.
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4018.3 FUNDING SOURCES FOR ENVIRONMENTAL MODIFICATIONS SERVICES
Funding sources include Choice under “Other Services” (See 4002 – Other Services
Funded by CHOICE) Administered by the FSSA DA. CHOICE funding shall be utilized
after all other possible payment sources have been identified and are being utilized –
(CHOICE Guidelines and Procedures, Page 14, Revised June 1, 2001)
4018.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING ENVIRONMENTAL
MODIFICATIONS SERVICES.
The FSSA DA is responsible for evaluating and approving requests for Environmental
Modifications submitted by Case Manager Supervisors and/or the AAAs and requested
through Title III, SSBG or CHOICE funding streams, for any service costing more than
$4,999.99.
4018.5 AAA AND CASE MANAGER POLICY AND PROCEDURES REGARDING
ENVIRONMENTAL MODIFICATIONS SERVICES
(a) After a provider is selected through a competitive bid process, the AAA or Case
Manager must complete a Request for Approval to Authorize Services form (RFA). The
Case Manager must submit the RFA form to the FSSA DA, if the request is for more
than $4,999.99. 1 The form must show a description of the service being requested, why
service is requested, what will be done, and cost of service.
(b) The AAA or Case Manager shall sign the RFA form only after the Service Provider
has satisfactorily completed the job.
(c) Case Managers must also submit a plan of care/cost comparison budget for each
client. The plan of care/cost comparison budget is a specific form that is required for all
clients. It lists the services the individual should receive, the amounts of each service
authorized, and the cost of the budget for that client, plus other pertinent information.
(d) Each AAA or Case Manager has the responsibility to arrange for the provision of
individually needed services through local providers, including the arrangement of
service agreements.
(e) Written price quotations must be obtained from at least 3 different providers, unless
only one is possible and justified, if the Environmental Modifications service costs more
than $4,999.99 . 2 The FSSA DA approval is required prior to authorization by the Case
Manager Supervisor, if the Environmental Modifications service costs more than
$4999.99. The AAA or case Manager must obtain a physician’s order for environmental
modifications costing more than $4999.99, prior to including the service in the client’s plan
of care.
1
Taken out 5/13/05 - ‘If the request is for less than $4,999.99, the AAA may approve any appropriate
Environmental Modifications service.’
2
Added 5/13/05
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(f) The Service Provider may not provide the service until after receiving official
notification of prior authorization. Each provider must meet all applicable federal, state,
and county requirements.
4018.6 DOCUMENTATION STANDARDS
Environmental Modifications documentation must include:
(1) documentation of time spent providing assessment and report with
recommendations from assessment;
(2) identified need in Plan of Care/Cost Comparison Budget (POC/CCB);
(3) identified direct medical benefit for the client;
(4) at least 3 bids for the service, or documentation explaining why 3 bids were
not available;
(5) a complete Request for Approval to Authorize Services form; and
(6) documentation of completed and approved work.
4018.7 PROVIDER QUALIFICATIONS
(a) Each provider will meet all applicable state and county requirements for licensure or
certification.
(b) All improvements and modifications are to be carried out in accordance with federal,
state, and county, and city housing codes.
(c) Services must be in compliance with federal, state and local codes relative to the
type of modification or assistive device.
(d) Provider requires working knowledge of ADA regulations as they apply to structural
and individual safety.
(e) Bonding/liability insurance, if applicable.
(f) All Environmental Modification supports shall be warranted for at least 90 days.
Workmanship must also be warranted for at least 90 days.
(g) Providers of a service, other than case management, may not perform the
assessment, write the specifications, and/or inspect service that was provided.
(h) Required documentation from the provider includes:
(1) The installation date of any adaptive aid or device, assistive technology, or
other equipment.
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(2) The maintenance date of any adaptive aid or device, assistive technology or
other equipment.
(3) A change made to any adaptive aid or device, assistive technology, or other
equipment, including any alteration, correction, or replacement.
4018.8 UNIT OF SERVICE
A unit of service equals:
(1) Initial Modification - one approved contract job; and
(2) Maintenance of Modification - one approved contract job.
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4019 MONEY MANAGEMENT SERVICES PROGRAM
(a) The Money Management Program provides financial management assistance to low
income older adults with few resources, who are unable to manage their financial affairs
and are in need of assistance.
(b) The objectives of the Money Management Services Program are:
(1) to develop and implement a statewide model of early intervention services as
an alternative to guardianships for vulnerable lower income persons;
(2) to promote independent living for low-income seniors who cannot manage
their financial affairs, and don’t have friends or family to assist them;
(3) to expand the availability of the representative payee and bill payer services
by operating a statewide Money Management Program; and
(4) to provide a state coordinating agency with technical assistance from
American Association of Retired Persons (AARP) so that it can effectively initiate,
support and monitor a statewide network of local projects.
(c) The FSSA DA works in cooperation with the American Association of Retired
Persons (AARP) to administer the statewide program.
(d) The program consists of:
(1) a Representative Payee component; and
(2) a Bill Payer component.
4019.1 ACTIVITIES OF THE MONEY MANAGEMENT PROGRAM
(a) The Money Management Program offers services to help low-income older adults
and persons with disabilities with:
(1) budgeting;
(2) paying routine bills; and
(3) keeping track of financial matters.
(b) All Money Management Program workers are volunteers. The volunteers receive
special training and will develop an ongoing relationship with the person in need of
assistance.
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4019.2 REPRESENTATIVE PAYEE
A volunteer Representative Payee is an individual appointed as payee of federal benefit
checks to represent a client who is unable to manage his/her own financial affairs. The
appointed Representative Payee maintains control over the client’s government benefits
(excluding any other income the client may have) and the client's personal checking
account, including the signing of checks.
4019.3 BILL PAYER
A volunteer Bill Payer assists a client who asks for or voluntarily accepts assistance with
budgeting, paying bills, and check writing. Funds are set aside in a designated account
for the designated amount needed to pay monthly bills. The dollar limits on the monthly
account is to be written in a Bill Payer Client Service Agreement Form, which is signed
by the volunteer and the client. The client shall retain control over the designated
checking account.
4019.4 BILL PAYER MONITOR
The Bill Payer Monitor shall compare bill payer monthly reports to both bank statements
and budgets. The Bill Payer Monitor shall notify the program coordinator promptly if any
problems occur with the client’s account. The Bill Payer Monitor shall maintain contact
with the client at least once a year to ensure that bill payer services are adequate for the
client’s current situation.
4019.5 ACTIVITIES NOT ALLOWED
(a) The volunteer Bill Payer Monitor does not sign the client’s checks.
(b) The Money Management Services Program volunteer shall not advise potential
clients on what to do with funds over the $30,000 asset limit, to make the client eligible
for the Money Management Program or for any other reason.
(c) No more the $3,400 should be kept in the designated account to pay bills.
(d) Under no circumstances should the Money Management volunteers or staff member
of a sponsoring agency serve as a financial planner.
4019.6 MONEY MANAGEMENT SERVICES PROGRAM SAFEGUARDS
(a) Safeguards are designed to reduce liability for the local sponsoring agency.
Safeguard practices to be built into the Money Management Program include the
following:
(1) regular monitoring of client’s funds completed by the local sponsoring agency
and the state coordinating agency (FSSA DA);
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(2) monitoring of Bill Payers at the local level. Bill Payers complete a monthly
report to record the financial activity in the client’s designated account;
(3) supervision of volunteers by the local Program Coordinator;
(4) volunteers working in concert with the client’s Case Manager; and
(5) screening and training of volunteers before they become Bill Payers or
Representative Payees.
(b) State Agency (FSSA DA) reviews of the Representative Payee client’s bank
statements, using the FSSA DA monitoring tool. The FSSA DA monitoring tool is used
to monitor errors such as, the check memo line incomplete, returned checks, check
written to payee, no account activity for a month, overdrafts, bank service charges, and
checks not being sent with the statement. The spreadsheet also indicates what kind of
action the local coordinator should take to correct the error such as, counseling, training,
or contact the bank. The spreadsheet also records the date the local coordinator took
action to correct the problem.
(c) Information is given to the client’s regarding the volunteer’s role and limits.
4019.7 REPORTING
(a) The Local Sponsoring Agencies are required to submit an AARP semi-annual report
to the AARP Foundation. The AARP semi-annual report, which documents average
income of clients, date of last local advisory council meeting, and date of last in-service
meeting, must be completed and submitted by the fifteenth day of July and again by the
fifteenth day of January.
(b) The Local Sponsoring Agencies shall enter all updated client and volunteer
information onto the AARP Foundation website by the last day of June and again by the
last day of December.
4019.8 PROGRAM SIZE
Programs with 10 clients or less are required to obtain a minimum of 15 clients by
December 31, 2004. Programs with 10 or more clients are required to obtain a minimum
of 24 clients by December 31, 2004. By December 31, 2005, all programs will be
required to have a minimum of 24 clients.
4019.9 INCOME AND LIQUID ASSETS
(a) Liquid Assets refers to assets that can easily be converted into cash within 90 days
at a readily determined fair market price. Examples of Liquid Assets are:
(1) 90 Day CD;
(2) savings;
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(3) stocks and bonds; and
(4) cash value life insurance.
(b) The dollar limit on “liquid assets” for clients in the Money Management Program is:
(1) for Bill Payer Clients: $30,000; and
(2) for Representative Payee Clients: $30,000
(c) Annual gross income means the annual rate of income received by an individual or
family from the following sources:
(1) money (wages or salary);
(2) net income from non-farm self-employment;
(3) net income from self-employment;
(4) social security;
(5) dividends, interest (on savings or bonds), income from estates or trusts; net
rental income, royalties;
(6) public assistance or welfare payments;
(7) pensions and annuities;
(9) unemployment compensation;
(10) worker’s compensation;
(11) alimony;
(12) child support; and/or
(13) veteran’s pension.
(d) For eligibility purposes, the dollar limit on income for clients in the Money
Management Services Program is:
(1) for a single person - $20,778; and
(2) for a couple: - $29,402
4019.10 F UNDING SOURCES FOR THE MONEY MANAGEMENT SERVICES PROGRAM
The Money Management Services Program has no source of funding other than local
funds and time given by volunteers. Within certain parameters, local agencies may use
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volunteer time as an in-kind match contribution for federal funding. 1 Coordinators should
check with the local agency for additional information.
4019.11 LOCAL SPONSOR ELIGIBILITY
(a) Local sponsors of the Money Management Services Program must be nonprofit
organizations with experience in working with 1 or more of the client population groups
and are located in an area where there is a documented need for service.
(b) Additionally, potential local sponsors must assess the need for a Money
Management Program through a survey of local agencies. If the survey indicates a need
for the program, then the organization is eligible to become a sponsor.
(c) Local agencies must have a minimum of 15 clients before establishing a program.
4019.12 RECOMMENDATIONS FOR ASSISTING CLIENTS ABOVE THE INCOME AND
ASSET LIMITS
For clients who are above the income/assets limit and do not meet eligibility guidelines
for the Money Management Program, the local Program Coordinator could use other
community resources to meet the challenge of serving ‘at risk’ persons with higher
income and assets.
4019.13 THE FSSA DA POLICY REGARDING THE MONEY MANAGEMENT SERVICES
PROGRAM
The FSSA DA will develop, coordinate, and seek to enhance a statewide Money
Management Services Program based on national sponsor guidelines implemented
through local program sponsors.
4019.14 STATE ADVISORY COUNCIL
See Section 2019.4 - Money Management Services Program Advisory Council.
4019.15 AARP/NATIONAL SPONSOR PROCEDURES
AARP, as the national sponsor will do the following:
(1) upon request, recruit volunteers from the AARP membership. If membership
does not provide sufficient volunteers, AARP will do a recruitment mailing to
people, suggested by the FSSA DA;
1
Code of Federal Regulations, 45 CFR 74.51
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(2) provide technical assistance for program development and operation to the
FSSA DA and, if asked by DDRS, to the local program sponsors;
(3) provide insurance covering certain loss of funds that may result from activities
of volunteer representative payees and bill payers, intentional or unintentional, to
a maximum of $10,000. (AARP will seek recovery of funds intentionally
misappropriated);
(4) provide guidelines for the monitoring of the financial activities of the volunteer
representative payees and bill payers;
(5) monitor the FSSA DA's monitoring operation in order to be able to continue to
provide insurance for the volunteers;
(6) work jointly with the FSSA DA to evaluate program operation and
effectiveness as indicated by:
(A) a periodic survey of all representative payees and bill payers;
(B) a joint survey of all local program coordinators;
(C) joint on site visits to local program sites; and
(D) independent evaluations conducted by the FSSA DA. (Results are
shared with AARP.)
4019.16 THE FSSA DA PROCEDURES REGARDING THE MONEY MANAGEMENT
SERVICES PROGRAM
The FSSA DA shall do the following:
(1) be responsible for the overall operation of the Money Management Program.
The FSSA DA will serve as a link between AARP, local sponsors, and all
applicable agencies, including all regional and/or state offices of the Social
Security Administration, Department of Veterans Affairs, Railroad Retirement
Board, and the Office of Personnel Management;
(2) attempt to establish local projects in areas of the state where a need for the
program can be demonstrated;
(3) recruit, hire, and supervise a state program coordinator and provide ongoing
logistical support to facilitate the carrying out of his/her duties;
(4) assist local agencies to recruit new clients to expand and maintain their
programs;
(5) establish a statewide money management program advisory council, are
responsible for its staffing and ongoing operations, including recruitment, and
convene the council at least quarterly;
(6) recruit local sponsors in order to establish local projects in areas of the state
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where there is a demonstrated need for the program;
(7) assist local sponsoring agencies to designate a local program coordinator;
(8) help each local sponsor to organize a local advisory council;
(9) assist the local sponsor in determining client eligibility criteria based on the
needs within each project and the policies of the state program and AARP;
(10) provide orientation and training to local program volunteers in conjunction
with local sponsors to the initial group of recruits; provide assistance to local
program coordinators to ensure that all subsequent volunteers receive orientation
and initial training and that in-service training is provided for all volunteers;
(11) assist the local sponsor in negotiations with local banks to provide no-cost or
low cost banking services for the representative payee component of the
program;
(12) maintain an accurate listing of all client/volunteer representative payee and
bill payer matches for each local sponsor and share that listing and any changes
or updates with AARP so that insurance for client funds can be provided by
AARP;
(13) operate an AARP approved financial monitoring system for funds handled by
representative payees; and
(14) provide monitoring, oversight, technical assistance, training, and other
supportive functions to local program sponsors, coordinators, volunteers, and
others in the network of services as appropriate.
4019.17 THE FSSA DA PROCEDURES REGARDING MONITORING OF THE MONEY
MANAGEMENT SERVICES PROGRAM
(a) The FSSA DA program staff will monitor and provide the Local Sponsoring Agencies
with a written document summarizing the findings and corrective actions needed to
maintain program integrity, within sixty days of a monitoring visit.
(b) The Local Sponsoring Agency shall have thirty days from the date of any program or
fiscal monitoring or any other request for information or action, to prepare a response
which shall describe specific actions that shall be completed to correct deficiencies and
shall acknowledge and respond to the recommended corrective actions and suggestions
outlined by the FSSA DA.
4019.18 L OCAL SPONSOR RESPONSIBILITIES REGARDING MONEY MANAGEMENT
SERVICES
Currently, responsibilities regarding Money Management Services were outlined in a
Memorandum of Understanding (MOU) between DDRS and AARP, and a Letter of
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Agreement (LOA) between DDRS and a sponsoring agency. DDRS may use a contract
with a sponsoring agency even if the program is unfunded, o outline responsibilities
regarding Money Management Services. Local program sponsors may continue to use
MOU’s and LOA’s at the local level.
(1) Local program sponsors will do the following:
(A) adhere to program policies of the FSSA DA and AARP;
(B) organize and hold regular meetings with a local advisory council
consisting of representatives of local agencies/ businesses which have
close ties to potential money management program individuals. The local
advisory council should meet at least twice a year;
(C) provide support for and oversight for all components of the local
money management program to include the development of a program
budget and responsibility for its funding;
(D) recruit, select, and supervise a program coordinator and provide
ongoing technical and in-kind support to facilitate the carrying out of
his/her duties. Immediately notify the FSSA DA of any change in that
position;
(E) develop a bill payer monitoring system using the FSSA DA/AARP
guidelines and implement that system after it has been approved by the
FSSA DA and AARP;
(F) comply and respond to the state monitoring tool within 21 calendar
days from the date it was received. If there are any problems meeting the
deadline, local coordinators should contact the state coordinator at the
FSSA DA;
(G) develop client eligibility criteria in coordination with the FSSA DA and
AARP;
(H) develop and implement a client referral system that includes a plan to
publicize the program locally;
(I) work cooperatively with the FSSA DA and AARP on the recruitment
and screening of volunteers. Background checks of volunteers are
strongly recommended;
(J) assure that all volunteers receive orientation and initial training;
(K) develop and implement in-service training programs for all volunteers;
(L) negotiate with a local bank to provide free banking services for the
representative payee component of the program;
(M) coordinate with local social service agencies to provide support to the
program and the individuals it serves;
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(N) serve as a link between the FSSA DA and all applicable local
agencies, volunteers, and individuals;
(O) work cooperatively with the FSSA DA to implement the financial
monitoring of the representative payee and bill payer/client accounts,
including notification to the FSSA DA of any new volunteer/client match in
a timely manner;
(P) enter all new volunteer and client information on the AARP web page;
(Q) participate in periodic program evaluations by the FSSA DA/AARP;
(R) submit completed semi-annual report data to the AARP website in a
timely manner. If the local program has difficulty or technology issues,
contact the state coordinator for assistance; and
(S) promptly comply with all requirements from the DDRS/FSSA DA and
AARP.
4020 L ONG TERM CARE OMBUDSMAN
The Long-Term Care Ombudsman receives and attempts to resolve complaints made by
or on behalf of individual residents in long term care facilities; provide information and
referral about facility selection and quality of care; assists resident and family councils,
and promote resident’s needs and interests to the public and elected officials. Long term
care facilities are defined as nursing home and facilities that provide housing with
services.
4020.1 ALLOWABLE ACTIVITIES
(a) Complaint Investigation and Resolution The verification of a problem or concern by
gathering facts from different sources and the efforts to resolve the issue through a
variety of means, including negotiation, mediation, education, and referral.
(b) Training for Ombudsman Staff and/or Volunteers
Time spent attending required ombudsman training; assisting in the training of a new
ombudsman trainee; or developing and delivering training to volunteers.
(c) Technical Assistance to and Supervision of Volunteers
Staff time devoted to developing volunteer programs, supporting volunteers, and
providing informal assistance to volunteers.
(d) Trainings for Nursing Facility Staff (In-Services)
Presentations/trainings/programs that the ombudsman makes to nursing
Facility staff on topics related to residents' right, quality care, laws and regulations or
other issues concerning long-term care.
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(e) Information and Consultation to Individuals
Community on a one-to-one basis concerning issues and questions related to long-term
care. Assisting individuals and non-nursing facility staff by telephone, in writing, or in
person.
(f) Consultations to Facilities
Providing information and technical assistance to facility staff, usually by telephone.
(g) Resident Visitation
Visits to residents that are not complaint-based or related to a request for assistance of
information.
(h) Survey Participation
The involvement in a facility's survey or complaint investigation through:
(1) the sharing of ombudsman information and concerns with Department of
Health or HCFA surveyors related to an Indiana State Department of Health
survey, HCFA survey, or Indiana State Department of Health complaint
investigation, including the provision of written and verbal information;
(2) attendance at a resident group interview; and
(3) attendance at an exit conference.
(i) Outreach
Involvement in activities that serve to promote knowledge and understanding
of the nature and availability of the ombudsman program/ and of issues
related to Long-Term Care.
(j) Work with Residents and Family Councils
Attendance at resident or family council meetings and technical support
provided to such councils.
(k) Community Education Programs
Presentations, programs, workshops, conferences, or trainings conducted by
the ombudsman or in which the ombudsman is a speaker or organizer.
(l) Monitoring/Working on Laws, Regulations, Government Policies and Actions
Time spent tracking, reviewing, commenting on and facilitating public comment on laws,
regulations, policies, and action to improve the health, welfare, safety, and rights of longterm care residents.
(m) Coordinate with Other Agencies
Working on committees with peers whose purpose will effect positive change to the
State–wide Ombudsman Program or to provision of long term care.
(n) Emergencies
Assistance provided to residents of long-term care facilities during an emergency
relocation or an emergency situation such as fire, tornado, or air conditioning/ heating
failure/voluntary or involuntary closure of facilities.
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(o) Documentation/Reporting
The maintenance of detailed, accurate records of complaint cases, program activities,
and the preparation of required quarterly reports in a confidential manner.
(p) Education
Time spent attending conferences that enhance job-related knowledge.
(q) Travel
Time spent traveling to and from required ombudsman trainings and meetings.
(r) Equipment Purchase
Approval or denial of request to purchase of equipment.
4020.2 UNIT OF SERVICE
One hour of staff time spent performing allowable activities.
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4021 O UTREACH SERVICES
CHART 10
45 CFR 1321.17(f)(8) Content of State Plan. The State agency will require area agencies on
aging to arrange for outreach at the community level that identifies individuals eligible for
assistance under this Act and other programs, both public and private, and informs them of the
availability of assistance. The outreach efforts shall place special emphasis on reaching older
individuals with the greatest economic or social needs with particular attention to low income
minority individuals, including outreach to identify older Indians in the planning and service area
and inform such older Indians of the availability of assistance under the Act.
Outreach Services identify older adults eligible for assistance under the OAA, Social
Services Block Grant (SSBG), CHOICE, and any other public or private funding source
and informs them of available assistance. Special emphasis shall be given to reaching
older adults in greatest economic or social need with particular attention to low income
minority individuals well as an annual evaluation of the effectiveness of outreach efforts
that identify older adults and persons with disabilities who are eligible for services.
4021.1 ALLOWABLE OUTREACH SERVICES
Outreach services include all "search and find" activities initiated by a service provider in
order to:
(1) identify older adults with the greatest social and/or economic needs;
(2) seek out and identify hard-to-reach individuals;
(3) provide information about available services and benefits; or
(4) inform individuals about how to access services and how to become
recipients of services.
4021.2 FUNDING SOURCES FOR OUTREACH SERVICES
Outreach services funding sources include Title III, Older Hoosier Funds, and local
funds.
4021.3 T HE FSSA DA POLICY AND PROCEDURES REGARDING OUTREACH SERVICES
(a) FSSA DA shall assure the provision of outreach services that identify older adults
eligible for services under various funding sources and informs them of services
available.
(b) The FSSA DA shall require AAAs to provide outreach services and shall:
(1) provide for outreach planning in the area plan format;
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(2) review area plans for the inclusion of outreach services and specific methods
and objectives used to reach individuals with the greatest economic or social
need, (with particular attention given to low income minority individuals living in
rural areas, or those with severe disabilities, limited English speaking ability, or
Alzheimer's disease and related disorders; and
(3) monitor each AAA's outreach service, both for program and fiscal
management, on a periodic basis.
4021.4 AAA POLICY AND PROCEDURES CONCERNING OUTREACH SERVICES
(a) Each AAA shall arrange for the provision of area wide outreach services that
identifies older adults and persons with disabilities in need of assistance, informs them of
the availability of assistance, and where assistance can be obtained. Special emphasis
shall be given to reaching older adults in greatest economic or social need with particular
attention given to low income minority individuals or those living in rural areas,
individuals with severe disabilities, limited English speaking ability, and Alzheimer's
disease and related disorders.
(b) The AAAs shall complete an annual evaluation of the effectiveness of outreach
efforts that identify older adults and persons with disabilities who are eligible for services.
(c) Each AAA shall:
(1) write specific objectives for outreach services especially for those older adults
with the greatest economic or social need, with particular emphasis on low
income minority older adults and persons with disabilities, and submit these
objectives along with projected outreach activities and expenditures, in the
agency's area plan;
(2) provide an annual evaluation of the effectiveness of outreach services,
especially concerning the effectiveness of reaching older adults and persons with
disabilities who are the following:
(A) reside in rural areas;
(B) have the greatest economic and greatest social need (with particular
attention to low income minority older adults);
(C) have severe disabilities;
(D) have limited English speaking ability; and
(E) have Alzheimer's disease or related disorders that are living
throughout the PSA.
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4021.5 UNIT OF SERVICE
One unit of service is defined as one contact in person or by telephone.
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4022 P ERSONAL ASSISTANCE SERVICES (FUNDED BY MEDICAID WAIVER ONLY)
For further information, please refer to Medicaid Waiver Section of this Manual.
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4023 P RE-ADMISSION SCREENING/RESIDENT REVIEW (PASRR)
CHART 11
PASRR is federally mandated under the Omnibus Budget Reconciliation Act of 1987 (OBRA '87),
Public Law 100-203 and OBRA '90, Public Law 101-408. These provisions are set forth in Section
1919 of the Social Security Act (42 USC 1396r) and the Code of Federal Regulations (42 CFR
405, 431, 433, And 483). Those laws and regulations direct the policies and procedures set forth
in Indiana's PASRR manual section.
(a) Medicaid certified nursing facilities (NF) are prohibited from admitting or retaining as
a resident any individual who has or is suspected of having a condition of mental illness
(MI), mental retardation (MR), or a related condition (MR/DD) unless the state PASRR
program has determined that the individual, because of his or her medical and mental
condition, requires the level of services provided by a NF.
(b) The PASRR program provides comprehensive assessments for those individuals
with a condition of MI and/or MR/DD who are applicants to or residents of a Medicaid
certified facility.
(c) If the appropriate state authority determines that the individual needs NF level of
services, the state authority must further determine whether the individual needs
specialized services for MI and/or MR/DD. If the individual needs NF level of services
but does not require specialized services, the state authority must identify if there are
services of a lesser intensity which the individual will need if admitted to a NF.
(d) Indiana (as well as all other states) is required to interface the PASRR process with
any other existing or future NF Pre-Admission Screening and/or resident assessment
procedures, to the greatest extent possible.
(e) Through its Medicaid state plan, Indiana has contracted with the Health Care
Financing Administration (HCFA) to incorporate and utilize Indiana's Pre-Admission
Screening (IPAS) program in the PASRR process.
(f) IPAS provides the following functions for the PAS portion of PASRR:
(1) identification of individuals seeking admission to Medicaid certified nursing
facilities;
(2) review of and certification on the Level I screen of need for Level II
assessment;
(3) written notice to the individual of the referral for a Level II;
(4) triggering mechanism for the CMHC or D&E Team to complete a Level II
assessment;
(5) provision of necessary assessment data to evaluate and determine need for
NF level of services, including physical status, functional assessment (activities
of daily living), alternative services, and placement;
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(6) liaison between NF, family, physician, and other entities as necessary;
(7) review of documentation and recommendation for placement; and
(8) coordinating entity to serve as a consultant for case problems and quality
assurance.
(g) PASRR also interfaces with other entities to assure that services that meet the
individual's MI and/or MR/DD needs are provided in the NF in which the individual
resides. The Medicaid NF audit team provides an annual review and an assessment of
continuing need for NF services for individuals with a condition of MI and/or MR/DD. NF
surveyors with the Indiana State Department of Health also target identified individuals
during review visits to assure that mental health service needs are met.
4023.1 FUNDING SOURCES FOR PASRR
PASRR is funded by Medicaid dollars.
4023.2 ELIGIBILITY AND PARTICIPATION REQUIREMENTS FOR PASRR
(a) Federal law requires that all individuals who are applicants to or residents of
Medicaid certified NFs and who have or are suspected of having a condition of MI and/or
MR/DD must participate in PASRR, regardless of the source of payment for the NF
services.
(b) Participation is required by the following:
(1) Medicaid Certified Nursing Facilities
All facilities Medicaid certified by the State department of health to provide NF
services are required to participate in the PASRR program.
(2) All NF Applicants and Residents
PASRR applies to the screening or assessment of all individuals with MI or
MR/DD who apply to or reside in Medicaid certified NFs, regardless of the source
of payment for the NF services.
4023.3 PARTICIPATION IN THE IPAS PROGRAM
(a) NF applicants to a Medicaid certified NF who triggers a Level II must participate in
the IPAS program. It is a federal requirement that may not be refused because IPAS is
an assessment component of the PAS part of PASRR.
4023.4 DETERMINATION OF CRITERIA
PASRR determination is based on a bi-level process.
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4023.4.1 Level I
Determination of whether an individual needs to participate in the PASRR
assessment is usually based on an 8 question identification screen named the
Level I. Other pertinent information or documentation may also reveal a need for
the PASRR assessment.
4023.4.2 Level II
The PASRR assessment and findings constitute the Level II. The assessment is
multidimensional and multidisciplinary as follows:
(1) reviewing need for NF level of services;
(2) making a diagnostic determination;
(3) ascertaining whether specialized services are required; and
(4) identifying service needs of less intensity than specialized services.
4023.5 PASRR - TWO PART PROGRAM
PASRR is a periodic assessment process for individuals who qualify as having a
condition of MI or MR/DD, whereas IPAS is only required for original NF admission and
may be done for discharge planning.
4023.5.1 PRE-ADMISSION SCREENING
(a) At the time of NF admission, the state MI or MR authority (as appropriate) is
required to determine for each NF applicant with a condition of MI or MR/DD
whether, due to his or her physical and mental condition, he or she needs the
level of services provided by a NF.
(b) If such an individual is found to need NF level of services, the state MI or MR
authority also shall determine whether the individual needs specialized services.
4023.5.2 RESIDENT REVIEW
RR reviews are repeated if there is a significant change in the individual's
condition. RRs may be conducted annually at the discretion of CMHCs.
4023.6 RESPONSIBLE ENTITIES IN THE ASSESSMENT PROCESS
For PAS purposes, PASRR enhances the needs assessment and service determination
functions of the IPAS requirement. Individuals with a condition of MI receive a
comprehensive assessment by mental health professionals from the local community
mental health center. Contracted diagnosis and evaluation teams determine whether an
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individual qualifies as MR/DD and, if so, the individual's service needs. The person with
MR/DD is also linked to case management at the BDDS office. a 4B is required to
provide proof of pre-admission screening and level of care determination.
4023.7 PASRR FINAL DETERMINATION
The AAAs complete the final determination for PASRR cases. Two documents are
issued by the AAA when final determination is completed: PAS form 4B and the PASRR
certification form. For RR cases, a certification form and cover letter is issued by the
Community Mental Health Centers.
4023.8 APPEALS AND FAIR HEARINGS
An individual may appeal any adverse decision and request a fair hearing.
As PASRR is governed by federal Medicaid law and regulations, Medicaid Hearings and
Appeals processes the appeals.
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4024 R ESIDENTIAL CARE ASSISTANCE PROGRAM (RCAP) (SEE SECTION 11)
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4025 R ESPITE CARE
(a) Respite care services are those services provided temporarily or periodically to older
adults or persons with disabilities to relieve the usual unpaid caregiver. Service may be
provided in the client's or caregiver’s home or in a nursing facility or other location,
depending on the funding source involved and individual program requirements. Respite
care is provided to assist a family in keeping an older adult or person with disabilities in
the home.
4025.1 ALLOWABLE SERVICES COVERED UNDER RESPITE CARE SERVICES
Respite care services may provide:
(1) homemaker services;
(2) attendant care;
(3) personal assistance services;
(4) home heath aide services;
(5) skilled nursing services; or
(6) nursing facility services.
4025.2 ACTIVITIES NOT ALLOWED
(a) Services that duplicate any other service provided under the client's plan of care.
(b) Provision of services to an older adult or person with disabilities who is without a
usual caregiver.
4025.3 FUNDING SOURCES FOR RESPITE CARE SERVICES
Funding for respite care services is available through SSBG, Title III, CHOICE, program
income, and local funds. Additionally, respite care must not duplicate any other service
being provided under the client's plan of care.
4025.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING RESPITE CARE
SERVICES
FSSA DA shall contract with each AAA to case manage respite care services funded
from any of the various funding sources.
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4025.5 AAA POLICY AND PROCEDURES CONCERNING RESPITE CARE SERVICES
The local AAA shall determine client eligibility for respite care services and refer them to
a service provider.
4025.6 SERVICE PROVIDER RESPONSIBILITIES CONCERNING RESPITE CARE
SERVICES
The service provider shall agree to provide respite care services following procedures
and directives required by the FSSA DA and the AAAs.
4025.7 UNIT OF SERVICE
A unit of service is defined as 1 hour of allowable activity. However, respite delivered in
a nursing facility is defined as 1 unit equals 1 day.
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4026 S ENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM (SCSEP)
(SEE SECTION 9)
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4027 SENIOR CENTERS
The multipurpose senior center is a community facility that offers a broad range of
services including health, nutrition, recreation, social and educational activities for older
adults.
4027.1 ALLOWABLE ACTIVITIES
The multipurpose senior center may offer a variety of services including services, such
as, but not limited to, the following:
(1) health screening or health education;
(2) social services;
(3) nutrition services, consisting of meals served in a congregate setting;
(4) educational services; and
(5) recreational and group activities.
4027.2 ACTIVITIES NOT ALLOWED
Sectarian instruction or religious worship shall not be conducted in a senior center.
4027.3 FUNDING SOURCES SPECIFIC FOR SENIOR CENTERS
Funding sources include Title III, state and local funds, donations, fees and fund-raisers.
4027.4 THE FSSA DA POLICY AND PROCEDURES REGARDING SENIOR CENTERS
(a) The FSSA DA shall review the AAA “Multipurpose Senior Center Assurance” part of
the area plan for compliance with all requirements.
(b) The FSSA DA shall maintain and annually update a Directory for Senior Centers
located in Indiana which contains the most current lists of senior centers and focal points
as submitted in the AAA area plans.
(c) The FSSA DA shall monitor to ensure that the AAAs are submitting timely reports
concerning senior centers, to NAPIS on a quarterly basis. The FSSA DA shall provide a
written summary report of the monitoring visit within 60 days from the date of the visit.
(d) The summary report shall include a description of any deficiencies found in the
submission of reports to NAPIS or any other service, policy, procedure or action
concerning a Senior Center or the administration of a Senior Center or any services or
programs offered at a particular Senior Center and shall recommend corrective actions
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which are based on state and federal regulatory and legal policies. The monitoring
summary report shall also verify the use of established sound business practices, and
assess conformity with the AAA performances based contract system.
(e) The FSSA DA shall grant the AAA a period of 30 days from the date of the letter to
prepare a response which shall describe specific actions linked to solutions to
deficiencies and shall also acknowledge and respond to the recommended corrective
actions and suggestions.
4027.5 AAA POLICY AND PROCEDURES REGARDING SENIOR CENTERS AND FOCAL
POINTS
(a) As part of the area plan, each AAA shall develop and carry out the following
requisites:
(1) provide through a comprehensive and coordinated system, for supportive
services, and where appropriate, for the establishment, maintenance, or
construction of multipurpose senior centers, including determining the extent of
need for multipurpose senior centers in such areas; 1 and
(2) designate, where feasible, a focal point for comprehensive service delivery in
each community, giving special consideration to designating multipurpose senior
centers as such focal points.
(b) The AAA shall provide through a comprehensive and coordinated system for the
establishment, maintenance or construction of multipurpose senior centers including
determining the extent of the need (taking into consideration the number of older adults
residing in the service delivery area, the number of older adults who have the greatest
economic need with particular attention to low-income minority adults and older adults
residing in rural areas) residing in the service delivery area, the number of older adults
who have greatest social need (with particular attention to low-income minority adults
residing in the service delivery area, and the number of older adults who are Indians
residing in the service delivery area).
(c) The AAA will designate, where feasible, a focal point for comprehensive service
delivery in each community, giving special consideration to designating multipurpose
senior centers (including multipurpose senior centers operated by organizations
providing day care services for children, assistance to older adults caring for relatives
who are children, and respite for families as such focal point.
(d) The AAA conducts annual reviews of the utilization of multipurpose senior centers to
ensure that they are being used for their originally intended purpose.
(e) The AAA maintains an up-to-date inventory of multipurpose senior centers that have
been acquired and/or constructed in whole or in part with Title III-B funds and contains
the minimum requirements described in the Administration on Aging Program
Instructions 91-04.
1
Older Americans Act, Section 306 (a) (1) and (3) (A)
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(f) The AAA shall ensure that the multipurpose senior center/focal point offer on site, at a
minimum, the following:
(1) health services, such as health screening or health education;
(2) social services, such as information and assistance, outreach or
transportation;
(3) nutrition services consisting of at least three meals per week served
in a congregate setting;
(4) educational services;
(5) recreational and group activities;
(6) compliance with the Americans with Disabilities Act; and
(7) compliance with all state and local health, fire, safety and sanitation
laws, ordinances and codes including a posted accident and emergency
evacuation plan.
(g) The AAA shall annually submit updates on senior centers and focal points to the
FSSA DA.
(h) The AAA shall have an up-to date inventory of the multipurpose senior centers that
have been acquired and/or constructed in whole or in part with Title III funds. The AAAs
are entitled to recover Title III funds:
(1) if within 10 years after acquisition or within 20 years after the
completion of construction the owner of the facility ceases to be a public
or non-profit private agency or organization; or facility ceases to be used
for the purpose for which it was acquired unless, in accordance with
regulations, there is no good cause for releasing the applicant or other
owner from the obligation; and
(2) in an amount which bears to the then value of the facility, or so much
thereof as constituted an approved project or projects, the same ratio as
the amount of such federal funds bore to the cost of the facility financed
with the aid of such funds. Such value is determined by agreement of the
parties or by action brought in the United States district court for the
district in which such facility is situated.
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4028 THERAPY SERVICES
Therapy Services include speech and language therapies, physical therapies, and
occupational therapies that are designed to increase a client's ability to function as
independently as possible.
4028.1 ALLOWABLE THERAPY SERVICE ACTIVITIES
Allowable Therapy Services include:
(1) Speech and Language Therapy
This service consists of therapy for the treatment of speech and hearing
disabilities and provides specialized auditory training.
(2) Physical Therapy
It provides treatment and training programs designed to preserve and improve
abilities for independent functioning, such as gross and fine motor skills, range of
motion, strength and muscle tone, activities of daily living, and mobility to prevent
progressive disability through such means as the use of purposeful activities,
orthotic and prosthetic devices, assistive and adaptive equipment, positioning,
behavior adaptation, and sensory stimulation.
(3) Occupational Therapy
Occupational Therapy Services provide evaluation, treatment, and training
programs such as gross and fine motor function, self-care, sensory and
perceptual motor function. Remedial techniques include the design, fabrication,
and adaptation of materials and equipment to individual needs.
4028.2 FUNDING SOURCES FOR THERAPY SERVICES
Therapy Services are available to eligible individuals under SSBG, CHOICE, and Title
III.
4028.3 T HE FSSA DA POLICY AND PROCEDURES REGARDING THERAPY SERVICES
The FSSA DA shall monitor and assess AAAs on the provision of Therapy Services.
4028.4 AAA POLICY AND PROCEDURES CONCERNING THERAPY SERVICES
The AAA shall determine eligibility and refer clients to a certified service provider.
4028.5 SERVICE PROVIDER PROCEDURES CONCERNING THERAPY SERVICES
The service provider shall agree to provide the service as required by the FSSA DA and
to handle billing directly to the fiscal agent.
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4028.6 UNIT OF SERVICE
A single unit of service is defined as 15 minutes of allowable activity.
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4029 T RANSPORTATION SERVICES
Transportation Services are a vital link that ensures older adults and persons with
disabilities (particularly those persons living in rural areas) access to services that help
them remain independent. All Transportation Services shall comply with federal (DOT)
and state (INDOT) rules and regulations as well as applicable codes, including the
Americans with Disabilities Act (ADA).
4029.1 ALLOWABLE TRANSPORTATION SERVICES
The AAAs may apply for a waiver to be able to provide Transportation Services directly.
As part of the waiver request, the AAA must justify reason by describing the steps taken
to recruit and develop other providers of this service.
4029.2 ACTIVITIES NOT ALLOWED
Staff of the AAA or subcontractors should not transport clients in their personal vehicles,
except in emergency situations.
4029.3 FUNDING SOURCES SPECIFIC FOR TRANSPORTATION SERVICES
(a) Funding sources include:
(1) Title III;
(2) Older Hoosier Funds;
(3) SSBG;
(4) CHOICE;
(5) program income; and
(6) local funds.
(b) Funding for purchases of vehicles and other necessary equipment may be provided
through some state and federal resources.
4029.4 T HE FSSA DA POLICY AND PROCEDURES REGARDING TRANSPORTATION
SERVICES
(a) The FSSA DA shall monitor AAAs and service providers for safety and effectiveness
in transportation programs for older adults and persons with disabilities by retaining a
transportation coordinator.
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(b) The FSSA DA transportation coordinator shall perform the following duties:
(1) coordinate policy development and training with other state agencies that are
involved with transportation services and/or regulations;
(2) coordinate with program and fiscal reviewers regarding monitoring and
evaluation of transportation programs;
(3) provide the AAAs with technical assistance with regard to transportation;
(4) monitor the transportation services provided by or funded through the AAAs;
(5) provide a written summary report of the monitoring visit within 60 days from
the date of the visit.
(c) the monitoring summary report shall include a description of any deficiencies found in
the program and should recommend corrective actions which are based on state and
federal regulatory and legal policies. The monitoring summary report shall also verify the
use of established sound business practices, and assess conformity with the AAA
performances based contract system.
4029.5 AAA P OLICY AND PROCEDURES REGARDING TRANSPORTATION SERVICES
(a) AAAs providing Transportation Services must have a transportation coordinator to
oversee the administration of Transportation Services.
(1) At a minimum, the transportation coordinator must have a high school
diploma or GED certificate.
(2) The transportation coordinator shall have a current job description outlining
duties and responsibilities such as review of trip records or deadhead miles, to
ensure efficiency.
(b) The AAAs and their service providers shall operate and maintain safe and effective
transportation services for older adults and persons with disabilities. The AAA shall
assure that coordination of transportation services is assigned to a specific person and
shall assure the operation and maintenance of a safe, effective, and within funding
limitations, an area wide transportation system through:
(1) safety inspections, preventive maintenance, prompt repair, proper insurance,
safe vehicles; and
(2) needs assessment and service analysis.
(c) When demand exceeds services available, the AAA shall prioritize the types of
transportation that will be provided and contracts for services shall reflect that
prioritization.
(1) This formal inspection shall include the:
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(A) electrical system;
(B) drive train;
(C) steering gear; and
(D) brake mechanism.
(d) All vehicles must be equipped with seat belts for all passengers. The seat belts must
be used any time the vehicle is in motion.
(e) Vehicles that transport clients in wheelchairs must be equipped with approved tie
downs and seat belts. These items must be used any time the vehicle is in motion.
Clients transported in wheelchairs must be facing forward.
(f) Vehicles must be equipped with emergency flasher lights or carry flares or reflective
warning signs.
(g) Vehicles shall comply with all laws, rules, regulations, and applicable codes,
including the Americans with Disabilities Act.
4029.6 DOCUMENTATION AND SERVICE STANDARDS
(a) For AAAs and service providers (receiving Title III funds) there must be:
(1) maintenance records and a preventive maintenance schedule for each
vehicle in use;
(2) a Pre-Trip Inspection completed before the driver’s scheduled shift and a
report of any maintenance concern they can identify;
(3) transportation staff who hold safety sensitive positions who have been given a
pre-employment screen and will submit to random drug tests;
(4) pre-employment Bureau of Motor Vehicle driver’s license checks and criminal
background checks on drivers, to determine employment and insurance
eligibility;
(5) drivers who have completed the required two week training period before
operating a vehicle without supervision. Training modules and personal training
may be from (RTAP) Rural Transit Assistance Program or from the AAA in the
form of videotape sessions from their library, personal driver observation during
training and training seminars selected by the (TAC) Transportation Advisory
Committee;
(6) vehicles that are properly insured for liability, medical payments, uninsured
motorist and collision/comprehensive coverage; and
(7) van drivers who hold valid Chauffeur’s Driver’s Licenses (CDL) and have
CPR certification as well as other specialized training.
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(b) The AAA shall establish procedures that provide for evaluation of any driver involved
in an accident and assure that corrective action is taken within 7 days of the accident, for
any negative findings. Each AAA shall coordinate with all other available transportation
systems.
(c) The AAA shall retain on file all appropriate documentation concerning any accident
involving a driver for a period of 3 years. The documentation shall include:
(1) accident reports;
(2) evaluation results; and
(3) any corrective action planned.
(d) The AAA shall provide each older adult receiving transportation services an
opportunity to voluntarily contribute to the cost of the service, if funded through Title III. 1
(e) The AAA shall have 30 days from the date of the letter to prepare a response which
shall describe specific actions linked to solutions to deficiencies and shall also
acknowledge and respond to the recommended corrective actions and suggestions.
4029.7 SERVICE PROVIDER PROCEDURES REGARDING TRANSPORTATION SERVICES
(a) The service provider must ensure the following:
(1) all vehicles shall be properly maintained. A standard list of items is checked
each day the vehicle in service is used.
(2) procedures are in place that require the vehicle be out of service until such
corrections are made of specific items that would include:
(A) brakes;
(B) fuel;
(C) emergency equipment; and
(D) seat belts.
(3) all vehicles shall have an inspection every 6 months or as recommended by
the vehicle manufacturer.
1
Code of Federal Regulations, 45 CFR 1321.67(a)
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4030 V OLUNTEER SERVICES
Volunteer groups and individuals, including older adults, provide assistance and services
appropriate to the needs of older adults and persons with disabilities.
4030.1 FUNDING SERVICES FOR VOLUNTEER SERVICES
Funding Sources are Title III, Older Hoosier Funds, and local funds.
4030.2 T HE FSSA DA POLICY AND PROCEDURES REGARDING VOLUNTEER SERVICES
(a) The FSSA DA shall encourage the AAAs to enlist the services of volunteer groups
and individuals, especially older adults, to provide assistance and services appropriate
to the unique needs of older adults and persons with disabilities.
(b) The FSSA DA shall:
(1) provide for volunteer services planning in the area plan format;
(2) provide encouragement and technical assistance to the AAAs in the
development of volunteer services in the PSAs; and
(3) monitor volunteer services goals and objectives as they develop in the AAAs.
(c) If at least 40 % of the area plans provide for area volunteer service coordinators, the
FSSA DA shall provide a state volunteer service coordinator, who shall:
(1) encourage AAAs to provide for area volunteer service coordinators;
(2) coordinate the volunteer services offered between the various AAAs;
(3) encourage, organize, and promote the use of older adults as volunteers to the
state;
(4) provide technical assistance, which may include training, to area volunteer
services coordinators; and
(5) promote the recognition of the contribution made by volunteers to the
programs administered under the state plan.1
4030.3 AAA POLICY AND PROCEDURES CONCERNING VOLUNTEER SERVICES
(a) At its discretion, the AAA should provide for a volunteer services coordinator.
(b) The AAA volunteer services coordinator shall do the following:
1
Older Americans Act, Section 307(a) (31) (A)
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(1) conduct and/or update an annual needs assessment to determine the need
for volunteer services within the community. If the needs assessment indicates a
need for volunteers, then the agency shall:
(A) develop and maintain a file of potential volunteer opportunities;
(B) design written job descriptions for each volunteer assignment which
includes job title, job responsibilities, training or preparation to be
provided, time and place of assignment, length of commitment, level of
on-the-job supervision, name of supervisor and other pertinent data;
(C) interview volunteers for assessment of skills and appropriate
assignments;
(D) develop written procedures regarding acceptance, denial, or
termination of volunteers;
(E) negotiate time commitments from each volunteer for each
assignment;
(F) establish and maintain a system for recording volunteer hours;
(G) provide orientation and training for volunteers prior to or at time of
assignment;
(H) provide supervision of volunteers;
(I) monitor and evaluate volunteer assignment and performance; and
(J) develop and maintain personnel files on all volunteers.
(2) encourage and enlist the services of volunteer groups to provide assistance
and services appropriate to the unique needs of older adults and persons with
disabilities;
(3) encourage, organize, and promote the use of older adults as volunteers in the
local communities. Promote volunteer involvement through use of the media and
other appropriate public relations techniques;
(4) promote recognition of the contribution made by volunteers to programs
administered under the area plan;1
(5) AAAs shall ensure that agencies shall provide adequate insurance coverage
for volunteers providing volunteer duties;
(6) AAAs shall ensure that all information collected on volunteers is maintained in
accordance with the FSSA DA Confidentiality Policies and Procedures in Section
2004 - Administrative Duties, of the FSSA DA Operations Manual; and
1
Older Americans Act, Section 306(a) (12) (A), (B), and (C)
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(7) AAAs shall provide to the FSSA DA any information or reports upon request.
Volunteers may be required to adhere to established policies or procedures such
as those established by RSVP or AARP in partnership with the FSSA DA.
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4031 R EQUESTS FOR AUTHORIZATION OF SERVICES (RFA)
(a) When an AAA needs to request authorization for a service, home or vehicle
modification, adaptive aid, device or other service, with a cost of over $4, 999.99, the
AAA shall send a completed Request for Authorization (RFA) document through the
State’s Computer Software Management System (CSMS) to the FSSA DA.1
4031.1 AAA PROCEDURES REGARDING REQUEST FOR AUTHORIZATION OF SERVICES
(a) The AAA shall electronically submit the RFA to the FSSA DA.
(b) Along with the RFA, the AAA shall send information and/or required documentation,
including but not limited to the following:
(1) three bids for the service, or all the bids received and documentation of why
three bids were not available;
(2) signed physician’s statement verifying the need for the service (faxed or
mailed to the appropriate FSSA DA staff person); and/or
(3) copies of any blueprints, drawings or plans for any proposed home or vehicle
modification (faxed or mailed to the appropriate staff person).
4031.2 THE FSSA DA PROCEDURES REGARDING THE REQUEST FOR AUTHORIZATION
FOR SERVICES
(a) The FSSA DA will review the RFA within 30 days. At this time, the FSSA DA may
request additional documentation and/or information, deny or approve the RFA.
(b) The FSSA DA shall consider the RFA and all additional required documentation,
including the following:
(1) entries listed on the client’s eligibility screen (via INsite) including general
comments; and
(2) medical condition listed for the client.
(c) If the FSSA DA needs more information, the FSSA DA shall request the AAA to
submit additional documentation and/or information within 30 days from the date of the
request.
(d) The FSSA DA shall make a final decision within 90 days from the submission date of
the original RFA. If the AAA has not sent all requested information and appropriate
documentation by that time, the FSSA DA has the right to delete the RFA.
1
Added 5/13/05
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(e) The FSSA DA shall notify the AAA of the approval or deletion via the State’s
Computer Software Management System (CSMS). 1
1
Added 5/13/05
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4032 T RANSFER OF CLIENTS
(a) Clients may relocate within the state without loss of services. The AAAs shall assure
that services are continued, if the services are available.
(b) Transfer of clients policy applies to the following funding sources:
(1) Social Services Block Grant (SSBG), Title III, CHOICE; and
(2) other funding that is administered by the FSSA DA and allows the flexibility of
client choice in location.
4032.1 AAA PROCEDURES REGARDING TRANSFER OF CLIENTS
(a) For active clients currently receiving services, the originating AAA will contact the
receiving AAA regarding a transfer of a client.
(b) If there are service dollars available at the receiving AAA, the originating AAA will
forward appropriate information to the receiving AAA. Information that will be sent (if
available) is the following:
(1) assessment and eligibility screen;
(2) notation or copy of original application date and relevant notes;
(3) 30 days of documentation notes; and
(4) other appropriate information.
(c) The receiving AAA will visit the client and follow their agencies policies regarding
authorization of services and care plan management.
(1) If there are not service dollars available:
(A) the client’s name will be placed on the receiving agency waiting list
and will receive services based on the receiving AAAs procedures.
(B) before implementing a new or revised care plan, the receiving AAA
will submit a new Plan of Care for approval.
(C) until the client’s services are paid by the receiving AAA, the
originating AAA will pay for the client’s services.
(D) The receiving AAA will bill the originating AAA monthly for services.
The paying AAA will report required demographics, fiscal information, and
other appropriate information, until the client and their service
expenditures are the responsibility of the receiving AAA.
(d) Only service dollars will be reimbursed between the AAAs. It is not cost effective to
include administrative and case management cost in the billing based on the potential
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brief period these individuals will be associated with two AAAs. When the client is
transferred to the receiving agency fiscal budget, the agreement between the agencies
will be terminated. 1 and 2
1
Indiana Association of Area Agencies on Aging Policy on Consumer Transfer/Move from One AAA to Another,
dated 10/15/99
2
Added 5/13/05
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More information can be found in the following:
Code of Federal Regulations
20 CFR Part 641-Department of Labor, 45 CFR 1321.17(f)(8), 45 CFR 1321.53(b)(1),
45 CFR 1321.67(a)
Workforce Investment Act of 1998, Section 134(c) (29 USC 2864(c))
Older Americans Act of 1965, as amended in 2000
Sections 102(1), 102(28), 301(b)(2), 302(3), 303(c)(1), 303(e), 304(d)(1)(D), 306, 307,
312, 321(1), 321(a)(2), 321(a)(12), 321(a)(14), 331(b)(1), 371, 372, 373, 374,374, 375,
376, 401, 416, 401, 402, 403, 404, 405, 406, 407, 408, 409, 510, 511, 512, 513, 514,
515 and 516
United States Code
42 USC 102, 42 USC 3030(s)
Administration on Aging, Program Instructions 91-04
CHOICE Guidelines and Procedures – Revised June 1, 2001
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SECTION 5
5000 FUNDING SOURCES AND ELIGIBILITY REQUIREMENTS
Table of Contents
5001 THE OLDER AMERICANS ACT OF 1965, AS AMENDED
5001.1 Title I: Declaration of Objectives
5001.2 Title II: Administration on Aging
5001.3 Title III: Grants for State and Community Programs for Aging
5001.4 Title IV: Training, Research, and Discretionary Projects and
Programs (OAA 401-402)
5001.5 Title V: Community Services Employment for Older Americans
5001.6 Title VI: Grants for Native Americans
5001.7 Title VII: Allotments for Vulnerable Elder Rights Protection Activities
5001.8 Title VIII: Native American Programs
5001.9 Responsibility for the Older Americans Act (OAA)
5001.10 Administration on Aging
5001.11 Regional Office of the OAA
5002 COMMUNITY AND HOME OPTIONS TO INSTITUTIONAL CARE FOR THE
ELDERLY AND DISABLED (CHOICE)
5002.1 Summary of the Indiana Code IC 12-10-10
5002.2 CHOICE Funding Requirements
5002.3 Eligibility Requirements for CHOICE Funding
5002.4 Financial Eligibility and Cost Share Requirements
5003 SOCIAL SERVICE BLOCK GRANT – TITLE XX
5003.1 Eligibility Requirements for SSBG Funding
5004 NUTRITION SERVICES INCENTIVE PROGRAM (NSIP) (OAA 311(D)) OF
2000, AS AMENDED
5005 GENERAL FUNDING ELIGIBILITY REQUIREMENTS
5005.1 Title III Funding Requirements
5005.1.1.Eligibility Requirements for Title III Funding
5005.2 Title V Funding Requirements (OAA)
5005.2.1 Eligibility Requirements for Title V Funding
5005.2.2 Financial Eligibility for Title V
5006 OLDER HOOSIER ACCOUNT FUNDING REQUIREMENTS
5006.1 Eligibility Requirements for Older Hoosier Account
Funding
5006.2 Financial Eligibility
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5007 FISCAL POLICIES AND PROCEDURES APPLICABLE TO THE FSSA
DA CONTRACTS WITH THE AAA ONLY
5007.1 Funding Accounts
5007.2 Budgets
5007.3 Contracts
5007.4 Allocation of Funds
5007.4.1 Funding Formulas
5007.4.2 AAA Provisions for Expenditures
5007.5 Program Income and Contributions
5007.5.1 Fees
5007.5.2 Allowable Uses of Program Income
5007.5.3 The FSSA DA Procedures Regarding Contributions
5007.5.4 Service Providers Policy and Procedures Regarding
Program Income
5007.5.5 In-Kind Contributions
5007.5.6 The FSSA DA Procedures Regarding In-Kind
Contributions 5007.5.7 AAA Policy and Procedures Regarding
In-Kind Contributions
5007.5.8 Service Provider Policy and Procedures Regarding InKind Contributions
5007.5.9 Carryover Funds
5007.5.10 Matching Funds
5007.6 Services
5008 ADULT PROTECTIVE SERVICES POLICIES AND PROCEDURES
APPLICABLE TO THE FSSA DA CONTRACTS (2005 COMPLIANCE NEW
SECTION)
5008.1 Adult Protective Services Funding Account
5008.2 Adult Protective Services Budgets
5008.3 Adult Protective Services Funding Formula
5008.4 Distribution of Adult Protective Services Funding Formula
5008.4.1 Adult Protective Services Prosecutors Provisions for
Expenditures
5009 FISCAL POLICIES AND PROCEDURES APPLICABLE TO ALL THE
FSSA DA CONTRACTS (AAA SPECIFIC)
5009.1 Insurance and Bonding
5009.2 Procurement
5009.2.1 Procurement Guidelines
5009.2.2 The FSSA DA Policy and Procedures Concerning
Procurement
5009.2.3 AAA Policy and Procedures Regarding Procurement
(Applicable to AAAs Only, not Contracts with Other Providers)
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5009.3 Equipment
5009.3.1 Equipment Purchases
5009.3.2 Purchase of Vehicles
5009.3.3 Equipment Inventory Records
5009.3.4 Disposal of Property
5009.3.5 Disposal of Vehicles
5009.4 Audits
5009.5 Claim Reimbursement Policies and Procedures
5009.5.1 How to Fill Out Claim Forms
5009.5.2 Lost Claims Procedures
5009.5.3 Late Claims Procedures
CHART 12
ADMINISTRATION OF PROGRAMS
Indiana Code 12-10-1-3
CHART 13
Public Law 89-73
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5000 F UNDING SOURCES AND ELIGIBILITY REQUIREMENTS
CHART 12
Administration of Programs Indiana Code, IC 12-10-1-3
The Bureau of Aging and In-Home Services shall administer the following programs:
(1) Older Americans Act under IC 12-9-5-1
(2) Area Agencies on Aging services under this article
(3) Adult Protective Services under IC 12-10-3
(4) Room and Board Assistance and assistance to residents in county homes under IC 12-10-6
(5) Adult Guardianship Program under IC 12-10-7
(6) Community and Home Options for the Elderly and Disabled under IC 12-10-10. (7) Nursing
home pre-admission screening under IC 12-10-12
(8) Long Term Care Advocacy under IC 12-10-13
(9) Nutrition services and home delivered meals
(10) Title III B supportive services
(11) Title III D in-home services
(12) Aging programs under the Social Services Block Grant
(13) United States Department of Agriculture Elderly feeding program
(14) Title V Senior Employment
(15) PASARR under older adult services under IC 12-10-1-3-15
(a) The FSSA DA administers several funding sources that support a wide range of
programs that offer services for adults age 55 and older, adults age 55 and under, with
disabilities and children with disabilities, through the Older Ame ricans Act (OAA),
Social Service Block Grant (SSBG), CHOICE, and other various funding sources.
(b) The FSSA DA uses these funds to focus on improving the lives of older adults and
adults with disabilities in areas of health, income, employment, retirement, and
community services. This section lists information about the funding sources
administered by the FSSA DA to assist older adults and persons with disabilities to
remain in their own homes and communities.
5001 O LDER AMERICANS ACT OF 1965, AS AMENDED IN 2000
CHART 13
Public Law 89-73
An ACT to provide assistance in the development of new or improved programs to help older
persons through grants to the States for community planning and services and for training,
through research, development, or training project grants and to establish within the
Department of Health, Education and Welfare an operating agency to be designated as the
'Administration on Aging'. Be it enacted by the Senate and House of representatives of the
United States of America in Congress assembled, that this act may be cited as the "Older
Americans Act of 1965".
(a) The Older Americans Act was enacted in 1965, and amended in 2000, to provide
assistance in the development of new or improved programs to help older adults by
doing the following:
(1) awarding grants to states for community planning and for training;
(2) awarding research, development, and training project grants; and
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(3) establishing the AoA within the Department of Health and Human Services.
(b) The OAA was passed and established to be the primary resource for
organizing and delivering community-based services through a coordinated
system at the state level for older adults.
5001.1 T ITLE I: DECLARATION OF OBJECTIVES
(a) Title I establishes the central theme of the act, which is to promote the
independence and dignity of older adults. It also calls for equal opportunity for all
older adults in the following areas.
(1) Income;
(2) Physical and mental health;
(3) Housing;
(4) Restorative services;
(5) Employment;
(6) Retirement;
(7) Meaningful activities;
(8) Continuum of care;
(9) Benefit from research;
(10) Participation in planning services; and
(11) Protection against abuse, neglect, and exploitation.
5001.2 T ITLE II: ADMINISTRATION ON AGING
Title II establishes the federal AoA as the principal agency for administering the
OAA (except Title V) and describes AoA's functions. 1
5001.3 T ITLE III: G RANTS FOR STATE AND COMMUNITY PROGRAMS ON AGING
(a) The Title III Section of the act includes the provision for appropriation of funds for use
by the states. Title III also requires AAAs and service providers to develop and
implement comprehensive and coordinated service-delivery systems that do the
following:
1
Older Americans Act, Section 201
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(1) secure and maintain maximum independence and dignity in a home
environment for older adults;
(2) remove individual and social barriers to economic and personal
independence for older adults;
(3) remove individual and social barriers to economic and personal
independence for older adults:
(4) provide a continuum of care for vulnerable older adults; and long-term
services and;1
(5) secure the opportunity for older adults to receive managed in-home and
community-based long term services.
(b) Among other requirements and assurances, Title III of the act also does the
following:
(1) sets forth matching funds/in-kind requirements and establishes organization
and designation requirements for the FSSA DA; 2
(2) sets forth provision requirements for the state and area plans; 3
(3) sets a requirement for assurances in state and area plans that preference will
be given to older adults with the greatest economic and social need, giving
particular attention to minority older adults in the provision of services; 4
(4) determines conditions and requirements for planning, coordination, evaluation,
and administration of state plans and establishes policy for payments of grants or
contracts;
(5) sets requirements for disaster relief reimbursements and availability of surplus
commodities;5
(6) establishes policy regarding audits and the recapture of payments for
multipurpose senior centers; 6 and
(7) lists the rights of older adults who receive in-home services.7
(c)Title III is divided into separate funding categories. Indiana administers funds for five
categories as set out below:
(1) III-B Supportive Services and Senior Centers
Supportive Services and Senior Center funding provides for services that are
1
Older Americans Act, Section 301(a)(1)(A) and (D)
Older Americans Act, Section 304
3
Older Americans Act, Section 306, and 308
4
Older Americans Act, Section 306, and 308
5
Older Americans Act, Section 310 (a) (1)
6
Older Americans Act, Section 313(a)
7
Older Americans Act, Section 314
2
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necessary for the general welfare of older adults and provides funding assistance
in the operation of multipurpose senior centers. 1
(2) III-C Nutrition Services
Nutrition Services provides hot or otherwise appropriate, nutritionally balanced
meals, nutrition education, and other appropriate nutrition services to older adults
in a congregate setting or to persons confined to their homes. 2
(3) III-D Disease Prevention and Health Promotion Services
Disease Prevention and Health Promotion Services provides disease prevention
and health promotion services and information at senior centers and other
appropriate sites, giving priority of service to areas medically underserved and to
those in which there are a large number of older adults who have the greatest
economic need for such services. 3
(4) III-E National Family Caregiver Support Program
The National Family Caregiver Support Program provides systems of support
services for family caregivers, and for grandparents or older individuals who are
relative caregivers. Support services include providing the following: information
to caregivers about available services; assistance to caregivers in gaining access
to the services; individual counseling, organization of support groups, and
caregiver training to caregivers that assist in making decisions with regard to
their caregiver roles; respite care to enable caregivers to be temporarily relieved
from their caregiver status; and limited supplemental services to complement the
care provided to individuals. 4
5001.4 T ITLE IV: T RAINING, RESEARCH, AND DISCRETIONARY PROJECTS AND
PROGRAMS (OAA 401- 402)
(a) The purpose of Title IV is to expand knowledge and understanding of aging and the
aging process; to design and test innovative ideas in programs and services for older
adults; and to help meet the needs for trained personnel in the field of aging through
special grants and contracts.
5001.5 T ITLE V: COMMUNITY SERVICE EMPLOYMENT FOR OLDER AMERICANS
(a) The Department of Labor administers the Title V Section of the act that provides for
the Older American Community Service Employment Program to promote and foster
useful part-time opportunities in community service activities for unemployed low-income
persons who are 55 years of age or older. 5
(b) Program requirements are outlined for provider and individual participation, nonfederal share requirements, allowances for administration, and equitable distribution
within each state.
1
Older Americans Act, Section 321
Older Americans Act, Section 331
3
Older Americans Act, Section 361
4
Older Americans Act, Section 372
5
Older Americans Act, Section 361-363
2
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5001.6 T ITLE VI: GRANTS FOR NATIVE AMERICANS
INDIANA DOES NOT RECEIVE FUNDING UNDER THIS TITLE.
5001.7 T ITLE VII: ALLOTMENTS FOR VULNERABLE ELDER RIGHTS PROTECTION
ACTIVITIES
(a) Title VII provides a program for making allotments to states to pay for the cost of
carrying out vulnerable elder rights protection activities. 1
(b) This section of the act includes general state provisions that establish Tit le VII
programs and set forth requirements for the authorization of appropriations; establish
state allotments, set forth state organization policy, list additional state plan requirements
for Title VII programs, and establish the requirements for demonstration projects.
(c) Title VII also establishes and defines the functions of the following:
(1) the ombudsman program;
(2) programs for prevention of abuse, neglect, and exploitation;
(3) the state rights and legal assistance development program;
(4) outreach, counseling, and the assistance program for insurance and public
benefits;
(5) subtitle B-Native American organization provisions; and
(6) subtitle C-general provisions.
5001.8 T ITLE VIII: NATIVE AMERICAN PROGRAMS
INDIANA DOES NOT RECEIVE FUNDING UNDER THIS TITLE.
5001.9 RESPONSIBILITY FOR THE OLDER AMERICANS ACT (OAA)
(a) At the federal level, the responsibility for carrying out the OAA, with the exception of
Title V, which is administered by the Department of Labor, is vested by statute in AoA. 2
(b) At the state level, the responsible entity is the designated state unit on aging which is
the Division of Aging.
1
2
Older Americans Act, Section 701
Indiana Code 12-10-10 (CHOICE is always considered the funding of the last resort)
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5001.10 ADMINISTRATION ON AGING
Pursuant to the OAA of 1965, as amended in 2000, the AoA, headed by an assistant
secretary appointed by the president, is established within the Department of Health and
Human Services.
5001.11 REGIONAL OFFICE OF THE AOA
(a) AoA has established 9 regional offices to serve as liaison between the federal and
state governments. Indiana is in Federal Region V, located in Chicago, Illinois, to which
FSSA/FSSA DA is accountable.
(b) Regional office responsibilities include the following:
(1) working directly with states to provide technical assistance and training; and
(2) reviewing state plans and recommending approval or disapproval of the plans
to the assistant secretary of AoA.
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5002 C OMMUNITY AND HOME OPTIONS TO INSTITUTIONAL CARE FOR THE ELDERLY
1
AND DISABLED (CHOICE)
(a) The Community and Home Options to Institutional Care for the Elderly and Disabled
Program (CHOICE) is designed to change the way the state provides and delivers longterm care for older adults and persons with disabilities. 2
(b) Above all, the purpose of CHOICE is to enable older adults or persons with
disabilities to live independently in their own homes or in community-integrated settings.
It is further intended to allow older adults ready access to community resources in order
to improve the quality of life of families and children, with an emphasis on seniors and
persons with disabilities.
(c) The program is also intended to encourage more coordinated planning; to give
increased attention to CHOICE participant views; to provide greater respect for
participant preferences; and to value participant selection of providers as well as
services.
5002.1 SUMMARY OF THE INDIANA CODE: IC 12-10-10
Indiana Code 12-10-10 includes the following:
(1) definitions of terms as applied to CHOICE;
(2) CHOICE eligibility requirements;
(3) the establishment of the CHOICE program and the administration and duties
of Division of Disabilities and Rehabilitative Services (DDRS);
(4) the disbursement of state funds for home health services to licensed healthcare professionals, facilities, and agencies;
(5) the establishment of a training program for relatives of eligible individuals and
reimbursement with CHOICE and Medicaid funds to the relatives for provision of
homemaker and personal care services; and
(6) the identification of specific requirements of a report to be submitted for
review before October 1st of each year, by the FSSA DA to the CHOICE board
who in turn must submit the report to the General Assembly between November
15th and December 31st of each year.
5002.2 CHOICE F UNDING REQUIREMENTS
CHOICE funds are exclusively state dollars used to provide services for older adults
and persons with disabilities enabling these individuals to maintain independence in their
1
2
Added 5/13/05
Indiana Code 12-10-10 (CHOICE is always considered the funding of last resort)
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own homes and communities.
5002.3 ELIGIBILITY REQUIREMENTS FOR CHOICE FUNDING
(a) To be eligible for CHOICE funding, the older adult or person with disabilities must:
(1) be a resident of Indiana;
(2) be at least 60 years of age or disabled;
(3) qualify under criteria developed by the CHOICE board as having an
impairment that places the person at risk of losing independence; and
(4) have no assets or have assets that do not exceed the worth of five
hundred thousand ($500,000) as determined by the FSSA DA.1
(b) A person is at risk of losing independence if the person is unable to perform two or
more activities of daily living as measured on the long-term care services eligibility
screen.
(c) The use by or on behalf of the person of any of the following services or devices do
not make the client ineligible for services under CHOICE:
(1) skilled nursing assistance;
(2) supervised community and home care services, including skilled nursing
supervision;
(3) adaptive medical equipment and devices; and
(4) adaptive non-medical equipment and devices.
5002.4 FINANCIAL ELIGIBILITY AND COST SHARE REQUIREMENTS FOR CHOICE
FUNDING
(a) CHOICE services are offered to all persons regardless of their income.
Although there are no income restrictions on eligibility, there is a method of cost
reimbursement applicable to individuals who can pay all or a portion of the cost
of CHOICE services rendered.
(b) The cost share requirement: The client's cost share of the payment for services
rendered shall be calculated by using the CHOICE Cost Share Worksheet, which
includes the United States Department of Health and Human Services Poverty Income
Guidelines. (For more information, consult the Community and Home Options to
Institutional Care for the Elderly and Persons with Disabilities (CHOICE)).
(c) CHOICE is the funding of last resort for in-home and community-based services. If
1
IC 12-10-10-4(a)(3) - Added 4/10/06
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any older adult or person with disabilities applying for or receiving services through the
CHOICE program is eligible for in-home and community-based services from sources
other than CHOICE, including services under Medicaid and Medicaid Waivers, those
services must be utilized prior to or in place of CHOICE funding.
5003 SOCIAL SERVICES BLOCK GRANT-TITLE XX
The Social Services Block Grant (SSBG) was created for the purpose of consolidating
federal assistance to states for social services into a single grant. States are given much
flexibility in using social services grants and are encouraged to furnish services directed
at particular objectives. The FSSA DA uses SSBG money to fund a compilation of inhome, community-based, and facility-oriented services targeted for low-income older
adults and persons with disabilities.
5003.1 ELIGIBILITY REQUIREMENTS FOR SSBG FUNDING
(a) To be eligible for SSBG funding, the older adult or person with disabilities client must
meet the following requirements:
(1) The client must be a resident of Indiana.
(2) The client must have a documented determination of service need. A service
need exists when the case management provider determines and documents
that the client's functional status may be enhanced through the provision of
appropriate services.
(3) The client must meet program income guidelines. If the client fails to meet the
income guidelines but has a documented need for service due to abuse, neglect,
exploitation, risk of institutionalization, and/or pending discharge from the hospital
or nursing facility, the client may qualify for SSBG funded services as a no
means-test client. Otherwise, the client must be determined to be in financial
need by the case management provider.
(4) Financial need exists when the client's and the family's incomes fall below
150% of the poverty level listed in the current Department of Health and Human
Services Poverty Guidelines. The client must meet program income guidelines
through a declaration of income (the verbal indication of the source and amount
of gross income).
5004 N UTRITION SERVICES INCENTIVE PROGRAM (NSIP) (OAA 311(D)) OF 2000,
AS AMENDED
(a) The NSIP is the new name for the former United States Department of Agriculture's
(USDA) program.
(b) The AoA is now administering the NSIP as well as the other nutrition programs as
part of the OAA, funded through Titles III Part C-1 and Part C-2 and Title VI. In each
fiscal year, the AoA, on behalf of the secretary of Health and Human Services, shall
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disseminate to state agencies, AAAs, and providers of nutrition services assisted under
this title, information concerning the following:
(1) the existence of any federal commodity-processing program in which such
state agencies, AAAs, and providers may be eligible to participate; and
(2) the procedures to be followed to participate in the program.
5005 G ENERAL FUNDING ELIGIBILITY REQUIREMENTS
The FSSA DA administers a variety of programs that provide funding for services to
meet the needs of older adults and persons with disabilities. All individuals must meet
general eligibility requirements as well as additional requirements specific to each
funding program. Listed below are the general funding eligibility requirements.
5005.1 TITLE III: FUNDING REQUIREMENTS (OAA)
Title III funds are federal dollars that are provided to the FSSA DA for allocation to AAAs
and service providers to develop and implement services necessary to allow older adults
to remain in their homes as long as possible, while enhancing their sense of dignity and
worth.
5005.1.1 ELIGIBILITY REQUIREMENTS FOR TITLE III FUNDING
(a) To be eligible for Title III funding, the client must be at least 60 years of age.
(b) Priority is given to serving those older adults who are in greatest economic need,
social need, or both, with particular attention to low-income minority older adults, and to
serving older adults residing in rural areas.
(c) Although there are no financial eligibility requirements for Title III, specific programs
funded partially or fully with Title III dollars may have special financial eligibility
requirements.
(d) For additional eligibility requirements, refer to Section 4 - Service Definitions 1.
5005.2 TITLE V: FUNDING REQUIREMENTS (OAA)
Title V funds are federal dollars allocated to the state to fund local employment and
training programs for eligible persons.
1
Corrected 5/13/05
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5005.2.1 ELIGIBILITY REQUIREMENTS FOR TITLE V F UNDING
To be eligible for Title V funding, the client must:
(1) be at least 55 years of age; and
(2) be a resident of Indiana.
5005.2.2 F INANCIAL ELIGIBILITY FOR TITLE V
Refer to Section 9000 - Senior Community Service Employment Program (SCSEP).
5005.3 T ITLE VII: FUNDING REQUIREMENTS (OAA)
Title VII dollars are federal funds made available to the states to protect the rights of
older adults by providing services and programs such as long-term care ombudsman,
elder-rights and legal-assistance development programs, and outreach and counseling
services.
5005.3.1 ELIGIBILITY REQUIREMENTS FOR TITLE VII F UNDING
Services are targeted to assist older adults who are in greatest economic need, social
need, or both, with particular attention to low-income minority older adults.
5006 O LDER HOOSIER ACCOUNT FUNDING REQUIREMENTS
The Indiana legislature appropriates state dollars to the FSSA DA to assist with meeting
the match requirements of various funding sources that support programs and activities
for older adults. Programs under Title III, Title V, and Title VII of the OAA require that
federal funds be matched by state and local funds.
5006.1 ELIGIBILITY REQUIREMENTS FOR OLDER HOOSIER ACCOUNT FUNDING
Eligibility requirements are the same as those of the funding source the Older Hoosier
account dollars are used to match.
5006.2 FINANCIAL ELIGIBILITY
(a) Financial eligibility requirements are the same as those of the funding source
the Older Hoosier account dollars are used to match.
(b) Older Hoosier accounts match a percentage of dollars provided by a
particular funding source. Services provided would depend upon the funding
source the Older Hoosier account dollars are used to match.
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5007 F ISCAL POLICIES AND PROCEDURES APPLICABLE TO THE FSSA DA CONTRACTS
WITH AAA O NLY
The fiscal policies and procedures outlined in this section are for programs contracted
between DDRS (through FSSA DA) and the AAAs.
5007.1 FUNDING ACCOUNTS
(a) The FSSA DA administers the following federal and state funding accounts:
(1) Adult Guardianship Services Acct. 1000-122930
(2) CHOICE Acct. 1000-121490
(3) General State Appropriations
Acct. 1000-104950 (Older Hoosiers Account)
(4) OAA (Title III and Title VII, Excluding Adult Protective Services) Acct. 6000149800
(5) SSBG
Acct. 3520-102000
(6) Title V (Senior Community Service Employment Act) Acct. 6000-105600
(7) AoA program administrator (Congregate and Home-Delivered Meal
Reimbursement)
Acct. 6000-149300
(8) Pre-Admission Screening/Resident Review Acct. 6000-155500
(9) Temporary Assistance to Needy Families (TAN F) Supports families caring for
children who are being served through the CHOICE program
Acct. 3500-185200
5007.2 BUDGETS
(a) Budgets are prepared on as part of the area plan process for each AAA. The amount
of the budget is constrained by the amount of funds allocated. With the prior written
approval of the FSSA DA, an AAA budget may be modified in the contract year and
during the closeout period of the contract.
(b) Contract amounts may be changed by use of two methods:
(1) A formal contract amendment is required to increase or decrease the grand
total amount of a contract.
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(2) Service dollars may be shifted between service codes without increasing or
decreasing grand-total contract amounts with an executive letter-modification
amendment. The adjustment in a program area may consist of either of the
following:
(A) a transfer within line items of a specific category (e.g., personnel to
contracted services within Title III-C)
(c) Administrative dollars may be transferred to service dollars with no limits on the
amount to be transferred. Program dollars may be transferred to administrative dollars
within specific guidelines as listed below. Not more than 10% of the allocated dollars
may be used for the administration of the programs.
(d) Specific guidelines govern each program area as follows:
(1) OAA (Title III-Grants for State and Community Programs on Aging)-10% of
the federal grant is taken from Title III-B, Title III-C1, and Title III-C2 to establish
Title III-A (local administration). Application of the IFF distributes the AAA's
administration funds. In addition, the FSSA DA will consider a written request
from an AAA to transfer up to 10% of an AAA's allocation under Title III-B, C-1,
C-2 and Title III-E to Title III-A. Transfers may be made only after receipt of
written approval from the FSSA DA. Title III-A must not exceed 10% of the total
allocated Title III-B, C-1, C-2 and Title III-E allotments.
(2) OAA (Title VII-Allotments for Vulnerable Elder Rights Protection Activities)Title VII dollars may not be used for administrative purposes. Funds made
available under this title must supplement, and not supplant, any federal, state, or
local funds expended to provide services prior to FY 2000.
(3) OAA (Title III-Chapter 3-Prevention of Elder Abuse, Neglect and Exploitation
Funds received under Title III)-Chapter 3 may not be used for involuntary or
coerced participation in services (i.e., services leading to court ordered nursing
home placement).
(4) Social Services Block Grant (SSBG)-Use of SSBG funds for administrative
duties is limited to 10% of the total aging grant.
(5) CHOICE-The combination of case-management and administration funds
cannot exceed 20% of the total contract amount, excluding Medicaid Waiver
administration.
(6) The total costs must not exceed 10% of the total contracted CHOICE budget.
(7) A waiver may be granted for an increase in funds above 10% for case
management services, provided there is adequate proof of services expansion
and improvement, as well as proof that case management services will benefit
from the direct increase in the percentage (for growth of program).
(8) Older Hoosier Funds-The primary use of these funds is to provide a required
match and/or support to the programs of Title III, Title V, and Title VII of the OAA.
The funds may be used in any proportion necessary to contribute toward meeting
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the matching requirements of the programs under the OAA. No minimum or
maximum amounts are required to be used as match for any programs. The
secondary purpose of these funds is to provide required matching funds (as
approved by the FSSA DA) for programs administered by the FSSA DA or other
agencies.
(9) OAA-Title V (Senior Community Service Employment Program) The
allocation of administrative funds is a function of the number of slots per area
against the available administrative funds from the grant. The allocation is 13% of
the grant minus the amount reserved for state administration.
5007.3 CONTRACTS
(a) A contract is a written agreement between the DDRS and an AAA that describes the
payment of money and responsibilities of the parties for the various federal and state
programs for the delivery of services.
(b) Contract amounts are not negotiated but are a result of the allocation of funds based
on respective funding formulas.
(c) A request for a contract is initiated by the FSSA DA. The document is prepared and
sent to the AAA or service provider who signs and returns the document to FSSA DA.
(d) The term request for a contract references a specific act by the FSSA DA, namely
the preparation of the Executive Document Summary (EDS). This is true for all funds or
all contracts, even those that are the result of Request for Proposal (RFP) or Broad
Agency Announcement (BAA).
(e) The document must also contain appropriate signatures from the director of DDRS,
the Department of Administration, the State Budget Agency, and the Office of the
Attorney General. A completed copy is mailed to the AAA or provider. The original
contract is maintained by the FSSA DA.
5007.4 ALLOCATION OF FUNDS
The FSSA DA uses a specific formula in allocating dollars for each program to the
AAAs. The following is a brief summary of each funding formula.
5007.4.1 F UNDING FORMULAS
(a) The Intrastate Funding Formula (IFF) is approved by the AoA and is included in the
state plan.
(b) The IFF is the method used to allocate OAA funds to AAAs under the following:
(1) Title III-A for Local Administration
(2)Title III-B for Supportive Services and Senior Centers
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(3) Title III-C1 for Congregate Nutrition Services
(4) Title III-C2 for Home-Delivered Nutrition Services
(5) Title III-D for Disease Prevention and Health Promotion Services
(6) Title III-E for National Family Caregivers Support
(c) The IFF utilizes the most recent available census data consisting of 6 categories of
the elderly (60 years of age and over) population. Those categories are as follows:
(1) Older adults 60 years of age and over
(2) Older adults below poverty
(3) Older minority adults below poverty
(4) Older adults living in rural areas
(5) Older minority adults
(6) Older adults with disabilities
(d) The IFF directs that certain proportions of funding be allocated to each category and
also provides for a base of funding. The IFF provides limitations on how much of an
increase or decrease in funding an AAA can receive from one year to the next.
(e) Title VII (Ombudsman) of the OAA distributes the funding based upon the number of
nursing home beds per county, while outreach counseling under Title VII and Title III-F
uses only the funding factor of the IFF. The other portion of Title VII, Protective Services
for the Elderly, is awarded to county prosecutors based upon the number of square
miles in the area and the number of cases reported to the FSSA DA on an annual basis.
(g) The SSBG formula distributes 80% of the funds utilizing the IFF and 20% of the
funds using the CHOICE funding factor for the non-elderly.
(h) Title V utilizes authorized slots as provided by the Department of Labor.
(i) The AAA shall maintain financial and accounting records that identify costs
attributable to each service code specified (see Appendix II for the FSSA DA Service
Codes).
(j) Additional fiscal requirements may be stipulated for the AAA by the FSSA DA should
it determine that the AAA:
(1) is financially unstable;
(2) has a history of poor performance or accountability; and
(3) has a management system that does not meet the standards required by the
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state of Indiana or the federal government.
(k) The FSSA DA shall notify the AAA of the nature of the additional requirements, and
the reasons for imposing them, as well as specify the corrective action needed.
(l) The AAA shall further maintain a written cost-allocation methodology accepted by the
FSSA DA that identifies procedures for attributing costs to each service code.
(m) The Medicaid Waiver Administration refers to time spent in performing activities
related to the determination of an individual's eligibility for services under the Indiana
home and community-based waivers, approved by the Centers for Medicare and
Medicaid Services (CMS) in the following cases:
(1) the individual was determined to be ineligible for Medicaid Waiver services;
(2) there was a delay in placing an eligible individual in a slot for services to
begin due to the limited number of individuals that the state is authorized to serve
on each Medicaid waiver; and
(3) as defined by federal or state regulations and/or policy.
(n) The AAA shall maintain the funds received from the FSSA DA pursuant to the
contract in identifiable bookkeeping accounts, and the AAA shall use funds solely for the
purposes set forth in the contract agreement (see Appendix II - FSSA DA Service
Codes).
(o) A single checking account is acceptable, but the AAA records shall identify the
source of each revenue and expenditure.
5007.4.2 AAA PROVISIONS FOR EXPENDITURES
(a) The AAA, including Adult Protective Services Providers (and any other provider) shall
do the following:
(1) abide by the Generally Accepted Accounting Procedures (GMP) and
practices that sufficiently and properly reflect all costs incurred by the AAA
pursuant to the contract agreement;
(2) not incur any costs against the contract after the specified expiration date.
Claims must be submitted to the FSSA DA within 60 calendar days after the date
costs are incurred. If all final claims and reports are not submitted to the FSSA
DA within 60 days after the expiration or termination of the contract, the FSSA
DA may elect to deny payment. At the time the final claim is submitted, all
unexpended grant funds must be returned to the FSSA DA.
(3) Upon written demand by the FSSA DA, the AAA may be required to repay the
FSSA DA all sums paid by the FSSA DA to the AAA for which adequate fiscal
and/or service-delivery documentation is not in existence for any time period that
has been audited. If an audit of the AAA results in an audit exception, the FSSA
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DA shall have the right to do the following, pending resolution between the
parties of any disputed amount:
(A) set off such amount against current or future allowable claims;
(B) demand cash repayment; and
(C) withhold payment of current claims in a like amount.
(4) Acknowledgement by the FSSA DA that no funds are available to the AAA pursuant
to the contract agreement:
(A) for the present fiscal year may be transferred for use in the next fiscal year;
and
(B) for the next fiscal year may be transferred or used by the AAA for costs
incurred in the present fiscal year.
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5007.5 PROGRAM INCOME AND CONTRIBUTIONS
CHART 14
United States Code, 42 USC 3030c-2 (b) (1) Voluntary contributions shall be allowed and may
be solicited for all services for which Title III funds are received, provided that the method of
solicitation is non-coercive.
(a) Free and voluntary contributions from individuals receiving Title III funded services,
shall be used to expand such services and shall be regarded as program income. 1
(b) Program income earned by the AAA provided through the contract must be
maintained and expended by the AAA in the program from which the income was
derived in accordance with applicable state and federal program rules, regulations, and
policies.
(c) Program income earned during the contract year shall be retained by the AAA
Program income is to be used for growth of the program and must be expended before
federal funds can be expended.
(d) Interest on grant funds, rebates, credits, discounts, and refunds earned by the AAA
on funds provided pursuant to the contract must be maintained and expended by the
AAA in accordance with applicable state and federal program rules, regulations, and
policies.
(e) The AAA must maintain and provide to the FSSA DA an accounting of all program
income, including interest on grant funds, rebates, credits, and discounts earned as a
result of and during the term of the contract.
5007.5.1 F EES
(a) The AAAs and Service Providers shall not devise a 'means test' for any service for
which contributions can be accepted.
(b) The AAAs or any Service Providers shall not deny service to any older adult or
person with disabilities for not making a contribution toward the cost of the received
services.
(c) Each AAA shall account for all program income received and expended under the
approved area plan and shall monitor the procedures developed by the Service Provider
to receive, bank, and disburse program income.
(d) The AAAs and service providers shall impose no fees upon the clients for any
services provided through the contract without the prior written approval of the FSSA
DA.
(e) Notwithstanding the previous paragraph, the AAA shall acknowledge that certain
clients are required to pay for all or a portion of the services provided to the client
1
Code of Federal Regulations, 45 CFR 1321.67 (b) (1) (2)
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through the CHOICE program (commonly referred to as a cost share) using the formula
developed by the FSSA DA.
(f) The AAA shall compute any cost share owed by clients receiving CHOICE services.
The AAA shall claim from the FSSA DA the actual cost of services rendered to CHOICE
clients, less the cost share amount collected by the AAA (or provider) from clients.
5007.5. 2 ALLOWABLE USES OF PROGRAM INCOME
(a) Service Providers are permitted to use contributions toward expanding the service for
which the contributions were given by following either:
(1) the Addition Alternative as stated in 45 CFR 92.25(g) (2); or
(2) the Cost Sharing Alternative as stated in 45 CFR 92.25(g) (3); or
(3) a combination of the two Alternatives.1
5007.5.3 T HE FSSA DA PROCEDURES REGARDING CONTRIBUTIONS
(a) The FSSA DA shall require each AAA to report all program income including
voluntary contributions, in-kind contributions and contributions received by the AAAs and
Service Providers from older adults or persons with disabilities.
(b) Contributions received by the AAAs and Service Providers from older individuals or
individuals with disabilities shall be monitored by the FSSA DA to assure the
contributions are applied to expand or increase services for which the contributions were
intended.
(c) The AAA's shall:
(1) define allowable uses of voluntary contributions to its Service Providers;
(2) require each Service Provider to make provisions for contributions to be made
by clients receiving the service and to encourage such contributions;
(3) monitor the Service Provider in the provision for, the receipt of, the accounting
for, and that the disbursement of all contributions. The Service Provider is
informing the client of the total cost of the service; and
(4) make sure the privacy of the contributor and the contribution is maintained
and that the Service Provider is informing older adults and persons with
disabilities of the total cost of the service.
1
Code of Federal Regulations, 45 CFR 1321.67 (b)(2)
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5007.5.4 SERVICE PROVIDERS POLICY AND PROCEDURES REGARDING PROGRAM
INCOME
(a) Service Providers shall do the following:
(1) provide an opportunity for clients receiving services, under the OAA, to make
voluntary and free contributions for the service being received based on:
(A) a determination made entirely by the individual; and
(B) information provided about the total cost for a Unit of Service.
(2) initiate a system or method, such as providing envelopes when appropriate,
by which the contributor can make a contribution without the knowledge of other
persons, to maintain the contributor's privacy. The Service Provider shall in no
manner give the impression that there is a charge for the service being received;
and
(3) make sure no older adults or persons with disabilities eligible to receive any
service funded with OAA money will be denied service because of failure to
contribute to the support of that service.
5007.5.5 IN-KIND CONTRIBUTIONS
(a) Third party in-kind contributions are property or services:
(1) that benefit a Title III supported service or program; and
(2) is contributed by non-federal third parties without charge to the AAA or
Service Provider.
(b) Third party in-kind contributions represent the value of non-cash contributions and
may be in the form of:
(1) charges for real property; or
(2) the value of donated goods or services that directly benefit and are
specifically identifiable to the service or program.
(c) Third party in-kind contributions shall be allowable as match or support for federal
grants:
(1) if they are utilized to benefit a project or program; and
(2) if the AAA or Service Provider would otherwise have to pay for the goods and
services.
(d) Costs and third party in-kind contributions counting towards satisfying a matching
requirement must be verifiable from the records of grantees and sub-grantee or cost -type contractors.
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(e) These records must show how the value placed on third party in-kind contributions
was derived. To the extent feasible, volunteer services will be supported by the same
methods that the organization uses to support the allocability of regular personnel
costs. 1
(f) A third party in-kind contribution shall not count as direct cost sharing or matching
where, if the AAA or Service Provider receiving the contribution were to pay for it, the
payment would be an indirect cost.
5007.5.6 T HE FSSA DA PROCEDURES REGARDING IN-KIND CONTRIBUTIONS
The FSSA DA is to complete the following procedures:
(1) require each AAA to develop a system that will account for and report all
allowable in-kind contributions received by an AAA or a Service Provider that
match or support federal grants under the OAA;
(2) require each AAA to report semiannually, as appropriate, in financial reports,
the amount of all in-kind contributions utilized in the provision of services; and
(3) monitor the system developed by the AAA and periodically review the AAA's
documentation on in-kind contributions.
5007.5.7 AAA POLICY AND PROCEDURES REGARDING IN-KIND CONTRIBUTIONS
(a) The AAA shall indicate all allowable in-kind contributions in the area plan and budget
or revisions and shall report in-kind expenditures to the FSSA DA on a quarterly basis
as required. Adequate documentation of the origin of the in-kind contribution shall be
maintained in the AAA's files.
(b) The AAA shall consult with the relevant Service Providers and older adults in the
AAA's PSA, to determine the best method for accepting voluntary contributions.2
5007.5.8 SERVICE PROVIDER POLICY AND PROCEDURES REGARDING IN-KIND
CONTRIBUTIONS
(a) Service Providers shall include all third party allowable in-kind contributions in
proposals or grant applications to AAAs and report in-kind expenses as required.
(b) Service Providers shall maintain adequate records of all allowable in-kind
contributions and provide appropriate documentation for review by the AAAs as
required.
(c) In-kind contributions used as support need not meet the requirement that the provider
could pay for the service if the service expands the program.
1
2
United States Code, 42 USC 3030c 2(b)(2)
United States Code, 42 USC 3030c 2(b) (2)
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5007.5.9 CARRYOVER FUNDS
(a) It is the policy of the FSSA DA to encourage full expenditure of the contracts as
appropriate within the contract period. Carryover funds are defined as those dollars
remaining in a contract following the closeout of the contract. These funds can be made
available in subsequent fiscal periods, subject to any state or federal rules. Only Title III
A - E and Title VII are affected by this provision. The SSBG funding source is at the
discretion of the DDRS director. Carryover cannot be assured for any of these programs.
(b) The AAAs need to submit to the FSSA DA closeout reports documenting carryover
amounts before the FSSA DA can grant the AAA the use of the carryover funds.
(c) The FSSA DA reserves the right to retain any or all carryover dollars, including the
right to distribute the carry-over dollars by the applicable allocation formula.
5007.5.10 MATCHING FUNDS
(a) Programs under Title III, Title V, and Title VII of the OAA require that federal funds be
matched by state and/or local funds.
(b) The AAA shall report the expenditure of non-federal matching funds to the FSSA DA
on a periodic basis, in compliance with the matching-fund requirement.
(c) The percentage of matching state and/or local funds to federal funds is as follows:
Title
Federal Funds
III-A
III-B
III-C
III-D
III-E
V
VII
85%
85%
85%
85%
75%
90%
85%
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Matching NonFederal Funds
(State and Local)
15%
15%
15%
25%
10%
15%
25
(d) As long as the minimum amounts are secured, the mixture of the funds i.e.,
how much of the match is local or how much of the match is state) is optional.
Matching funds can be monetary, in-kind or state and local monies. No federal
funds can be used as match for these programs or for the purpose of securing
other funding from the state of Indiana or the United States government.
(e) Adult Guardianship Services, a state funded program, requires that state
funds be matched by local funds. The percentage of matching local funds to
state funds for adult guardianship services are as follows:
State Funds
Matching Local Funds
75%
25%
(f) Adult Protective Services, a state funded program, requires that state funds
be matched by local funds. The percentage of matching local funds to state
funds for Adult Protective Services is as follows:
State Funds
Matching Local Funds
75%
25%
5007.6 SERVICES
Specific programs administered by the FSSA DA place restrictions on services
or minimum/maximum amounts that must be spent.
(1)Title III-B
Key service areas must be budgeted to spend a minimum amount, which
is a percentage of the allocation and prior year carryover. These
percentages are as follows:
(A) 40% for access services, which includes the following:
(I) case management;
(ii) information and assistance;
(iii) outreach;
(iv) transportation; and
(v) assisted transportation.
(B) 15% for in-home services, which includes the following:
(i) adaptive services;
(ii) adult day care;
(iii) attendant personal care;
(iv) homemaker; and
(v) other services necessary to prevent institutionalization.
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(C) 3% for legal services (Legal Assistance)
(D) 3% for ombudsman services (Long-Term Care Ombudsman
services)
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5008 ADULT PROTECTIVE SERVICES FISCAL POLICIES AND PROCEDURES APPLICABLE
TO FSSA DA CONTRACTS (2005 COMPLIANCE)
5008.1 ADULT PROTECTIVE SERVICES FUNDING ACCOUNT
Adult Protective Services Acct. 1000-122740 5008.2 - ADULT PROTECTIVE
SERVICES BUDGETS
5008.2 ADULT PROTECTIVE SERVICES BUDGETS
(a) Budgets are to be prepared on an annual basis as part of the contracting process.
The amount of the budget is constrained by the amount of funds allocated to each
prosecutor's district(s) covered in the contract.
(b) With the prior written approval of the FSSA DA, a prosecutor's district(s) budget may
be modified in the contract year and during the closeout period of the contract.
(c) A formal contract amendment is required to increase or decrease the amount of a
contract.
5008.3 ADULT PROTECTIVE SERVICES FUNDING FORMULA
(a) A contract is a written agreement between the FSSA DA and a County
Commissioner and/or Prosecutor that describes the payment of money and
responsibilities of the parties for the various federal and state programs for the delivery
of services.
(b) Contract amounts are not negotiated but are a result of the allocation of funds based
on respective funding formulas. A request for a contract is initiated by the FSSA DA. The
document is prepared and sent to the AAA or service provider who signs and returns the
document to the FSSA DA.1
(c) The document must also contain appropriate signatures from the director of DDRS,
the Department of Administration, the State Budget Agency, and the Office of the
Attorney General. A completed copy is mailed to the AAA or prosecutor's office. The
original contract is maintained by the FSSA DA.
5008.4 DISTRIBUTION OF ADULT PROTECTIVE SERVICES FUNDING FORMULA
(a) Funding will be distributed based on the Intrastate Funding Formula (IFF) county
distribution table to be developed for use with the Adult Protective Services program,
1
Special Note: The term request for a contract references a specific act by DOA, namely the preparation of
the Executive Document Summary (EDS). This is true for all funds or all contacts, even those that are the
result of RFPs or BAAs.
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using a cross section of adults for which services were rendered during the prior fiscal
year.
(b) This procedure will be instituted with the inception of the FY 2006 contracts.
Current contract funding at the time of this publication was determined based on
previous patterns and statistics.
5008.4.1 ADULT PROTECTIVE SERVICES PROSECUTOR PROVISIONS FOR
EXPENDITURES
See 5007.4.2 - AAA Provisions for Expenditures.
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5009 F ISCAL POLICIES AND PROCEDURES APPLICABLE TO ALL THE FSSA DA
CONTRACTS (AAA SPECIFIC)
5009.1 INSURANCE AND BONDING
(a) The provider shall provide general liability insurance coverage in a minimum
amount of $500,000 for bodily injury and property damage. The grantee (usually
the AAA) shall also secure insurance in amounts sufficient to reimburse the
grantee for damage to any property purchased with state funds. The FSSA DA
may at its discretion require the grantee to furnish additional or different
insurance or bonding coverage.
(b) When the provider is a department or division of the state of Indiana or of a
county or local government, the foregoing insurance coverage shall not be
required; however, the grantee may elect to provide such coverage. The grantee
shall provide for workers' compensation and unemployment compensation as
required by Indiana law. 1
(c) The AAAs must provide the FSSA DA with certificates of insurance that
illustrate the following, in regards to AAA insurance policies:
(1) the types of coverage;
(2) the limits of liability; and
(3) the expiration dates.
(d)The AAA shall provide a bond or insurance coverage for all persons who will
be handling funds or property as a result of the contract or who may carry out the
duties specified in the contract:
(1) in an amount equal to one-half of the total annual funding provided to
the AAA through the state; or
(2) in the amount of $125,000, whichever is less, to be effective for the
period of the contract plus three years for purposes of discovery.
(e) The provider's coverage must do the following:
(1) provide protection against losses resulting from criminal acts and
wrongful and negligent performance of the duties specified in the
contract; and
(2) specify the state of Indiana as an obligator or additional insured.
(f) The AAA shall immediately notify the FSSA DA if the amount of the bond or
insurance is canceled or modified. In the event of cancellation, the FSSA DA
shall make no further disbursements until certification is provided by a bonding or
1
Indiana Code, IC 22-3-2 and IC 22-4
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insurance company that the provisions set forth in this section have been
satisfied.
(g) In the event such verification is not received by the FSSA DA within 10 days
of the notice of cancellation, the AAA shall agree to return to the FSSA DA the
balance of all money paid to the AAA by the FSSA DA under the contract. The
FSSA DA may at its discretion require the AAA to furnish additional or different
bond or insurance coverage.
5009.2 PROCUREMENT
(a) The FSSA DA and the AAAs shall adhere to the procurement policies defined
in the following to procure real and personal properties and services:
(1) Family and Social Services Administration Procurement Procedures
Manual; and
(2) Code of Federal Regulations, 45 CFR, Part 74, Appendices G and H.
5009.2.1 PROCUREMENT GUIDELINES
(a) Maintaining documentation of acquisitions is recommended to foster
confidence in the administration of public funds. Open competition is our
best tool in maintaining accountability. In addition, with proper
specifications and research, the best products and services may be
obtained at the best price possible. 1
(b) Open competition or competitive bidding, is a process used to
determine the lowest most responsive vendor. Open competition is
obtained by alerting the vendor community to a need defined by the
purchaser. Information can be distributed in a variety of methods,
including phone quotations, written quotations and sealed bids.
(c) Information concerning ethics guidelines and Request For Proposals
(RFP's has been taken from the Indiana Department of Administrations
(IDOA) procurement manual and can be used as examples for processing
acquisitions. The IDOA Procurement guidelines are available at
http://www.in.gov. Information found at the IDOA website can be useful in
assisting with procurement policies.
(d) The FSSA and the FSSA DA are State Agencies and are required to
follow all2 procurement codes, laws, (specifically IC 5-22) and procedures.
It is highly recommend that any funds obtained from FSSA should also be
contracted in accordance with policies that follow Indiana Code 5-22. The
FSSA DA and the AAA's are not required to process purchases through
IDOA, however, if an acquisition is processed through IDOA all current
1
2
Added 5/13/05
Added 5/13/05
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procurement codes and procedures will apply.
(e) The following recommendations are to assist with obtaining goods and
services at competitive prices. It is important that the funding source be
considered when making a purchase. Certain additional guidelines may
or may not1 apply relevant to the funding source (state, federal, or local).
(f) For example most federal funds must be contracted in accordance with
the Office of Management and Budget (OMB) Circulars. You must meet
the minimum requirement regarding purchases for that funding source. It
is essential that the AAA follow guidelines set up by the funding source.
Depending on the estimated price, (you may obtain informal estimates
from vendors to determine a base cost), the following procedures apply:
(1) on all purchases, minority and women vendors should be
actively sought for quotations. A good faith effort must be made
for each acquisition for minority business participation. The FSSA
DA or the AAA's may contact the Minority Business Development
area of IDOA for information on assistance in seeking minority
vendors. MBD has a directory of minority vendors available. For
this information, please call at (317) 232-3061 or visit the Internet
web site at http://www.in.gov. Additional information on Minority
Business is available in Chapter 19 of the IDOA Procurement
Manual, found at the above web site;
(2) Purchases of $01-$4,999 do not require formal competition. It
is recommended that informal methods be used to ensure a fair
and reasonable price is obtained. Informal methods include;
catalogs, sale flyers, and phone quotes. It is recommended that a
brief notation explaining how and why the vendor was chosen and
the purpose of the purchase be kept with the receipt, along with
any other documentation of the purchase;
(3) Purchases of $5000-$9,999 require either informal or formal
competition. Informal methods can be phone quotes, sale flyers or
catalogs, however if these methods are used, written documentation
listing vendor and price should be maintained in the purchase file. You
may also obtain written quotations, by faxing or mailing your requirements
to several vendors. All vendors should receive identical requests for
quotation to ensure all vendors have the same information available to
prepare a response. It is recommended that at minimum, three vendors
be contacted to ensure proper competition. No vendor should be given
any information concerning the purchase unless the information is shared
with all vendors;
(4) Purchases of $10,000-$24,999 should be obtained by written
quotations and evaluated based on specifications and price. Vendors
should be given a reasonable amount of time to respond to quotations; a
minimum of 7 days is recommended, unless there are time constraints
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that should be noted in the purchase file; and
(5) Purchases over $25,000 should be obtained through written
quotations, with public notification provided in several newspapers or
other publications. Advertisements in newspapers and on the Internet are
good tools for seeking out available vendors. The Internet is useful as a
search tool to check vendor availability for a product or service.
(6) Procurements may be required to be justified. The more information
that reflects an open and competitive process, the safer it will be if
challenged on a selection of a vendor.
5009.2.2 T HE FSSA DA POLICY AND PROCEDURES CONCERNING
PROCUREMENT
(a) The FSSA DA shall monitor, assess, evaluate, and provide technical
assistance and training on procurement for the AAAs.
(b) The FSSA DA shall also abide by the regulations of the following entities that
are consistent with 45 CFR, Part 74:
(1) the Indiana Department of Administration;
(2) the State Budget Agency;
(3) the State Board of Accounts; and
(4) the Attorney General.
5009. 2.3 AAA POLICY AND PROCEDURES REGARDING PROCUREMENT
(APPLICABLE TO AAAS ONLY, NOT CONTRACTS WITH OTHER PROVIDERS
(a) All grant applications to the FSSA DA shall identify the following:
(1) real properties and/or facilities to be acquired, altered, renovated, or
constructed;
(2) the probable costs of the acquisition, alteration, renovation, or
construction of real properties and/or facilities; and
(3) the rationale for acquiring, altering, renovating, or constructing
real properties and/or facilities.
(b) AAAs and their service providers shall have and implement
procurement policies and procedures that shall be consistent with 45 CFR
Part 74, Appendices G and H.
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5009.3 EQUIPMENT
(a) Equipment is tangible, nonexpendable personal property, including exempt
property charged directly to the grant award by an AAA, having the following:
(1) a useful life of more than one year; and
(2) an acquisition cost $5000 or more per unit.
5009.3.1 EQUIPMENT PURCHASES
(a) The DDRS will consider approval for the purchase of equipment for an
item costing $5000 or more only after a procurement request,
accompanied by copies of 3 written price bids, is submitted to and
approved by the FSSA DA.
(b) Requests to procure from an entity at a price above lower price
estimates must have justification. If 3 bids are not available, an AAA shall
request a waiver regarding the requirement for 3 written price bids. (FSSA
Procurement Procedures Manual, Subgrantee Procurement Policy)
(c) For purchases of equipment, an AAA must request approval and have
approval granted in advance of the purchase.
(d) Purchases completed without approval will not be considered for
reimbursement.
5009.3.2 PURCHASES OF VEHICLES
(a) To ensure compliance with federal regulations, the FSSA DA by
contract must be a lien holder on all vehicles purchased with funding
obtained through the FSSA DA.
(b) When a vehicle has been purchased by an AAA, the original title of
the vehicle title document shall be sent to the FSSA DA.
(c) The FSSA DA will forward the vehicle title document to the legal
division of DDRS to ensure that the lien-holder information is in order.
(d) At the discretion of the FSSA DA, the vehicle title may be changed to
reflect the state as the lien holder if more than 50% state or federal funds
are used for the purchase of the vehicle.
5009.3.3 EQUIPMENT INVENTORY RECORDS
(a) The AAA shall maintain all records relative to the contract:
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(1) During the effective period of the contract and for a period of
three years from the date the AAA submits its final claim to the
FSSA DA; or
(2) One year from the resolution of any outstanding administrative,
program, or fiscal audit question; or legal action; whichever is
later.
(b) The retention period for records relating to any equipment authorized
to be purchased through the contract begins on the date of the
disposition, replacement, or transfer of ownership of such equipment.
(c) Upon request, the provider shall maintain and provide to the FSSA DA
a schedule of the following, in the provider's possession, purchased with
federal or state funds:
(1) all inventory;
(2) all capital equipment; and
(3) any unusable property.
(d) The schedule shall include the following:
(1) a brief description of the property;
(2) a serial number or other identification number of the property;
(3) the funding source under which the property was purchased;
(4) the name of the entity in which title to the property is vested;
(5) the acquisition date and cost of the property;
(6) the percentage of federal and/or state participation in the cost
of the property;
(7) the location, use, and condition of the property; and
(8) any ultimate disposition data, including the date of disposal
and sale price upon disposition.1
1
DDRS Contract
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5009.3.4 DISPOSAL OF PROPERTY
(a) The provider shall not dispose of, replace, or transfer any
equipment authorized to be purchased with funding obtained
through the FSSA DA, without the express written approval of the
FSSA DA.1
(b) Money received from the sale of property used to provide a
service or program shall be used toward the cost of the service, or
to expand such services, and shall be regarded as program
income.
5009.3.5 DISPOSAL OF VEHICLES
If a provider at any time requests approval for disposal, transfer,
or replacement of a vehicle and is granted written approval, the
FSSA DA will release the lien. 2
5009.4 AUDITS
It is the responsibility of the FSSA DA to provide accurate, current, and
complete disclosure of the financial results of each project or program in
accordance with the financial reporting requirements of the grant. In
adhering to this responsibility, the FSSA DA requires all grantees to
follow procedures outlined in the "boilerplate" of contracts with regard to
reporting requirements.
5009.5 CLAIM REIMBURSEMENT POLICIES AND PROCEDURES
The FSSA DA maintain certain procedures and policies regarding claim
reimbursement for service providers and the AAAs. Any questions not
addressed in this section of the Operations Manual regarding claim
reimbursement policies and procedures may be submitted to the FSSA
DA director.
5009.5.1 HOW TO FILLOUT CLAIM FORMS
The appropriate claim forms are to be used for reimbursement for
expenses incurred by the grantee. These claim forms are to be
filed based on actual expenses incurred in the process of carrying
out the duties listed in the grantee-obligatory portion of an
executed contract. By submitting this claim form, the grantee is
pledging that the conditions of the contract have been fulfilled and
that all amounts claimed are legally due for reimbursement.
1
2
DDRS Contract
FSSA Legal Division Memo – November 14, 1994
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5009.5.2 L OST CLAIMS PROCEDURES
(a) It is necessary that grantees keep copies of each claim. If a claim has
not been reimbursed to the grantee within 20 business days from the date
of submission, it is correct to conclude the claim has possibly been
misplaced during the payment process.
(b) Grantees can contact the fiscal manager of the FSSA DA by phone or
e-mail with this problem. A second set of originals may be asked for at
that time to be submitted to the claims processing area by the fiscal
manager of the FSSA DA. Lost claims will be expedited as soon as
possible.
5009.5.3 L ATE CLAIMS PROCEDURES
Tardy claims submitted beyond the 90-day limit will need to be approved
under the late claims procedures set forth by FSSA financial management
in Bulletin 5, revision date, January 1, 2004. This added procedure will
require from the provider a letter listing the barriers that prevented timely
submission of the claim. Approval or denial of late claims is at the
discretion of the FSSA DA and financial management directors. 1
1
Claims submitted beyond the 60 day limit will need to be approved under the late claims procedures set
forth by FSSA financial management in Bulletin 5.
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More Information can be found in:
Older Americans Act of 1965, as amended in 2000 325(b) (1)-(4)
Code of Federal Regulations
45 CFR Part 74 - Administrative requirements for Non-Profit Corporations
45 CFR Part 92 - Administrative Requirements for State and Local Governments
45 CFR 1321 Title III Regulations
45 CFR 1321.67
United States Code 42 USC 3030c-2
P.L.106-501
Circular A-87 Cost Principles for State and Local Government Circular A-122
Cost Principles for Non-Profit Organizations Circular A-133 Audits of States,
Local Governments and Non-Profit Organizations
Indiana Code
Title 12 and Title 460
Websites
Administration on Aging – http://www.aoa.gov
Access Indiana – http://www.state.in.us
Indiana Association for Area Agencies on Aging – http://www.IAAA.org
GPO Access – http://www.access.gpo.gov
INDIANA DIVISION OF AGING Operations Manual
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SECTION 6
6000 THE FSSA DA DATA MANAGEMENT SYSTEMS
Table of Contents
6000 DATA MANAGEMENT
6001 ADMINISTRATIVE SERVICE UNIT
6002 DATA MANAGEMENT UNIT
6003 COMPUTER SOFTWARE MANAGEMENT SYSTEM
6003.1 Other Uses for Computer Software Management Systems
6003.2 Reports and Queries
6003.3 Ad-Hoc Requests and Queries
6003.4 Technical Support
6003.5 Software Contractor Liaison
6003.6 EDS/MARS (Electronic Date Services/Management and Report
System)
6003.7 Related FSSA DA Software Support
6004 AAA RESPONSIBILITIES
6004.1 AAA Data Entry Completion Time Frames
6004.2 The Bureau Information Directory (BID)
6004.3 The FSSA DA Website1
CHART 15
ILLUSTRATION OF THE DATA UPLOAD PROCESS
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6000
D ATA MANAGEMENT
The Division of Aging of collects client, fiscal and provider data generated by the Area
Agencies on Aging (AAAs).
6001 ADMINISTRATIVE SERVICE UNIT
(a) The Administrative Services Unit (ASU) provides support and monitoring services to
the Division of Aging. The ASU has responsibility for the maintenance of supplies,
equipment, management and data systems, and procedures to assure an informed and
prepared staff, to carry management, supervisory, and program responsibilities.
Included, but not limited to these services are:
(1) development and maintenance of policies, procedures, and manuals;
(2) personnel and Human Resource needs;
(3) red folder correspondence;
(4) data management;
(5) use of data reports;
(6) development and maintenance of manuals;
(7) equipment and supplies;
(8) orientation of staff;
(9) development and technical support of data-based applications;
(10) assistance (trouble shoot) with office equipment problems, including PC;
(11) research and assistance with laws, rules, and procedures;
(12) printing request;
(13) purchasing of equipment and supplies;
(14) consultation and technical assistance on Agency, State and Federal laws,
rules, and procedures;
(15) maintain information on Website (Access Indiana); and
(16) oversee HIPAA compliance.
6002
DATA MANAGEMENT UNIT
(a) The ASU manages the data and regularly produces reports for distribution and
review in response to information requests from a variety of sources, including requests
from the FSSA DA and from outside State government. These reports and queries
typically contain client count and fiscal calculations for the programs administered
through the FSSA DA.
(b) A goal of this report generation is to establish consensus and consistency of
responses to information requests. These reports are also used in conjunction with
reports from other divisions that monitor the same population of clients. The ASU
represents the FSSA DA for all data management related activities, meetings and
committees.
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6003 C OMPUTER SOFTWARE MANAGEMENT SYSTEM (CSMS)
(a) The Administrative Services Unit (ASU) uses a computer software management system
(CSMS) to facilitate the collection and organization of client information and provider data. 1
(b) At the local level, the AAA’s use CSMS application to input client data. There is a contractual
arrangement between the Division of Aging and the AAAs that this application is used to collect
client data.2
(c) Data is uploaded to the FSSA Division of Aging, on a daily basis for inclusion in the FSSA
DA program. This data provides the basis for reports and for queries developed by the FSSA
DA in response to information requests. (See data flow chart for specific method of data
transfer.)
6003.1 OTHER USES FOR COMPUTER SOFTWARE MANAGEMENT SYSTEMS
(a) FSSA DA staff also use the computer software management system (CSMS) to:
(1) retrieve information;
(2) modify client records;
(3) delete or add client data; and
(4) review case information.
(b) Currently, the CSMS contains a registry of the following documents:
(1) A & D Renewal -2003
(2) Adult Day Service Manual
(3) Assisted Living Manual
(4) Autism Waiver Manual
(5) FSSA DA Bulletins
(6) FSSA DA Operations Manual
(7) BDDS Policy and Procedures Manual
(8) BQIS Annual
(9) Providers\Case Management Survey
(10) CHOICE Guidelines and Procedures
(11) DD Bulletins
(12) DD Waiver Manual
(13) DDP Instructions
1
2
The current software contractor is the Roeing Corporation and the current system in use is called INsite
DDRS/IDA/AAA Agreement Contract 2004, General Provisions Section, Paragraph 1
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(14) EDS Bulletins
(c) The CSMS may add new documents to the registry, when the need is made evident.
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CHART 15
Illustration of the Data Upload Process
Independent Case
Managers
ISP Users
(Website
Users)
Area Agencies
on Aging
FTP
FTP
HTTP
Cisco PIX
Firewall
Internet
Software
Contractor
FTP Splitter
Win2k Server
FTP Services
ISP Web Application
Win2k Server
ASP.Net
Visual Basic .Net
SQL 2000
Visual FoxPro 6
Visual Basic 6
SQL Server 2000
Cisco PIX
Firewall
Internet
FTP
INDIANA DIVISION OF AGING Operations Manual
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FSSA
- DA
1
6003.2 R EPORTS AND QUERIES
The FSSA Division of Aging regularly uses client centered data in the administration and
oversight of in-home and community–based services. Data used in reports and queries
include, but are not limited to information regarding:
(1) Gender
(2) Age
(3) Disability
(4) Household Income
(5) Demographics
(6) Service Costs
(7) Providers
(8) Family Size
(9) Payor (Funding Source)
6003.3 AD-HOC REQUESTS AND QUERIES
(a) Information requests which cannot be answered through the use of standard report methods,
are referred to as ad-hoc requests, or queries. Since these types of information requests are
one-time requests in response to specific questions or needs that are outside the scope of
normal report production. These requests are handled in 3 ways:
(1) A query is written by the ASU using raw data. The ASU staff have experience
utilizing the query language which manipulates the CSMS data.
(2) If the ad-hoc query is too complicated for an in-house query, a request is made to the
software contractor to have the query written.
(3) When standard reports are run or ad-hoc queries are written in response to
information requests, the unit identifies for the requestor, within reason, the report
source and logic. This is an attempt to maintain understanding and consistency in report
production.
6003.4 TECHNICAL SUPPORT
(a) The ASU also provides technical support, including:
(1) Software installation for the FSSA Division of Aging and other staff.
(2) Configuring user computers to allow the appropriate operation of the software.
(3) Assigning user names, passwords and level of access for the FSSA Division of
Aging staff.
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(4) Performing updates to the software as instructed by the software contractor.
(5) Troubleshooting software/hardware issues for the FSSA Division of Aging in
conjunction with the software contractor and DTS.
6003.5 SOFTWARE CONTRACTOR LIAISON
The contractor will notify ASU when the system is taken off line for program modification,
updates or maintenance.
6003.6 EDS/MARS (ELECTRONIC DATA SYSTEMS/MANAGEMENT AND REPORT SYSTEM)
Expenditure information for the Medicaid Model Waivers is obtained from the EDS/MARS
system. The CSMS is not used for cost information for the waivers, since the costs contained
therein are estimated only.
6003.7 RELATED FSSA DA SOFTWARE SUPPORT
The ASU supports a variety of in-house software applications developed by the ASU, in
response to FSSA DA needs. Where appropriate, new applications may be developed and
maintained according to the FSSA DA need.
6004 AAA RESPONSIBILITIES
(a) The FSSA DA must have the most current client data in order to utilize report features and
to develop queries of its own when necessary.
(b) The AAAs will provide data regarding IN-HOME services to the FSSA DA by means of the
specified data reporting system on a daily basis and the NAPIS system on a monthly basis. All
data transmissions to the FSSA DA for the NAPIS system data are to be completed on the 15th
of each month. The method and manner of providing the data will be prescribed by the FSSA
DA and shall include the unduplicated count of clients, services by type, number of services and
frequency of services, funding source, and number of providers. All software updates provided
by the software contractor must be installed by each AAA within 15 days of receipt to ensure
accurate data transmissions to the FSSA DA. If a software failure occurs that would effect the
transmission of data to the FSSA DA, the AAA must notify the FSSA DA within a 15 day period,
starting from the date of the first software failure.
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6004.1 AAA DATA ENTRY COMPLETION TIME FRAMES
(a) Area Agency on Aging time frames for data entry has been established as such:
(1) the AAAs shall provide data regarding In-Home Services to the FSSA DA on a daily
basis;1
(2) the AAAs shall conduct consumer satisfaction surveys of consumers, per funding
source of consumers receiving In-Home services using the Quality Improvement
Program prescribed by the FSSA DA. The data shall be submitted to the FSSA DA on a
quarterly basis in a method and manner prescribed by the FSSA DA;2 and
(3) National Aging Programs Information System (NAPIS) data transmitted to the FSSA
DA by the AAAs should be complete, accurate, and should include all AAA generated
NAPIS related data reports including;
(A) expenditures/non-federal;
(B) focal point data;
(C) staffing;
(D) other service profile data; and
(E) non-registered client estimates.
(4) Final submission of NAPIS data is due no later than 90 days following the end of the
state fiscal year.
6004.2 T HE BUREAU INFORMATION DIRECTORY (BID)
(a) The Bureau Information Directory (BID) serves as a repository of official FSSA DA
information. A primary purpose of this system is the provision of an official central location of
information that can be accessed by all FSSA DA staff and thereby provide consistency for
reporting purposes and distribution of information. Other uses include but are not limited to:
(1) Staff and unit responsibilities
(2) Official client counts by program
(3) Organizational Chart
(4) Website access for FSSA DA related topics
(b) The BID system is expected to undergo additions and modifications of features as the
function of the BID is better defined by FSSA DA use and need.
1
DDRS/FSSA DA/AAA Agreement Contract 2004, General Provisions Section,
Paragraph 1.
2
DDRS/FSSA DA/AAA Agreement Contract 2004, General Provisions Section,
Paragraph 1.
INDIANA DIVISION OF AGING Operations Manual
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6004.3 THE FSSA DA WEBSITE
(a) The FSSA DA Data Management Unit also manages the FSSA DA Website. The FSSA DA
website address is http://www.in.gov/fssa/elderly/aging/index.html.
(b) Among other documents and information, the FSSA DA website contains:
(1) Provider Information
(2) The Statewide In-Home Services Annual Report
(3) The FSSA DA Operations Manual
(c) New or revised information to be placed in the FSSA DA website shall be given to the Data
Management Unit, which in turn will contact the State webmaster.
(d) The Data Management Unit may review, edit or revise information, according to need, before
it is sent to the State webmaster for placement in the FSSA DA website.
(e) The FSSA DA website may be accessed through the BID by completing the following steps:
(1) Clicking on the BID icon, then
(2) Clicking on FSSA DA and Related Websites. 1
1
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PART 3
SECTION 7
7000 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
OF1996 (HIPAA)
Table of Contents
7000 HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
OF1996 (HIPAA) (PC 104-191)
7001 THE FSSA DA POLICY AND PROCEDURES REGARDING HIPAA
COMPLIANCE
7002 HIPAA COMPLIANCE POLICY FOR THE FSSA DA INCLUDING
SECURING CENTRAL, ELECTRONIC AND INDIVIDUAL FILES (DESKS)
7002.1 Copy Room
7002.2 Fax Machines
7002.3 Copier/Printer
7002.4 Phone/Public Areas
7003 DISPOSAL OF PROTECTED HEALTH INFORMATION (PHI)
7004 AAA POLICY AND PROCEDURES
7005 SERVICE PROVIDERS POLICY AND PROCEDURES
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7000 H EALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
(HIPAA) (PL104-191)
(a) The Health Insurance Portability and Accountability Act of 1996 (HIPAA) affects the
handling of Protected Health Information (PHI).
(b) Compliance with the HIPAA is to insure and maintain privacy and confidentiality of
sensitive materials, including personal health information of individuals, in accordance
with HIPAA laws. (PL 104-191)
(c) Protected Health Information (PHI) includes demographic information collected by the
FSSA DA, that relates to the past, present, or future physical or mental health or
condition of an individual.
(d) PHI also includes past, present, or future payment provision of healthcare to an
individual, and identifies (names) the individual, or information that can be used to
identify the individual, such as SSN or address. Names and addresses alone are not
protected information. It must be accompanied by medical information.
7001 THE FSSA DA POLICY AND PROCEDURES REGARDING HIPAA COMPLIANCE
Employees of the FSSA DA shall adhere to the guidelines listed in this part of the FSSA
DA Operations Manual and to the rules of the Health Insurance Portability and
Accountability Act of 1996 (HIPAA) (PL104-191).
7002 HIPAA COMPLIANCE POLICY FOR THE FSSA DA INCLUDING SECURING
CENTRAL, ELECTRONIC AND INDIVIDUAL FILES (DESKS)
(a) All PHI is to be filed in locking file cabinets, whether in the central files or in individual
files.
(1) Keys for the central files will be maintained by the office manager. The Asst.
Director of Administrative Services and the HIPAA Coordinator will serve as
back-ups for the office manager.
(2) Each individual will be responsible for locking his/her own files and desks
nightly. Keys can be obtained from the office manager, who will keep a duplicate
key for each cubicle or cabinet in a locked location.
(b) Should an employee need to be away from the workstation for any length of time,
PHI needs to be secured. For short trips away, such as going to the restroom or copier,
PHI must be removed from sight until the return of the employee.
(c) Electronic files or computer applications containing PHI must be exited or obscured
by a password protected screensaver prior to employees leaving the workstations. No
applications should be left “open” overnight.
(d) Unauthorized persons may not view files, electronic or otherwise, containing PHI at
any time. “Unauthorized persons” is defined as staff persons not directly associated with
FSSA DIVISION OF AGING Operations Manual
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the case/program. This may include staff from other areas or divisions.
(e) Files containing confidential information are not to be removed from the office unless
written authorization is received by the FSSA DA Director. Requests must be made in
writing or e-mail, prior to the removal of the information and must state the purpose of
the removal, the length of time the information will be out, and the location that the file
will be used. In addition, the request and approval must show the date and time the
request was submitted and subsequently approved.
7002.1 COPY ROOM
(a) The copy room will be off limits to any individual who is not HIPAA certified or
accompanied by a HIPAA certified staff person. Individuals who are HIPAA certified
must have proof of HIPAA certification on file with the HIPAA coordinator.
(b) Signs will be posted outside the copy room stating this policy.
7002.2 FAX MACHINES
(a) The office manager will designate individuals who will check the fax machines 3
times daily to remove any PHI. These documents will be distributed into the fax boxes
located between the machines. Individuals are responsible for retrieving/filing and or the
destruction of these documents.
(b) The fax machines are set to receive overnight documents into their memory banks.
Overnight faxes will be retrieved each morning by an individual designated by the office
manager or Assistant Director of Administrative Services.
7002.3 COPIER/PRINTER
(a) Any document containing PHI that is copied on the FSSA DA copier must not be left
unattended and must be removed immediately upon completion of the task.
(b) Any documents containing PHI sent to the copier for printing must either:
(1) be removed immediately upon completing the print task; or
(2) be stored in the individual’s electronic mailbox contained in the hard drive of
the copier for later printing. See the FSSA DA office manager for instructions on
printing to your mailbox.
(c) At no time should documents containing PHI be left on any of the network printers.
7002.4 PHONE/PUBLIC AREAS
Employees are required to use reasonable measures such as speaking in a soft voice
when discussing confidential issues when on the phone or in public areas.
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7003 DISPOSAL OF PROTECTED HEALTH INFORMATION (PHI)
(a) According to the Indiana Commission on Public Records General Retention
Schedule, inactive client files are to be retained for 3 years once the files have become
inactive. After 3 years of inactivity, client files are to be destroyed. 1
(b) Bank statements for the Money Management Program will be retained in the FSSA
DA for 3 years and then will be transferred to the Records Center, and will subsequently
be destroyed after 12 more years (15 years total). 2
(c) Once inactive files achieve the required retention, those files are to be shredded.
(1) Employees may use the FSSA DA shredder on small amounts of PHI
documents.
(2) PHI can be deposited in the locked container located on the 4W freight
elevator loading dock.
(d) Each Unit is responsible for the disposal of their PHI waste on a daily basis. The Unit
Manager can determine how that is to be done, but it must be done daily. No PHI
should be put in an unsecured recycle box at any time.
7004 AAA POLICY AND PROCEDURES
(a) AAAs will provide assurances of compliance with Public Law 104-191 (HIPAA)
through written policy and procedures.
(b) These assurances will include policies and procedures regarding the following:
(1) PHI destruction;
(2) HIPAA files; and
(3) HIPAA copy/print/fax.
(c) The AAA will also provide assurances through written policy and procedures of all
Service Providers compliance with Public Law 104-191 (HIPAA).
7005 SERVICE PROVIDERS POLICY AND PROCEDURES
(a) Service Providers will cooperate with all monitoring procedures and assurances
performed by the AAAs, to insure adherence to HIPAA guidelines and policies. 3
(b) Service Providers will adhere to HIPAA guidelines regarding the disposal of PHI, in
using copy machines, fax machines, printers and in the use and storage of electronic
and individual files.
1
(GRADM-4) General Records Administration
(GRACC-3) General Records Accounting
3
Public Law 104-191 (HIPAA)
2
FSSA DIVISION OF AGING Operations Manual
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More Information can be found in the following:
Public Law 104-191
FSSA – ADI -18
Web Site
Indiana Family and Social Services Administration Intranet
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SECTION 8
8000 NUTRITION SERVICES
Table of Contents
8000 NUTRITION PROGRAM SERVICES
8001 RESPONDING TO THE NEEDS OF INDIANA’S OLDER ADULTS
8002 FUNDING SOURCES FOR INDIANA’S NUTRITION PROGRAM
8003 NATIONAL SERVICE INCENTIVE PROGRAM (NSIP)
8003.1 NSIP Meals
8003.2 Cash or Commodities to Supplement Meals
8004 PROGRAM SERVICES ELIGIBILITY
8004.1 Nutrition Services Program Income
8004.2 Voluntary Contributions
8004.3 Cost Sharing and Means Test
8004.4 Client Privacy
8005 DIVISION OF AGING POLICY AND PROCEDURES REGARDING
NUTRITION SERVICES
8005.1 Monitoring and Assessment
8005.2 Training Activities
8006 AAA POLICIES AND PROCEDURES REGARDING NUTRITION
SERVICES
8006.1 Congregate and Home Delivered Meals
8006.2 Congregate Meal Sites
8006.2.1 Meal Site Location
8006.2.2 Meal Site Services
8006.2.3 Postings at the Meal Site
8006.2.4 Home Delivered Meals
8006.2.5 Meal Delivery
8006.3 Meal Service Requirements
8006.3.1 Meal Frequency and Form
8006.3.2 Meal Planning Requirements
8006.4 Emergency Meals
8006.5 Volunteer and Disabled Individual Meals
8006.6 Restaurant Voucher Meals
8006.7 Requested Information
8006.8 Nutrition Screens
8006.9 Nutrition Education Activities
8006.10 Nutrition Counseling
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8006.11 National Program Information System (NAPIS)
8006.11.1 Units of Service (For NAPIS Reporting)
8006.12 Provision of Nutrition Services
8006.12.1 AAA and Provider Monitoring
8007 SENIORS FARMER’S MARKET NUTRITION PROGRAM (SFMNP)
8007.1 Eligibility for SFMNP
CHART 16 – Older Americans Act, Section 339 (2)(b)
CHART 17 – Older Americans Act, Section 315(b)(2)
CHART 18 – Older Americans Act, Section 315(b)(1)
CHART 19 – Division of Aging Policy Statement Regarding Nutrition
Services
CHART 20 – Older Americans Act, Section 339(2)(G)
CHART 21 – Older Americans Act Section 339(2)(J)
Appendix A - Menu Standards
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8000 N UTRITION PROGRAM SERVICES
Nutrition Program Services provide eligible participants with hot or otherwise appropriate,
nutritionally balanced meals served in a congregate setting where surroundings promote social
interaction among the individuals or home delivered meals to those participants in need of this
service. Individual nutrition assessments, individual nutrition counseling, group and individual
nutrition education, and outreach are also services provided as part of Indiana’s Nutrition
Program.
8001 R ESPONDING TO THE NEEDS OF INDIANA’S OLDER ADULTS
CHART 16
Older Americans Act, Section 339 (2)(B) A State that establishes and operates a nutrition project
under Title III-C shall provide flexibility to local nutrition providers in designing meals that are appealing to
program participants.
(a) The OAA allows flexibility to develop slightly different nutrition programs in each Planning
and Service Area (PSA). This means that Nutrition Providers can develop programs that are
responsive to local need. Service delivery for both congregate and home-delivered meals
programs can evolve with the needs of local nutrition services participants.
(b) Indiana’s Area Agencies on Aging and their Nutrition Providers are encouraged to think
broadly about defining nutrition services in terms of effective outreach to target populations,
screening, assessment, counseling, education, programming, service coordination, and
referrals, as well as meal provision.
8002 F UNDING SOURCES FOR INDIANA’S NUTRITION PROGRAM
(a) Nutrition services are funded by:
(1) Title III from the Administration on Aging (AoA) including the Nutrition Services
Incentive Program (NSIP); and
(2) Social Services Block Grant (SSBG) and the Aged and Disabled Medicaid Waiver
provide additional Federal funding. The State also provides funding for nutrition services
through the Older Hoosier Fund and the Community and Home Options to Institutional
Care for the Elderly and Disabled (CHOICE) Program. In addition, the local Area
Agencies on Aging supplement their nutrition service programs through Program
Income, and with local support from their PSA.
8003 N UTRITION SERVICE INCENTIVE PROGRAM (NSIP)
(a) Until 2003, the Nutrition Services program was administered by USDA as a cash and/or
commodities program to supplement OAA meals, but it has been authorized under the Older
Americans Act in one form or another, since 1978.
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(b) In 2003, administration of the program was transferred to the Administration on Aging. There
are no significant changes in the program as a result of this transfer. Commodities or cash in
lieu of commodities are still available. The new name refers to the fact that the cash or cash for
commodities allocation is a proportional share of a federal fiscal year allocation.
(c) As long as the meal satisfies the requirements of the OAA they are eligible to be reported for
purposes of the NSIP regardless of funding source. The more meals reported to AoA by the
State, the larger the state’s share of the federal allocation. The purpose of the program is to
reward performance in meal delivery by programs funded, in whole or in part, under Title III and
VI of the OAA.1
(d) For information regarding reporting requirements for NAPIS purposes, see Section 2037 of
this Manual.
8003.1 NSIP MEALS
(a) A Nutrition Services Incentive Program (NSIP) Meal is a meal served that meets all the
requirements of the OAA, which means at a minimum, the following:
(1) it has been served to a participant who is eligible under the OAA and has NOT been
means-tested2 for participation;
(2) it is compliant with the nutrition requirements;
(3) it is served by an eligible agency; and
(4) it is served to an individual who has an opportunity to contribute.
(b) NSIP meals also include home delivered meals provided as Supplemental Services under
the National Family Caregiver Support Program (Title III-E) to persons aged 60 and over who
are either care recipients (as well as their spouse of any age) or caregivers. 3
(c) NSIP cash may still be used to purchase U.S. agricultural commodities and other foods of
U.S. origin. NSIP funds may not be used to supplant funds previously earmarked for services to
older adults.
8003.2 CASH OR COMMODITIES TO SUPPLEMENT MEALS
(a) The AAA has the option to receive cash and/or commodities from the NSIP Program
(pending State approval).
(b) The AAA must ensure the nutrition service provider uses the commodities offered for meal
preparation and service to the meal program participant.
(c) The nutrition service provider is responsible for transportation, if necessary, proper storage,
1
United States Code, 42 USC Section 3030a
See Glossary of Terms found in the front of this manual.
3
Administration on Aging, HHS, Reporting Requirements For Title III and VII, March 2004
2
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and use of the food in a safe, efficient, and effective manner.
8004 PROGRAM SERVICES ELIGIBILITY
(a) The AAA is to ensure that nutrition services will be provided to older individuals and to their
spouses.1
(b) Service priority shall be given to participants who are age 60 or over and who are frail,
homebound by reason of illness or incapacitating disability, or otherwise isolated.
(c) The AAA may make available nutrition services to individuals with disabilities who are not
older individuals but who reside in housing facilities occupied primarily by older individuals at
which congregate nutrition services are provided. 2
(d) Refer to Operations Manual, Family Caregivers Support Program, Section 4011 for
information regarding delivery of meals to unpaid caregivers.
8004.1 NUTRITION SERVICES PROGRAM INCOME
CHART 17
Older Americans Act, 315(b)(2)
The Area Agency on Aging shall consult with the relevant service providers and older individuals in
agency’s planning and service area in a State to determine the best method for accepting voluntary
contributions…
8004.2 VOLUNTARY CONTRIBUTIONS
CHART 18
Older Americans Act, 315(b)(1)
Voluntary Contributions shall be allowed and may be solicited for all the services for which funds are
received under Title III, provided that the method of solicitation is non-coercive.
(a) The AAA must safeguard and account for all contributions and have written policies and
procedures in place to ensure collected contributions are used to expand nutrition services
within the PSA.3
(b) Program income includes voluntary contribution made by the client. For more information,
see Section 5007.5.4 - Service Providers Policy and Procedures Regarding Program Income of this manual.
(c) Also, see the Older Americans Act, Section 315.
1
2
3
Older Americans Act (as amended in 2000), Title III, Part C-Nutrition Services, Subpart 3,Section 339 (2)(I).
Older Americans Act (as amended in 2000), Title III, Part C-Nutrition Services, Subpart 3,Section 339 (2)(H).
Older Americans Act (as amended in 2000), Sec. 315. Consumer Contributions (b) Voluntary Contributions (4).
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8004. 3 COST SHARING AND MEANS TEST
(a) The State is not permitted to implement any cost share for congregate and home delivered
meals.1
(b) The AAA/provider, under the OAA may develop a suggested contribution schedule for
services provided. In developing a contribution schedule, the provider shall consider the income
ranges of older persons in the community and the provider’s other sources of income.
However, means tests may not be used.2
(c) For more information, see Section 5007.3 - The Division of Aging Procedures Regarding
Contributions- of this manual. Also, see the Code of Federal Regulations, 45 CFR 92.25(g) (3).
8004. 4 CLIENT PRIVACY
The AAA must ensure the privacy and confidentiality of each participant with respect to the
participant’s contribution or lack of contribution. 3
8005 D IVISION OF AGING POLICY AND PROCEDURES REGARDING NUTRITION SERVICES
CHART 19
Division of Aging Policy Statement Regarding Nutrition Services
The Division of Aging shall develop and coordinate a statewide nutrition program that will be administered
through 16 AAAs. The Division of Aging shall establish minimum standards for the delivery of nutrition
services.
(a) The Division of Aging shall establish, monitor, and assess the nutrition program to assure
operation in compliance with the OAA, Division of Aging Operations Manual, and Area Plan. 4
(b) The Division of Aging shall solicit the advice of a dietitian or individual with comparable
expertise in the planning of nutritional services. 5
8005.1 MONITORING AND ASSESSMENT
(a) The Division of Aging and United States Government shall have the right to enter the
premises of the AAA or any subcontractor of the AAA and audit any records and property
maintained by the AAA or its subcontractors in connection with their agreement with the Division
of Aging.
(b) The AAA and its subcontractors shall make all books, records and documents that relate to
their activities available for inspection, review and audit when requested by authorized
1
Older Americans Act (as amended in 2000), Sec. 315. Consumer Contributions (a) Cost Sharing (2), (C), and Title
Code of Federal Regulations 11/00, Title 45, Chapter XIII, Part 1321, Subpart D, Sec. 1321.67 (c).
3
Older Americans Act (as amended in 2000), Sec. 315. Consumer Contributions (b) Voluntary Contributions (4).
4
State/Grantee Agreement V. Audits, Records, Reports, and Inspections
5
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 3-General Provisions, Sec.339,
Nutrition, (1).
2
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representatives of the State of Indiana or the United States government. 1
(c) For information on Division of Aging monitoring and assessment responsibilities, see Section
2008 - Monitoring and Assessment.
8005.2 TRAINING ACTIVITIES
The Division of Aging shall provide technical assistance and training to AAA and service provider
staff as needed or requested.
8006 AAA POLICIES AND PROCEDURES REGARDING NUTRITION SERVICES
CHART 20
Older Americans Act, 339 (2)(G)
A State that establishes and operates a nutrition project under Title III-Part C- Nutrition Services is to
ensure the nutrition services program is provided through the advice of dietitians (or individuals with
comparable expertise), meal participants and other individuals knowledgeable with regard to the needs of
older individuals.
8006.1 CONGREGATE AND HOME DELIVERED MEALS
(a) A congregate meal is food provided by an AAA through a contracted service provider, to a
qualified individual in a congregate or group setting. The meal, as served, shall meet all the
requirements of the Older Americans Act and State/Local laws. 2
(b) A Home delivered meal is a meal provided to a qualified individual at his/her place of
residence. The meal is served as part of a program administered by the AAA and meets all the
requirements of the Older Americans Act and State/Local laws. 3
8006. 2 CONGREGATE MEAL SITES
(a) The AAA shall notify the Division of Aging in writing before a meal site is opened, relocated,
or closed. The notification shall include the following:
(1) name and location of current meal site, and proposed relocation site (if
applicable);
(2) the rationale for the closure or relocation, including supporting documentation
such as meal counts and participant survey results;
1
State/Grantee Agreement III, (V.) Audits, Records, Reports, and Inspections, (G).
Older American Act, Title III, Part C – Nutrition Services, Subpart 3 – General Provisions, Administration on Aging,
HHS, Reporting Requirements For Title III and VII, March 2004, and Indiana State Department of Health Food
Codes.
3
Older American Act, Title III, Part C – Nutrition Services, Subpart 3 – General Provisions, Administration on Aging,
HHS, Reporting Requirements For Title III and VII, March 2004, and Indiana State Department of Health Food
Codes.
2
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(3) a statement describing the impact of the proposed closure/relocation upon the
surrounding congregate setting; and
(4) a summary of the AAA’s efforts to provide information to meal site participants
regarding transportation options to a relocated meal site or alternate meal site or
making other arrangements for meal delivery.
(b) Congregate meal site participant must receive written and verbal notification 30 days
prior to the closure or relocation of the meal site (unless an emergency situation exists).
In addition, all meal site closures or relocations should be publicized using local media
outlets and updating the area agency website.
(c) The AAA shall discuss and document transportation and/or meal options (such as
home delivered meals) with those congregate meal site participants who will be
displaced or have services suspended. If the displaced participants will be attending
another meal site, the AAA is to ensure the displaced participants are welcomed to the
new site (i.e., personal contact, open house, site activity or other action).1
8006.2.1 MEAL SITE LOCATION
(a) The AAA is to ensure the meals are provided in congregate settings, including adult day care
facilities and multigenerational meal sites; 2
(b) The AAA is to ensure the congregate meal site must be in a location that is in close proximity
to the majority of eligible older adults’ residences as feasible.3
(c) Where feasible, the AAA is to encourage arrangements with schools and other facilities
serving meals to children in order to promote intergenerational meal programs. 4
(d) It is recommended that each congregate meal site meet minimum requirements related to
the physical facility and equipment, including, but not limited to:
(1) access to a kitchen or approved work area, for the set-up and dispensing of meals.
This includes all equipment necessary to maintain proper food temperatures. If used for
the nutrition program, there shall be operating thermometers in the refrigerator and
freezer. Approval of the area by the local health department is required; 5
(2) separate sinks for hand washing and food service;
(3) equipment, including tables and chairs for the meals and other programs, which are
sturdy and appropriate for older persons;
1
Revised 4/10/06
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 1-Sec. 331(1).
3
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions,
Sec.339(2), (E).
4
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions,
Sec.339(2), (D).
5
Indiana State Department of Health, Retail Food Establishment Sanitation Requirement, Title 410 IAC 7-20,
Effective April 29, 2000 to present
2
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(4) fire extinguisher(s) in good working order; and
(5) readily accessible first aid kit.
(e) The Americans with Disabilities Act (ADA) requires certain public accommodations for
persons with disabilities, including the following:
(1) visible directional and informational signs;
(2) telephone accessibility to staff;
(3) ramps and route of travel that does not require the use of stairs;
(4) all public spaces on an accessible route of travel;
(5) rest rooms which are accessible to the public, at least one rest room (either one for
each sex, or unisex) fully accessible; and
(6) adequate space to accommodate persons with canes, walkers, wheelchairs, and
other assistive devices. 1
(f) Congregate meal sites and satellite meal sites should comply with local and state health, fire,
safety, building, zoning, and sanitation laws, ordinances, and codes. The nutrition service
provider should maintain appropriate documentation.
(g) Congregate meal sites and satellite meal sites must be neat and clean, and have
appropriate lighting and ventilation for participants.
(h) For information regarding the Americans with Disabilities Act requirements for Nutrition
Services, see the cover page addendum of this manual. Also, see Public Law 101-336 and Title
42 USC Chapter 126, Section 12101.
8006. 2.2 MEAL SITE SERVICES
(a) The AAA is to ensure the meal site complies with applicable provisions of State or local laws
regarding the safe and sanitary handling of food equipment, and supplies used in the storage,
preparation, service, and delivery of meals to older individuals. 2
(b) The AAA shall compile available information, with necessary supplementation, on courses of
post-secondary education offered to older individuals with little or no tuition. The assurance
shall include a commitment by the area agencies to make a summary of the information
available to older individuals at congregate meal sites.3 This means a summary or listing of
post-secondary educational courses that are provided at no fee or at a minimal fee, shall be
made available to congregate meal site participants on a regular basis.
1
Americans with Disabilities Act Checklist for Readily Achievable Barrier removal (August 1995) Checklist for
Existing Facilities
2
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions, Sec.339(2),
(F).
3
Code of Federal Regulations 11/00, Title 45, Chapter XIII, Part 1321, Subpart D, Sec. 1321.17 (f)(11).
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(c) Nutrition education services and other appropriate nutrition services for older individuals may
be provided specifically at the congregate meal site. 1
8006. 2.3 POSTINGS AT THE MEAL SITE
Meal site hours should be posted within the meal site and if allowed, posted on the outside
exterior of the meal site room/building.
8006.2.4 HOME DELIVERED MEALS
(a) Upon request, current menus should be provided to home delivered meal participants.
(b) Home delivered meal participants are not charged any fee for the meals or related nutrition
service.
(c) The AAA shall encourage home delivered meal participants whose conditions improve to
participate in the Congregate Nutrition Program.
8006. 2.5 MEAL DELIVERY
The AAA is to encourage providers to enter into contracts that limit the amount of time meals
must spend in transit before the meals are consumed.2
8006.3 MEAL SERVICE REQUIREMENTS
Requirements for meal services administered under the FSSA DA and the AAAs are contained
in this section.
8006. 3.1 MEAL FREQUENCY AND FORM
(a) The AAA is to ensure the following:
(1) home delivered and congregate meals are provided 5 or more days a week (except
in a rural area where such frequency is not feasible and a lesser frequency is approved
by the Division of Aging)3 (See Section 2028 –Direct Delivery of Services - FSSA DA
Operations Manual);
(2) ensure the nutrition service provider provides the home delivered meal participant at
least one hot, cold, frozen, dried, canned, or supplemental foods (with satisfactory
1
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions, Section
331(3).
2
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions, Section
339(2)(C).
3
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 1 – Congregate Nutrition Services,
Sec. 331(I), and Subpart 2-Home Delivered Nutrition Services
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storage life) meal per day and any other appropriate meal per day that the AAA may
elect the provider to provide; and 1
(3) ensure the nutrition service provider provides the congregate meal site participants at
least one hot or other appropriate meal per day and any additional meals that the AAA
may elect the provider to provide. 2
8006.3.2 MEAL PLANNING REQUIREMENTS
(a) Meal Design;
(1) The AAA should provide flexibility to local nutrition providers in designing meals that
are appealing to program participants.3
(b) Menu Development;
(1) The AAA is to ensure the provided meals must comply with the current Dietary
Guidelines for Americans, published by the Secretary and the Secretary of Agriculture. 4
(For specific Dietary Guidelines For Americans, see Appendix A: Menu Standards)
(2) The AAA is to ensure the meals provide:
(A) a minimum of 33 1/3% of the RDA as established by the Food and Nutrition
Board of the Institute of Medicine of the National Academy of Sciences, if the
project provides one meal per day 5; (For specific FSSA DA DRI requirements,
see Appendix A: Menu Standards);
(B) a minimum of 66 2/3% of the allowances if the project provides two meals per
day6; and
(C) 100 percent of the allowances if the project provides three meals per day 7.
(3) The AAA shall ensure compliance with requirements listed above, by utilizing the
services of a registered dietitian to review and verify through signature .
1
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 2-Home Delivered Nutrition Services,
Sec. 336.
2
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 1 - Congregate Nutrition Services,
Sec. 331(I).
3
Older Americans Act (as amended in 2000),Part C-Nutrition Service, Subpart 3, Sec.339,Nutrition,(2), (B).
4
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 3-General Provisions, Sec. Sec.339,
Nutrition, (2), (A), (i).
5
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 3-General Provisions, Sec. Sec.339,
Nutrition, (2), (A), (ii), (I).
6
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 3-General Provisions, Sec. Sec.339,
Nutrition, (2), (A), (ii), (II).
7
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 3-General Provisions, Sec. Sec.339,
Nutrition, (2), (A), (ii), (III).
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8006.4 EMERGENCY MEALS
The AAA may provide meals during an emergency.
8006.5 VOLUNTEER AND DISABLED INDIVIDUAL MEALS
(a) The AAA shall have established procedures that allow nutrition project administrators the
option to offer a meal, on the same basis as meals provided to participating older individuals, to
individuals providing voluntary services during the meal hours, and individuals with disabilities
who reside in a non-institutional household with and accompany a person eligible for
congregate meals under this part shall be provided a meal on the same basis that meals are
provided to volunteers. 1
8006.6 RESTAURANT VOUCHER MEALS
(a) The AAA may choose to offer participants the opportunity to receive individual meals using
an established restaurant voucher system at a restaurant in which the AAA has a valid contract.
The individual meals, offered by the restaurant must adhere to the requirements found in
Section 8006.32 - Meal Planning Requirements.
8006. 7 REQUESTED INFORMATION
(a) Information regarding the following may be requested by FSSA DA staff:
(1) completed nutrition education activities (if applicable);
(2) completed AAA, nutrition service provider trainings (if applicable);
(3) changes in any AAA, nutrition service providers/caterer policies and
procedures;
(4) suggested donation rate and average meal donation for the previous month;
(5) meal site directory updates; and
(6) contract updates.
(b) The AAA or nutrition services provider shall respond appropriately and in a timely
manner to any FSSA DA staff requests for information.2
1
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions, Section
339(2)(H), and Code of Federal Regulations 11/00, Title 45, Chapter XIII, Part 1321, Subpart D, Sec. 1321.17 (f)(11).
2
Added 4/10/06
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8006.8 NUTRITION SCREENS
CHART 21
Older Americans Act, 339 (2)(J) A State that establishes and operates a nutrition project shall ensure
that the project provide for nutrition screening and, where appropriate, for nutrition education and
counseling.
(a) The AAA is to provide for nutrition screening and, where appropriate for nutrition education
and counseling. 1
(b) For NAPIS reporting, the assessment tool to be used is the Determine Your Nutritional
Health Checklist published by the Nutrition Screening Initiative. 2
(c) It is recommended each AAA establish written policies and procedures relating to the
individual responsible for administering, evaluating, and providing appropriate intervention
related to the nutrition assessment findings. Documentation is required.
8006.9 NUTRITION EDUCATION ACTIVITIES
(a) Nutrition education services and other appropriate nutrition services for older adults may be
included as part of Nutrition Services. 3
(b) For purposes of NAPIS reporting, nutrition education should be reported as one session per
participant. The education may be provided in a group or individual setting overseen by a
dietitian or individual of comparable expertise.4
(c) The AAA may be asked to help plan and participate in nutrition activities throughout the
program year.
8006.10 NUTRITION COUNSELING
(a) Individualized counseling should be offered to all individuals who are at nutritional risk,
especially to those participants who are assessed as having a high nutritional risk.5
(b) For purposes of NAPIS reporting, AAA provided nutrition counseling should be reported as 1
session per participant. The AAA provided nutrition counseling shall be a direct one-on-one
session conducted by a registered dietitian in an individual setting. The AAA may refer an
individual at risk participant to a qualified health professional, in lieu of providing the participant
with direct nutrition counseling. This referral must be documented and may not be reported in
NAPIS as meeting a nutrition counseling session.
1
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions, Section
339(2)(J).
2
Administration on Aging, HHS, Reporting Requirements For Title III and VII, March 2004.
3
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General Provisions, Section
331(3).
4
Administration on Aging, HHS, Reporting Requirements For Title III and VII, March 2004.
5
Administration on Aging, HHS, Reporting Requirements For Title III and VII, March 2004.
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8006.11 NATIONAL PROGRAM INFORMATION SYSTEM (NAPIS)
(a) All nutrition services provided under Title III must be counted and reported to the Division of
Aging. These services include:
(1) both congregate and home delivered meals served;
(2) individual nutrition counseling; and
(3) group and individual nutrition education.
(b) These services do not include meals funded by the Aged and Disabled Medicaid Waiver,
SSBG or any program where means testing occurs.
(c) Information regarding NAPIS reporting requirements can be found in Section 2037–Required
Reports from the Division of Aging.
8006.11.1 UNITS OF SERVICE (FOR NAPIS REPORTING)1
(a) For purposes of NAPIS reporting, units of service must be reported for each participant
receiving the service. A unit of service is defined as follows:
(1) Congregate Meal = 1 meal
(2) Home Delivered Meal = 1 meal
(3) Nutrition Counseling = 1 session per participant
(4) Nutrition Education (in an individual or group setting) = 1 session per
participant/group
8006.12 PROVISION OF NUTRITION SERVICES
(a) The AAA shall subcontract all direct services provided under Title III of the Older Americans
Act and IC 12-10-10, unless the grantee has received a waiver from the Division of Aging
authorizing it to provide direct services under Title III of the Older Americans Act and/or IC 1210-10.2
8006.12.1 AAA AND PROVIDER MONITORING
(a) The AAA should have written policies and procedures related to the monitoring of
their contracted nutrition service providers and caterers.
1
2
Administration on Aging, HHS, Reporting Requirements For Title III and VII, March 2004.
See the Section 2006 – Direct Delivery of Services for more information.
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8007 SENIORS FARMER’S MARKET NUTRITION PROGRAM (SFMNP)
(a) The Indiana State Department of Health administers the Senior Farmer’s Market Nutrition
Program grant. The grant provides for no administrative funding and participation in the program
by the AAA is strictly voluntary.
(b)The Senior Farmers' Market Nutrition Program (SFMNP) awards grants provides low-income
seniors with coupons that can be exchanged for eligible foods at farmers' markets, roadside
stands, and community supported agriculture programs.
(c) The grant funds may be used only to support the costs of the foods that are provided under
the SFMNP.
8007.1 ELIGIBILITY FOR SFMNP
Low-income seniors, generally defined as individuals who are at least 60 years old and who
have household incomes of not more than 185% of the federal poverty income guidelines
(published each year by the Department of Health and Human Services), are the targeted
recipients of SFMNP benefits.
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For more information, contact the FSSA DA nutrition coordinator or other
FSSA DA designated staff.
Also, information can be found at the following:
State/Grantee Agreement III, (V.) Audits, Records, Reports, and Inspections
HHS, Reporting Requirements For Title III and VII, March 2004, and Indiana State
Department of Health Food Codes.
Indiana State Department of Health, Retail Food Establishment Sanitation
Requirements, Title 410 IAC 7-24, Effective November 13, 2004 to present.
Code of Federal Regulations 11/00, Title 45, Chapter XIII, Part 1321, Subpart D, Section
1321.17, 1321.67
Older Americans Act (as amended in 2000), Part C-Nutrition Service, Subpart 2-Home
Delivered Nutrition Services, Section 307, 315, 331, 336, 339
United States Code, 42 USC, Chapter 35, Sections 3016, 3020e, 3023, 3024, 3028,
3030a, 3030c, 3030c-3, 3030d, 3030e, 3030f, 3030g, and 3030g 21 and 22
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SECTION 9
9000 SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM (SCSEP)
Table of Contents
9000 SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM (SCSEP)
9001 FUNDING SOURCES
9002 RECRUITMENT AND SELECTION OF ELIGIBLE INDIVIDUALS
9003 INITIAL ELIGIBILITY REQUIREMENTS
9004 BASIC ELIGIBILITY REQUIREMENTS FOR SCSEP
9004.1 Income Inclusions and Exclusions
9004.2 Preference Criteria and Enrollment Priorities
9004.2.1 Definition of a Veteran and Definition of a Spouse of a Veteran
9004.2.2 Definition of Special Consideration Criteria
9005 SERVICES AND RESPONSIBILITIES OF THE SUBGRANTEE (AAA)
9005.1 Policy Governing Political Patronage
9005.2 Nepotism
9005.3 One Stop Delivery System
9005.4 Termination of a Participant
9005.5 Wages
9005.6 Fringe Benefits
9005.7 Participant Activities Not Allowed
9006 THE FSSA DA POLICY AND PROCEDURES REGARDING SCSEP
9006.1 The FSSA DA Coordinator
9007 HOST AGENCIES
9007.1 Subgrantees (AAAS) Policy and Procedures Regarding the
Host Agencies
9007.2 Unsubsidized Employment
9007.3 Activities and Services Not Allowed
9007.4 Miscellaneous
9008 THE ANNUAL AND QUARTERLY REPORTS
9008.1 National Grantee Recommendations Regarding the State Plan for
Indiana SCSEP
9008.1.2 Information Included in the State Plan for Indiana SCSEP
9008.2 Equitable Distribution Report (ED)
9008.3 SCSEP Grant Application to the DOL
9008.4 Financial Quarterly Reports to the DOL
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9008.5 Close Out Financial Reports to the DOL
9009 DOL PERFORMANCE STANDARDS FOR GRANTEES (FSSA DA)
9009.1 Indiana Performance Measures for the Program Year
9010 PERFORMANCE MEASURES SANCTIONS
9011 APPEALS POLICY AND PROCEDURES FOR SCSEP PARTICIPANTS
(SAME AS FOR CLIENTS)
CHART 22
SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM FINAL RULE,
APRIL 19, 2004
CHART 23
SCSEP CITATIONS AND CODES
CHART 24
ENROLLMENT PRIORITIES
CHART 25
SCSEP ORGANIZATIONAL CHART
CHART 26
TIPS FOR SUCCESS
CHART 27
PERFORMANCE MEASURES
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9000 SENIOR COMMUNITY SERVICE EMPLOYMENT PROGRAM (SCSEP)
CHART 22
Senior Community Service Employment Program, Final Rule, April 9, 2004. All grantees must follow the
BAIHS Operations Manual policy and procedures and Code of Regulations, 20 CFR Part 641
The Senior Community Service Employment Program (SCSEP) promotes useful parttime employment opportunities in community service activities for unemployed low
income persons who are 55 years of age or older and who have poor employment
prospects; to foster individual economic self-sufficiency and to increase the number of
older persons who may enjoy the benefits of unsubsidized employment in both the public
and private sectors.
CHART 23
Legal Citations for the “Senior Community Service Employment Program”
20 CFR Part 641- U. S. Department of Labor
(29 U.S.C. 2864(c)) Section 134(c) of the Workforce Investment Act of 1998
Older Americans Act
Section 102(1)
Section 321(a) (12)
Sections 501, 502, 504, 509, 510, 511 and 516-Subgrantees, Host Agencies and Participants
Sections 503, 505, 506, 507, 508, 512, 513, 514 and 515
9001 FUNDING SOURCES
This program is funded through the Title V federal grant, Older Hoosier Account funds,
and local funds. Unlike other titles of the Older Americans Act, Title V is administered by
the Department of Labor (DOL).
9002 RECRUITMENT AND SELECTION OF ELIGIBLE INDIVIDUALS
Subgrantees (Area Agencies on Aging) must develop methods of recruitment and
selection that assure the maximum number of eligible individuals have an opportunity to
participate in the SCSEP.
9003 INITIAL ELIGIBILITY REQUIREMENTS
(a) Initial eligibility is determined at the time an individual applies to participate in the
SCSEP. Once an individual becomes a participant, the subgrantee (AAA) is responsible
for verifying continued income eligibility at least once every 12 months. Subgrantees
must also verify an individual’s eligibility as circumstances require.
(b) An individual with a disability may be treated as a ‘‘family of one’’ for income eligibility
determination purposes.
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(c) Subgrantees must list all community service opportunities with the State Workforce
Agency and all appropriate local offices and must use the One-Stop Delivery System in
the recruitment and selection of eligible individuals. 1
9004 BASIC ELIGIBILITY REQUIREMENTS FOR SCSEP
To be eligible for the SCSEP, participants must meet the following basic requirements:
(1) Be at least 55 years old; and
(2) Be a member of a family with an annual income that is not more than 125 %
of the family income levels prepared by the Department of Health and Human
Services and approved by the Office of Management and Budget (OMB).
9004.1 INCOME INCLUSIONS AND EXCLUSIONS
(a) The types of income that are included in participant eligibility determination are as
follows:
(1) Earnings (gross wages, net income from farm self-employment and non-farm
self-employment),
(2) Unemployment compensation,
(3) Net Social Security less the Medicare Deductions 2 and 3
(4) Veteran’s payments,
(5) Survivor benefits,
(6) Pension or retirement income,
(7) Interest income,
(8) Dividends,
(9) Rents,
(10) Royalties, Estates and Trusts,
(11) Educational assistance (Pell Grants, etc.),
(12) Alimony, and
(13) Financial assistance from outside of the households.
(b) The types of income that are excluded in participant eligibility determination are as
follows:
(1) Capital gains received;
(2) Withdrawals of bank deposits;
(3) Money borrowed;
(4) Tax refunds;
(5) One time gifts;
(6) Lump-sum inheritances or insurance payments;
(7) Supplemental Security Income;
(8) Public assistance or welfare payments;
(9) Disability benefits;
1
Older Americans Act, Section 502(b)(1)(H)
Training and Employment Guidance Letter, No. 13-04
3
Added 5-13-05
2
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(10) Child support;
(11) Worker’s compensation; and
(12) First $2,000 of certain per capita fund distributions to Indians. 1
(c) The prior practice of excluding the first $500 of an individual’s income for eligibility
purposes will no longer be permitted, either for current participants or new applicants.
9004.2 PREFERENCE CRITERIA AND ENROLLMENT PRIORITIES
(a) Subgrantees(AAA) must apply the preference criteria, to the extent feasible, when
selecting individuals within a priority group, unless the subgrantee determines, based on
an assessment of circumstances and available community service employment
opportunities, that a non-preference individual should receive services over a preference
individual.
(b) Eligible individuals who are not employed in any project funded under Title V shall
not be considered to be Federal employees. 2
(c) The subgrantee (AAAs) may be asked to provide evidence that it is adhering to the
enrollment priorities and preferences.
9004.2.1 DEFINITION OF A VETERAN AND DEFINITION OF THE SPOUSE OF A VETERAN
(a) For eligibility purposes, a veteran must have received an honorable discharge from
one of the U. S. armed services and must submit Veteran FORM DD-214 as verification.
(b) For eligibility purposes, to be considered as a qualified spouse, an individual must be
one of the following:
(1) the spouse of a veteran who died of a service-connected disability;
(2) the spouse of a member of the Armed Forces on active duty, who has been
listed for a total of more than 90 days as missing in action, captured in the line of
duty by a hostile force, or forcibly detained by a foreign government or power;
(3) the spouse of any veteran who has a total disability resulting from a serviceconnected disability; or
(4) the spouse of any veteran who died while a disability so evaluated was in
existence, who meets program eligibility requirements under Section 2 of the
Jobs for Veterans Act, Public Law 107–288 (2002). 3
1
Older Worker Bulletin Number 04-05
Older Americans Act, Section 504(a)
3
U.S. Department of Labor (Training and Employment Guidance Letter -TEGL)
2
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9004.2.2 DEFINITION OF SPECIAL CONSIDERATION CRITERIA
To meet the special consideration criteria, an individual must be one of the following:
(1) an individual who has income below the poverty level;
(2) an individual who has poor employment prospects;
(3) an individual who is an eligible minority;
(4) an individual who has limited English speaking ability; or
(5) an American Indian.
CHART 24 ENROLLMENT PRIORITIES
INDIVIDUALS SHALL BE PRIORITIZED IN THE FOLLOWING SEQUENCE:
(1) An individual who meets basic eligibility requirements is age 60 or older and is a veteran or qualified
spouse who MEETS special consideration criteria.
(2) An individual who meets basic eligibility requirements, is age 60 or older and is a veteran or qualified
spouse who DOES NOT meet special consideration criteria.
(3) An individual who meets basic eligibility requirements, is age 60 or older and is a non-veteran who meets
special consideration criteria.
(4) An individual who meets basic eligibility requirements, is age 60 or older and is a non-veteran who DOES
NOT meet special consideration criteria.
(5) An individual who meets basic eligibility requirements, is between the ages of 55-59 and is a veteran or
qualified spouse who MEETS special consideration criteria.
(6) An individual who meets basic eligibility requirements is between the ages of 55-59 and is a veteran or
qualified spouse who DOES NOT meet special consideration criteria.
(7) An individual who meets basic eligibility requirements is between the ages of 55-59 and is a non-veteran
who MEETS special consideration criteria.
(8) An individual who meets basic eligibility requirements is between the ages of 55-59 and is a non-veteran
who DOES NOT meet special consideration criteria.
9005 SERVICES AND RESPONSIBILITIES OF THE SUBGRANTEE (AAA)
(a) Subgrantees (AAAs) are responsible for providing participants with the following
services:
(1) orientation, including information on project goals and objectives, for
individuals selected for participation in the SCSEP;
(2) community service assignments;
(3) training opportunities;
(4) available supportive services;
(5) availability of a free physical examination (if physical is waived, there must be
documentation);
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(6) notification and explanation of participant rights and responsibilities and
permitted and prohibited political activities, including the posting of a notice at a
project and will make available to each participant a written explanation, clarifying
the law with respect to allowable and unallowable political activities;
(7) assessment of the participant’s work history, skills and interests, talents,
physical capabilities, aptitudes, needs for supportive services, occupational
preferences, training needs, potential for performing community service
assignments, and potential for transition to unsubsidized employment as
necessary, no less frequently that 2 times during a 12 month period;
(8) Using the information gathered during the assessment to develop the
Individual Employment Plan (IEP), a plan with the ultimate goal of
unsubsidized employment will be developed with a minimum of three goals
and objectives and an appropriate sequence of service for the participant
and updated no less than twice during a twelve month period. 1
(9) placing participants in appropriate community service activities in the
community in which they reside, or in a nearby community; 2
(10) providing or arranging for necessary training specific to the participants’
community service assignments;3
(11) assisting participants in arranging for other training identified in their IEPs; 4
(12) assisting participants in arranging for needed supportive services identified
in their IEPs;5
(13) providing participants with wages and fringe benefits for time spent working
in the assigned community service employment activity; 6
(14) ensuring that participants have safe and healthy working conditions at their
community service worksites by using the Health and Safety checklist for
Host Agencies which will be placed either in the participant’s file or with
the Host Agency Agreement; 7 and 8
(15) verifying participant income eligibility at least once every 12 months;
(16) assisting participants in obtaining unsubsidized employment, including
providing or arranging for employment counseling in support of their IEPs;
1
Added 2/03/06
Older Americans Act, Section, 502(b)(1)(B)
3
Older Americans Act, Section 502(b)(1)(I)
4
Older Americans Act, Section 502(b)(1)(I)
5
Older Americans Act, Section 502(b)(1)(N)
6
Older Americans Act, Section 502(b)(1)(I)
7
Added 2/03/06
8
Older Americans Act, Section 502(b)(1)(J)
2
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(17) providing appropriate services for participants (who have registered with
the One-Stop office)1 through the One-Stop Delivery System established under
WIA;2
(18) providing counseling on participant’s progress in meeting the goals and
objectives identified in their IEPs, and in meeting their supportive service needs;3
(19) following-up with participants placed into unsubsidized employment during
the first 6 months of placement to make certain that participants receive any
follow-up services they may need to ensure successful placements;
(20) following-up at 6 months with participants who are placed in unsubsidized
employment to determine whether they are still employed; and 4
(21) providing service to participants according to administrative guidelines that
may be issued by the DOL. 5
(b) All management reports shall be submitted timely by the subgrantee.
(c) Subgrantees (AAAs) may provide skill training that is realistic and consistent with the
participant’s IEP, and that makes the most effective use of the participant’s skills and
talents. This does not apply to training provided as part of a community service
assignment.
(d) Training may be provided before or after placement in a community service activity.
(e) Training may be in the form of lectures, seminars, classroom instruction, individual
instruction, on-the-job experiences, or other arrangements, including but not limited to,
arrangements with other workforce development programs such as WIA. 6
(f) Subgrantees (AAAs) are encouraged to place a major emphasis on training available
through on-the-job experience.
(g) Subgrantees (AAAs) are encouraged to obtain training through locally available
resources, including host agencies, at no cost or reduced cost to the SCSEP.
(h) Subgrantees (AAAs) may pay reasonable costs for instructors, classroom rental,
training supplies and materials, equipment, tuition, and other costs of training.
Participants may be paid wages while in training. Subgrantees may pay for costs
associated with travel and room and board necessary to participate in training.
(i) Nothing in the SCSEP prevents or limits participants from engaging in selfdevelopment training available through other sources, during hours when not assigned
to community service activities.
1
Added 4/10/06
Older Americans Act, Section 502(b)(1)(O)
3
Older Americans Act, Section 502(b)(1)(N)(iii))
4
Older Americans Act, Section 513(c)(2)(B)
5
Older Americans Act, Section 502(c)(6)(A)(i)
6
Older Americans Act, Section 502(c)(6)(A)(ii))
2
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(j) Subgrantees (AAAs) may provide or arrange for supportive services to assist
participants in successfully participating in projects. Supportive services include, but are
not limited to:
(1) payment of reasonable costs of transportation;
(2) health care and medical services;
(3) special job-related or personal counseling;
(4) incidentals such as work shoes, badges, uniforms, eyeglasses, and tools;
(5) child and adult care;
(6) temporary shelter; and
(7) follow-up services.1
(k) To the extent practicable, the subgrantee should provide for the payment of these
expenses from other resources.
(l) Subgrantees have the responsibility to place participants in unsubsidized
employment.
(m) Subgrantees also have the responsibility (once participants have been placed
in unsubsidized employment) to contact placed participants during the first 6 months to
determine:
(1) if participants have the necessary supportive services to remain in the job;
(2) if the participant have been retained by the employer or use wage records to
verify continued employment;2
(3) follow-up requirements under the Performance Standards.
(n) Each project funded under Title V must result in an increase in employment
opportunities in addition to those that would otherwise be available.
(o) Subgrantees cannot place participants directly into unsubsidized employment.
Subgrantees are encouraged to refer individuals who may be placed directly in an
unsubsidized employment position to an employment provider, including the One-Stop
for job placement assistance under WIA. The DOL encourages grantees to work closely
with participants to develop an IEP and assessment to determine what training the
individual may need. The DOL encourages subgrantees to work with those participants
who are the most difficult to place to provide them with the services necessary to
develop the skills needed for job placement.
1
2
Older Americans Act, Section 502(c)(6)(A)(iv)
Older Americans Act, Section 513(c)(2)(B)
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(p) Subgrantees (AAAs) and host agencies are required to comply with the nondiscrimination provisions codified in the DOL’s regulations at 29 CFR Part 37, if the
recipient:
(1) is a One Stop partner listed in Section 121(b) of WIA. 1
(2) operates programs and activities that are part of the One-Stop Delivery
System established under the Workforce Investment Act.
(q) Maintenance of effort requirements as it applies to the use of SCSEP funds means
the employment of a participant funded under Title V of the OAA is permissible only in
addition to employment that would otherwise be funded by the subgrantee and the host
agency without assistance under the OAA. 2
(r) Subgrantees (AAAs) must provide informational materials relating to age
discrimination and/ or their rights under the Age Discrimination in Employment Act of
1975 that are distributed to subgrantees by the DOL pursuant to Section 503(b) (3) of
the OAA.
(s) Subgrantees are required to display all mandated posters and policies as required by
the DOL.
(t) Questions about or complaints alleging a violation of the nondiscrimination
requirements cited in this section may be directed or mailed to:
Director, Civil Rights Center,
U.S. Department of Labor, Room N-4123
200 Constitution Avenue, NW., Washington, DC 20210
9005.1 POLICIES GOVERNING POLITICAL PATRONAGE
(a) The policies governing political patronage are as follows:
(1) A subgrantee must not select, reject, promote, or terminate an individual
based on political services provided by the individual or on the individual’s
political affiliations or beliefs.
(2) In addition, certain subgrantees of SCSEP funds are required to comply with
the Workforce Investment Act nondiscrimination regulations in 29 CFR part 37.
These regulations prohibit discrimination on the basis of political affiliation or
belief.
(3) A subgrantee must not provide funds to any sub-subgrantee or other entity
based on political affiliation.
1
2
See Section 90005.2
Older Americans Act, Section 502(b)(1)(F)
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(4) Policies governing political activities are:
(A) No project under Title V of the OAA may involve political activities.
SCSEP recipients must ensure compliance with the requirements and
prohibitions involving political activities.
(B) State and local employees involved in the administration of SCSEP
activities may not engage in political activities prohibited under the Hatch
Act (5 U.S.C. Chapter 15), including:
(i) seeking partisan elective office.
(ii) using official authority or influence for the purpose of affecting
elections, nominations for office, or fund-raising for political
purposes.1
(b) SCSEP recipients must provide all persons associated with SCSEP activities with a
written explanation of allowable and unallowable political activities under the Hatch Act.
A notice explaining these allowable and unallowable political activities must be posted in
every workplace in which SCSEP activities are conducted. The DOL will provide the
form and content of the notice and explanatory material by administrative issuance. 2
(c) SCSEP recipients must ensure that:
(1) no SCSEP participants or staff persons engage in partisan or nonpartisan
political activities during hours for which they are being paid with SCSEP funds.
(2) no participants or staff persons engage in partisan political activities in which
such participants or staff persons represent themselves as spokespersons for the
SCSEP program.
(A) No participants are employed or out-stationed in the offices of a
Member of Congress, a State or local legislator, or on the staff of any
legislative committee.
(B) No participants are employed or out-stationed in the immediate
offices of any elected chief executive officer of a State or unit of general
government, except that units of local government may serve as host
agencies for participants, provided that their assignments are nonpolitical.
(C) While assignments may technically place participants in such offices,
such assignments actually must be concerned with program and service
activities and not in any way involved in political functions.
(3) No participants are assigned to perform political activities in the offices of
other elected officials. Placement of participants in such offices in non-political
1
2
United States Code, 5 USC 1502
Older Americans Act, Section 2 (b) (l)(P)
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assignments is permissible. However, Units of Local Government may serve as
host agencies for participants, provided that their assignments are non-political
and while assignments may technically place participants in such offices, such
assignments actually must be concerned with the program and service activities
and not in any way involved in political functions.
(4) SCSEP subgrantees develop safeguards to ensure that participants placed in
these assignments are not involved in political activities. These safeguards are
subject to review and monitoring by FSSA DA and by the DOL.
(5) The subgrantees must ensure that SCSEP funds are not used in any way to
assist, promote, or deter union organizing.
9005.2 NEPOTISM
(a) The policies governing nepotism are:
(1) SCSEP subgrantees must ensure that no subgrantee hires, and no host
agency serves as a worksite for, a person who works in an SCSEP community
service position if a member of that person’s immediate family is engaged in a
decision-making capacity (whether compensated or not) for that subgrantee or
host agency. The DOL may exempt this requirement from worksites on Native
American reservations and in rural areas provided that adequate justification can
be documented, such as that no other persons are eligible and available for
participation in the program.
(2) For purposes of the definition of nepotism “Immediate family’’ means wife,
husband, son, daughter, mother, father, brother, sister, son-in-law, daughter-inlaw, mother-in-law, father-in-law, brother-in-law, sister-in-law, aunt, uncle, niece,
nephew, stepparent, stepchild, grandparent, or grandchild.
(b) To the extent that an applicable State or local legal requirement regarding nepotism
is more restrictive than this provision, SCSEP subgrantees must ensure that the more
restrictive requirement is followed.
9005.3 ONE STOP DELIVERY SYSTEM
(a) The SCSEP is a required partner under the Workforce Investment Act (WIA). As
such, it is a part of the One-Stop Delivery System. Subgrantees are required to follow all
applicable rules under WIA and its regulations. (WIA Section 121(b) (1) (B)(vi), (29 USC
2841(b)(1)(B)(vi) and the 29 CFR, Part 662, subpart B.
(b) Title V resources may only be used to provide Title V services to Title V-eligible
individuals. The Workforce Investment Act (WIA) creates a seamless service delivery
system for individuals seeking workforce development services by linking the One-Stop
partners in the One-Stop Delivery System. Although the overall effect is to provide
universal access to core services, resources may only be used to provide services that
are authorized and provided under the SCSEP to eligible individuals. Title V funds can
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be used to pay wages to SCSEP participants receiving intensive and training services
under Title I of WIA provided that the SCSEP participants are functioning in a community
service assignment. All other individuals who are in need of the services provided under
the SCSEP, but who do not meet the eligibility criteria to enroll in the SCSEP, should be
referred to or enrolled in WIA or other appropriate partner programs. (WIA SECTION
121(b)(1)). These arrangements should be negotiated in the Memorandum of
Understanding (MOU) between the subgrantee and the Local Board.
(c) In addition to providing core services, subgrantees must make arrangements through
the One-Stop Delivery System to provide eligible and ineligible individuals with access to
other activities and programs carried out by other One-Stop partners.
(d) Section 502(b)(4) of the OAA provides that an assessment or IEP completed by the
SCSEP satisfies any condition for an assessment, service strategy, or IEP completed at
the One-Stop and vice-versa. These reciprocal arrangements and the contents of the
IEP and WIA IEP should be negotiated in the MOU. 1
(1) Participants who have been assessed through an IEP have received an
intensive service according to 20 CFR 663.240(a) of the WIA regulations.
participants, who seek unsubsidized employment as part of their IEP, may
require training to meet their objectives. The grantee/subgrantee, the host
agency, the WIA program, or another One-Stop partner may provide training as
appropriate and as negotiated in the MOU.
(2) The SCSEP provides opportunities for eligible individuals to engage in parttime community service activities for which they are compensated. These
assignments are analogous to work experience activities or intensive service
under 20 CFR 663.200 of the WIA regulations.
(3) Participants may be paid wages while receiving intensive or training services
provided that the participant is functioning in a community service assignment.
(e) WIA Intensive and Training services. SCSEP participants are not automatically
eligible for intensive and training services under Title I of WIA, Local Boards may deem
SCSEP participants, either individually or as a group, as satisfying the requirements for
receiving adult intensive and training services under Title I of WIA.
9005.4 TERMINATION OF A PARTICIPANT
(a) The subgrantee (AAA) must give the participant written notification of termination,
within 30 days of the determination, either through mail or in person, if a participant is
found ineligible for the SCSEP because of an increase in the participant’s family income
(b) A participant that is found ineligible because of providing false information shall be
terminated immediately. Written notification of the reason for the immediate termination
shall be given, either through mail or in person, to the participant. Termination will be
effective as of the date of the written notification.
1
Older Americans Act, Section 502(b) (4)
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(c) If, at any time, the subgrantee determines that it incorrectly determined a participant
to be eligible for the program through no fault of the participant, the subgrantee must
give the participant immediate written notice explaining the reason(s) for ineligibility and
must terminate the participant 30 days after the participant receives the notice.
(d) Subgrantees (AAAs) must refer terminated participants to the services provided
under the One-Stop Delivery System or other appropriate partner program. Terminated
participants may file a grievance according to the FSSA DA appeals procedures found in
Section 9011. 1
(e) Subgrantees (AAAs) may terminate a participant for cause (a justified reason). In
doing so, the subgrantee must inform the participant, in writing, of the reason(s) for
termination. Terminations for cause must be discussed with participants and provide
each participant a written copy of its policies for terminating a participant for cause or
otherwise at the time of enrollment.
(f) When a subgrantee (AAAs) makes an unfavorable determination of enrollment
eligibility, the subgrantee must give the individual a reason for termination and, when
feasible, should refer the individual to other potential sources of assistance, such as the
One-Stop Delivery System.
(g) Any termination must be consistent with administrative guidelines issued by the DOL,
and the termination must be subject to the applicable grievance procedures as described
in Section 9011.
(h) Participants may not be terminated from the program solely on the basis of their age.
Subgrantees may not impose an upper age limit for participation in the SCSEP.
(i) Individual Employment Plan-Related Terminations
(1) The project sponsor will have a participant sign a 30 day written corrective
action agreement following an incident where a participant has been warned to
follow action steps depicted in their IEP. The following reasons may be cause to
start the corrective action agreement:
(A) refusal to accept an initial or alternative community service
assignment;
(B) refusal to register at the WorkOne center;
(C) refusal to improve personal habits or appearance;
(D) refusal to participate in workshops, training, OJT;
(E) refusal to job search;
(F) refusal to transition into unsubsidized employment; or
1
Also see the FSSA DA Operations Manual, Section 4, Appeals and Hearings
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(G) other action steps as identified in the participant’s IEP.
(2) After three infractions of the seven reasons for an IEP Related
Termination (which would include failure to follow the signed corrective
action plan) 1 and if the participant does not follow the corrective action
agreement, and there are no extenuating circumstances that would hinder the
participant from moving to unsubsidized employment, the participant will be given
a termination letter that states the right to appeal and cites appropriate time
frames and the name of the person whom an appeal may be made. This letter
becomes part of the participant’s personnel record.
(3) Participants who have received IEP terminations will be referred to the
WorkOne centers. 2
9005.4.1 IEP Related Termination (Not Appropriate)
(a) An IEP Related Termination would not be appropriate when:
(1) occurrences are not within the control of the participant (such as
transportation to training or unsubsidized employment is unavailable);
(2) death of a closely related persons or partner impacts the situation;
(3) training or unsubsidized employment places undue hardship on the
participants that exceed those of the community service assignment; or
(4) other related reasons (to be considered on a case by case basis).3
9005.5 WAGES
(a) Subgrantees (AAAs) must pay participants the highest applicable minimum wage for
time spent in orientation, training required by the subgrantee, and work in community
service assignments. The highest applicable minimum wage is either the minimum wage
applicable under the Fair Labor Standards Act of 1938; the State or local minimum wage
for the most nearly comparable covered employment; or the prevailing rate of pay for
persons employed in similar public occupations by the same employer.
(b) If a subgrantee requests a waiver to pay above the current state minimum
wage (unless Congress approves a new minimum wage rate), the waiver will only
be approved base don the following three criteria:
(1) The subgrantee must provide documentation containing local market
information and economic statistics including the prevailing wage market
of comparable employment of the subgrantee’s local economic climate that
prevents the subgrantee from recruiting eligible participants.
1
Added 4/10/06
Added 7/01/05
3
Added 4/10/06
2
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(2) The subgrantee must provide studies on the effect of minimum wage on
the recruitment and provide a recruitment plan explaining how a higher
wage rate would allow the subgrantee to recruit and place participants into
unsubsidized employment .
(3) if the subgrantee is paying a higher wage to participants, the
subgrantee must explain why this higher wage is not a barrier to the
participant exiting into unsubsidized employment.
(4) if the subgrantee has not met the unsubsidized employment goal
for two or more program years, the subgrantee will not be allowed to
pay higher wage to participants and must return the participants to
the state’s minimum wage rate. 1
9005.6 FRINGE BENEFITS
(a) Allowable fringe benefit costs for Subgrantees may include the following:
(1) holidays;
(2) social security; and
(3) any other fringe benefits approved in the grant agreement (submitted by the
FSSA DA to the DOL) and permitted by the appropriate Federal cost principles
found in OMB Circulars A–87 and A–122, except for retirement costs.
(b) Except for retirement benefits and unemployment compensation, subgrantees must
ensure that participants receive all fringe benefits required by law.
(c) Subgrantees (AAAs) must provide fringe benefits uniformly to all participants within a
project or subproject, unless the DOL agrees to waive this provision due to a
determination that such a waiver is in the best interests of applicants, participants, and
project administration.
(d) When participants are not covered by the State workers’ compensation law, the
subgrantee must provide participants with workers’ compensation benefits equal to
those provided by law for covered employment.
(e) Subgrantees may not use grant funds to provide contributions into a retirement
system or plan.
(f) Unless required by law, subgrantees may not pay the cost of unemployment
insurance for participants.
1
United States Code, 20 USC 641.565 - Added 4/10/06
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9005.7 PARTICIPANT ACTIVITIES NOT ALLOWED
(a) Lobbying requirements apply to the use of SCSEP funds. SCSEP recipients and
subrecipients must comply with the restrictions on lobbying codified in the DOL’s
regulations. 1
(b) Each project funded under Title V must not result in:
(1) the displacement of currently employed workers, including partial
displacement such as a reduction in hours of non-overtime work, wages, or
employment benefits.
(2) impairment of existing contracts for service or result in the substitution of
Federal funds for other funds in connection with work that would otherwise be
performed.
(3) the substitution of SCSEP-funded positions for existing federally assisted
jobs.
(4) the employment or continuance of the employment of any participant to
perform work that is the same or substantially the same as that performed by any
other person who is on layoff. 2
9006 THE FSSA DA POLICY AND PROCEDURES REGARDING SCSEP
The FSSA DA will develop, maintain, and seek to enhance a statewide senior
community services employment program, in coordination with subgrantees that meets
all requirements of the Older Americans Act. The FSSA DA will enter into contractual
agreements with subgrantees. However, in Indiana, 2 subgrantees have contracts with
Experience Works (sub-subgrantees), a national grantee operating in Indiana to deliver
the SCSEP.
9006.1 THE FSSA DA COORDINATOR
The FSSA DA shall appoint a program coordinator who shall:
(1) monitor subgrantee's programs for contractual and programmatic compliance
in accordance with established program regulations from the DOL.
(2) provide ongoing training and technical assistance to subgrantee program
coordinators.
(3) coordinate training to subgrantee's program coordinators that includes the
Indiana Department of Workforce Development personnel and Title V National
1
2
See Code of Federal Regulations, 29 CFR, Part 93.
Older Americans Act, Section 502(b)(1)(G)
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grantee representatives.
(4) monitor subgrantee's expenditures to assure full utilization of funding.
(5) provide coordination and interaction with the Department of Workforce
Development and all Title V National grantees in Indiana.
(6) host an annual roundtable inviting the SCSEP partners who include but are
not limited to grantees, subgrantees, National grantees operating in Indiana, the
Indiana Department of Workforce Development, the local and State boards.
The purpose of the SCSEP Roundtable is to develop and plan the State Plan for
Indiana SCSEP.
(7) assure that subgrantees are meeting all of the requirements listed in Section
9007.
(8) periodically monitor the program for compliance with required common and
performance measures as established by the DOL, and the FSSA DA.
9007 HOST AGENCIES
(a) Organizations eligible to act as host agencies are public and private nonprofits
organizations exempt from taxation under the provision of Section 501(c)(3) of the
Internal Revenue Code of 1986. Host agencies will employ eligible individuals in service
related to publicly owned and operated facilities and projects, or projects sponsored by
organizations, other than political parties, exempt from taxation.
(b) Units of local government may serve as host agencies for participants, provided that
their assignments are non-political.
9007 .1 SUBGRANTEES (AAAS) POLICY AND PROCEDURES REGARDING HOST
AGENCIES
Subgrantees shall enter into an agreement with a host agency defining the following:
(1) Provide adequate supervision on a daily basis.
(2) Provide orientation and the necessary training concerning the work site, its
activities, and the participants’ daily activities.
(3) Assure that the subgrantees and the participants have a current and dated
copy of his/her job description and to upgrade each job description as job
functions change.
(4) Provide safe and sanitary work conditions, any necessary employee liability
coverage, and compliance with the Americans with Disabilities Act. The Host
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Agency will be subjected to the Health and Safety Checklist.1
(5) Not discriminate on the basis of race, color, religion, sex, national origin,
disability, age, political affiliation, or ancestry.
(6) Provide the grantee with time and attendance records, activity reports, annual
evaluations, and accurate program budget records, when requested, on a timely
basis.
(7) Assure that participants work only the total number of hours authorized by the
subgrantee. Participants cannot receive stipends from the host agency above the
SCSEP wages they are receiving from the subgrantee. Additionally, participants
cannot volunteer at the host agency for the same community service assignment
that they are receiving wages from the subgrantee.
(8) Make no change in a participant’s work schedule, job duties, supervisor,
place of work, or status with the agency without written notification/approval of
the grantee.
(9) The maximum length of time that a participant may remain in the same
job assignment will be determined by the IEP. 2
(10) Consider participants for all job openings for which the participants qualify
and to employ the participants in their current community service assignment (or
a similar one) should funds become available.
(11) Recognize that, unless non-Title V funding becomes available, the position
occupied by the participants are to be considered temporary and must actively
support (the 24 month rotation period occurs) the participants transfer to another
work site that can provide the participants with new or upgraded job skills.
(12) Provide to participants the same consideration, support, and treatment
extended to other part-time agency employees.
(13) Wages earned by participants under this program are not to be considered
as income for the purposes of determining eligibility for participation in any
housing program for which Federal funds may be available or for any income
determination under the Food Stamp Act of 1977.
9007.2 UNSUBSIDIZED EMPLOYMENT
(a) Because one goal of the program is to foster economic self-sufficiency, subgrantees
should make reasonable efforts to place as many participants as possible into
unsubsidized employment, in accordance with each participant’s IEP.
(b) Subgrantees are responsible for working with participants to ensure that, for those
participants whose IEPs include an unsubsidized employment goal, the participants are
receiving services and taking actions designed to help them achieve this goal.
1
2
Added 4/10/06
Added 4/10/06
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(c) Subgrantees must contact private and public employers directly or through the OneStop Delivery System to develop or identify suitable unsubsidized employment
opportunities. They must also encourage host agencies to assist participants in their
transition to unsubsidized employment, including unsubsidized employment with the host
agency.
9007.3 ACTIVITIES AND SERVICES NOT ALLOWED
(a) Subgrantees (AAAs) may not use funds for individuals who only need job search
assistance or job referral services. Subgrantees may provide job search assistance and
job club activities to participants who are enrolled in the SCSEP and are assigned to
community service assignments.
(b) Participants must do their community services assignments at a host agency site.
Participants are not allowed to do their community service assignments in their homes.
This would not meet their definition of adequate supervision.
9007.4 MISCELLANEOUS
Subgrantees (AAAs) shall follow any and all Federal laws, regulations, rules, policies,
procedures, Older Worker Bulletins, TEGL’s (DOL Training and Employment Guidance
Letters), TEN’s (DOL Training and Employment Notices), TAGs (DOL Technical
Assistance Guides), DOL Manuals and User Guides, FSSA DA contracts, transmittals,
Operation Manual and emails, or any other policy guidance provided.
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CHART 25
SCSEP ORGANIZATIONAL CHART
United States Department of Labor
(DOL)
Federal
Level
DOL/Employment and Training
Administration
DOL/Employment and Training
Administration/Division of
Older Worker Programs
States Units on
Aging and National
Sponsors
State
Level
State of Indiana
Family and Social
Services
Administration
(FSSA)
Local
Level
FSSA Division of Aging
(FSSA DA)
SubGrantees (Area
Agencies on Aging)
----------------------------Sub-SubGrantees
(Area 12 and 13 subcontract with
Experience Works
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9008 THE ANNUAL AND QUARTERLY REPORTS
The FSSA DA shall produce the following annual and quarterly reports for the DOL (and
other reports as requested by the DOL):
(1) State Senior Employment Services Coordination Plan (State Plan for Indiana
SCSEP);
(2) Equitable Distribution Report (ED);
(3) SCSEP Grant Application to the DOL;
(4) Financial Quarterly Reports to the DOL; and
(5) Close Out Financial SCSEP Report to the DOL.
9008.1 NATIONAL GRANTEE RECOMMENDATIONS REGARDING THE STATE PLAN FOR
INDIANA SCSEP (State Senior Employment Services Coordination Plan due annually,
by April 1)
(a) The Governor has delegated the task of developing the State Plan for Indiana to the
FSSA DA.
(b) The State Senior Employment Services Coordination Plan (the State Plan for
Indiana) is submitted by the FSSA DA on behalf of the Governor as an independent
document or as part of the Workforce Investment Act (WIA) Unified Plan, that describes
the planning and implementation process for services in Indiana.
(c) In developing the State Plan for Indiana, the FSSA DA must obtain the advice and
recommendations of representatives from:
(1) The FSSA DA and AAA’s;
(2) State and Local Boards under the Workforce Investment Act (WIA);
(3) Public and private nonprofit agencies and organizations providing
employment services, including each grantee operating a project within Indiana;
(4) Social service organizations providing services to older individuals;
(5) Grantees under Title III of the OAA;
(6) Affected communities;
(7) Underserved older individuals;
(8) Community-based organizations serving older individuals;
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(9) Business organizations (Business appointees to the State Board can be used
to meet this requirement); and
(10) Labor organizations (Labor appointees to the State Board can be used to
meet this requirement).
(d) The FSSA DA is required to obtain the advice and recommendations of national
grantees with no reciprocal provision requiring the national grantees to participate in the
state planning process.
(e) The eligibility provision requires grantees to coordinate with other organizations at
the state and local level. Therefore any national grantee that does not participate in the
state planning process may be deemed ineligible to receive funds in the following
program year.
(f) National Grantees serving older American Indians are exempted from participating in
the planning requirements under Section 503(q)(8) of the OAA. These national grantees
may choose not to participate in the state planning process; however, the DOL
encourages participation. If a national grantee serving older American Indians does not
participate in the state planning process, it must describe its plans for serving older
American Indians in its application for SCSEP.
9008.1.2 INFORMATION INCLUDED IN THE STATE PLAN FOR INDIANA SCSEP
(a) At a minimum, the State Plan for Indiana SCSEP must include information on the
following:
(1) The ratio of eligible individuals in each service area to the total eligible
population in Indiana;
(2) The relative distribution of:
(A) eligible individuals residing in urban and rural areas within Indiana;
(B) eligible individuals who have the greatest economic need;
(C) eligible individuals who are minorities; and
(D) eligible individuals who have the greatest social need;
(E) the employment situations and the types of skills possessed by
eligible individuals;
(F) the localities and populations for which community service projects of
the type authorized by Title V are most needed;
(G) actions taken or planned to coordinate activities of grantees and
subgrantees with the activities being carried out in Indiana under Title I of
WIA;
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(H) a description of Indiana procedures and time line for ensuring an open
and inclusive planning process that provides meaningful opportunity for
public comment;
(I) public comments received and a summary of the comments;
(J) a description of the steps taken to avoid disruptions to the greatest
extent possible (see Equitable Distribution Report); and
(K) such other information as the DOL may require in the State Plan for
Indiana instructions.
(b) The State Plan for Indiana should identify the following community service needs:
(1) the types of community services that are needed and the places where these
services are most needed.
(2)the needs and locations of those individuals most in need of community
services and the groups working to meet their needs. 1
(c) The State Plan for Indiana should address the coordination of services with activities
funded under Title I of WIA by describing the following:
(1) the steps that are being taken to coordinate activities within the state with
activities being carried out under Title I of WIA. 2
(2) the steps being taken to ensure that the SCSEP is an active partner in each
One-Stop Delivery System and the steps that will be taken to encourage and
improve coordination with the One-Stop Delivery System.
(d) Modifications for the State Plan for Indiana SCSEP are required when:
(1) there are changes in Federal or State law or policy that substantially change
the assumptions upon which the State Plan for Indiana is based;
(2) there are changes in the State’s vision, strategies, policies, performance
indicators, or organizational responsibilities;
(3) the State has failed to meet performance goals and must submit a corrective
action plan; or
(4) there is a change in a grantee or subgrantees.
(5) modifications to the State Plan for Indiana are subject to the same public
review and comment requirements that apply to the development of the State
Plan for Indiana.
1
2
Older Americans Act, Section 503(a)(3)(4) and(6)
Older Americans Act, Section 503(a)(2)
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(6) the DOL will issue additional instructions for the procedures that must be
followed when requesting modifications to the State Plan for Indiana.1
(7) public comments are solicited and collected as follows:
(A) The Governor should follow established State procedures to solicit
and collect public comments. The State Plan for Indiana must include a
description of the State’s procedures and schedule for ensuring an open
and inclusive planning process that provides meaningful opportunity for
public comment. A draft of the State Plan for SCSEP in Indiana is sent to
the following entities, for review and comment:
(i) Appropriate FSSA DA staff;
(ii) Each SCSEP grantee operating in Indiana;
(iii) Non-profit providers of employment services;
(iv) Workforce Investment Boards; and
(v) Other organizations including business and labor.
(B) Any individual or organization may comment on the SCSEP State
Plan for Indiana.
(e) The SCSEP State Plan for Indiana relates to the equitable distribution (ED) report as
follows:
(1) The 2 documents address some of the same areas, and are prepared at
different points in time. The ED report is prepared by the FSSA DA at the
beginning of each federal fiscal year and provides a ‘‘snapshot’’ of the actual
distribution of all of the authorized positions within the State, grantee-by-grantee,
and the optimum number of participant positions in each designated area based
on the latest available Census data. It provides a basis for improving the
distribution of positions within the State. The ED report is a separate document
and is an attachment to the SCSEP State Plan for Indiana.
(2) The SCSEP State Plan for Indiana is prepared by the FSSA DA on behalf of
the Governor and covers many areas in addition to equitable distribution, as
discussed in Equitable Distribution Report (4), and sets forth a proposed plan for
distribution of authorized positions in the State. Any distribution or redistribution
of positions made as a result of a SCSEP State Plan for Indiana proposal will be
reflected in the subsequent year’s ED report, which then forms the basis for the
proposed distribution in the next year’s State Plan for Indiana. This process is
iterative in that it moves the authorized positions from over-served areas to
underserved areas over a period of time. The FSSA DA must send a written
request to the DOL for authorization to move employment positions from one
county to another. Employment positions cannot be changed or moved without
prior authorization from the DOL.
1
Older Americans Act, Section 503(a)(1)
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9008.2 EQUITABLE DISTRIBUTION REPORT (ED) -due annually October 1.
The equitable distribution provisions must be reconciled with the provision that
disruptions to current participants should be avoided.
(1) The Governor must describe the steps that are being taken to comply with the
statutory requirement to avoid disruptions in the State Plan for Indiana. 1
(2) When there is new census data indicating that there has been a shift in the
location of the eligible population or when there is over-enrollment for any other
reason, the DOL recommends a gradual shift that encourages current
participants in subsidized community service positions to move into unsubsidized
employment to make positions available for eligible individuals in the areas
where there has been an increase in the eligible population. The DOL does not
define disruptions to mean that participants are entitled to remain in a subsidized
community service employment position indefinitely.
(3) The Grantee (FSSA DA) may, under certain circumstances, place time limits
on an SCSEP community service assignment, thus permitting positions to be
transferred over time. Grantees shall not transfer positions from one geographic
area to another without first notifying the State agency responsible for preparing
the State Plan for Indiana and equitable distribution report.
(4) The Grantee (FSSA DA) must submit, in writing, any proposed changes in
distribution that occur after submissions of the equitable distribution report to the
Federal Project Officer for approval. All grantees are strongly encouraged to
coordinate any proposed changes in position distribution with the other grantees
servicing in the State, including the State project director, prior to submitting the
proposed changes to their Federal Project Officer for approval.
9008.3 SCSEP GRANT APPLICATION TO THE DOL -due annually, April 1 (or
otherwise upon the directions of the DOL)
(a) The entities that are eligible to apply to the DOL for funds to administer community
service projects are as follows:
(1) National Grantees.
Entities eligible to apply for national grants include nonprofit organizations,
Federal public agencies, and Tribal organizations. These entities must be
capable of administering a multi-State program. State and local agencies may
not apply for these funds.
(2) National Grantees in a State.
Section 514(e)(3) of the Older Americans Act permits nonprofit organizations,
public agencies, and States to receive funds when a National grantee in a State
fails to meet its performance measures in the second and third year of failure.
The poor performing grantee that had its funds competed is not eligible to
1
Older Americans Act, Section 503(a)(6)
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compete for the same funds.
(3) State Grantees.
Section 506(e) of the Older Americans Act requires the DOL to enter into
agreements with each State to provide services. States may use individual State
agencies, political subdivisions of a State, a combination of such political
subdivisions, or a national grantee operating in the State to administer funds. If
the State’s funds are competed under Section 514(f) of the OAA, other agencies
within the State, political subdivisions of a State, a combination of political
subdivisions of a State, and national grantees operating in the State are eligible
to apply for funds. Other States may not apply for this funding.
(b) An eligible entity applies in the following manner:
(1) General.
An eligible entity must follow the application guidelines issued by the DOL. The
DOL will issue application guidelines announcing the availability of State and
national funds whether they are awarded on a competitive or noncompetitive
basis. The guidelines will contain application due dates, application instructions,
and other necessary information.
(c) All entities must submit applications in accordance with the DOL’s instructions.
(d) National Grant Applicants. All applicants for national grant funds, except
organizations proposing to serve older American Indians, must submit their applications
to the Governor of each State in which projects are proposed before submitting the
application to the DOL. 1
(e) State Applicants. A State that submits a Unified Plan under W IA Section 501 may
include the State’s SCSEP community service project grant application in its Unified
Plan. Any State that submits an SCSEP grant application as part of its WAIT Unified
Plan must address all of the application requirements as published in the DOL’s
instructions. State Plan for Indiana SCSEP applications and modifications are addressed
in State Plan for Indiana SCSEP.
(f) The factors that the DOL will consider in selecting grantees are:
(1) The DOL will select grantees from among applicants that are able to meet the
eligibility and responsibility review criteria at Section 514 of the OAA. If there is a
full and open competition, the DOL also will take the rating criteria described in
the Solicitation for Grant Application or other instrument into consideration,
including the applicant’s/grantee’s past performance in any prior Federal grants
or contracts for the past 3 years.
(g) The eligibility criteria that each applicant must meet are:
(1)To be eligible to receive SCSEP funds, each applicant must be able to
demonstrate:
1
Older Americans Act, Section 503(a)(5)
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(A) an ability to administer a program that serves the greatest number of
eligible participants, giving particular consideration to individuals with
greatest economic need, greatest social need, poor employment history
or prospects, and over the age of 60;
(B) an ability to administer a program that provides employment for
eligible individuals in communities in which they reside, or in nearby
communities, that will contribute to the general welfare of the community;
(C) an ability to administer a program that moves eligible participants into
unsubsidized employment;
(D) an ability to move participants with multiple barriers to employment
into unsubsidized employment;
(E) an ability to coordinate with other organizations at the State and local
levels, including the One-Stop Delivery System;
(F) an ability to properly manage the program, including its plan for fiscal
management of the SCSEP program;
(G) an ability to minimize program disruption for current participants if
there is a change in project sponsor and/ or location, and its plan for
minimizing disruptions; and
(H) any additional criteria that the Secretary of Labor deems appropriate
in order to minimize disruptions for current participants.
(h) The responsibility conditions that an applicant must meet are each of the listed
responsibility ‘‘tests’’ by not having committed any of the acts of misfeasance or
malfeasance described in A through N of this section.
(1) The DOL has been unable to recover a debt from the applicant, whether
incurred by the applicant or by one of its subgrantees or subcontractors, or the
applicant has failed to comply with a debt repayment plan to which it agreed. In
this context, a debt is established by final agency action, followed by three
demand letters to the applicant, without payment in full by the applicant.
(2) Established fraud or criminal activity of a significant nature within the
applicant’s organization.
(3) Serious administrative deficiencies identified by the DOL, such as failure to
maintain a financial management system as required by Federal regulations.
(4) Willful obstruction of the auditing or monitoring process.
(5) Failure to provide services to applicants as agreed to in a current or recent
grant or to meet applicable performance measures.
(6) Failure to correct deficiencies brought to the grantee’s attention in writing as a
result of monitoring activities, reviews, assessments, or other activities.
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(7) Failure to return a grant closeout package or outstanding advances within 90
days after the grant expiration date or receipt of closeout package, whichever is
later, unless an extension has been requested and granted.
(8) Failure to submit required reports.
(9) Failure to properly report and dispose of Government property as instructed
by the DOL.
(10) Failure to have maintained effective cash management or cost controls
resulting in excess cash on hand.
(11) Failure to ensure that a subgrantee complies with applicable audit
requirements, including OMB Circular A–133 audit requirements specified within
the audit requirements.
(12) Failure to audit a subgrantee within the period required under audit
requirements.
(13) Final disallowed costs in excess of five percent of the grant or contract
award if, in the judgment of the Grant Officer, the disallowances are egregious
findings.
(14) Failure to establish a mechanism to resolve a subgrantee’s audit in a timely
fashion.
(i) The responsibility conditions that alone will disqualify an applicant are:
(1) an applicant may be disqualified if either of the first 2 responsibility tests listed
in (h) is not met.
(2) the remainder of the responsibility tests listed in (h) require a substantial or
persistent failure (for 2 or more consecutive years).
(3) the second responsibility test addresses ‘‘fraud or criminal activity of a
significant nature.’’ The existence of significant fraud or criminal activity will be
determined by the DOL and typically will include willful or grossly negligent
disregard for the use, handling, or other fiduciary duties of Federal funding where
the grantee has no effective systems, checks, or safeguards to detect or prevent
fraud or criminal activity. Additionally, significant fraud or criminal activity will
typically include coordinated patterns or behaviors that pervade a grantee’s
administration or are focused at the higher levels of a grantee’s management or
authority. To be consistent with the OAA Section 514(d)(4)(B), this determination
will be made on a case-by-case basis regardless of what party identifies the
alleged fraud or criminal activity.
(j) The DOL may examine the responsibility of eligible entities by completing the
following:
(1) The DOL will conduct a review of available records to assess each applicant’s
overall fiscal and administrative ability to manage Federal funds. The DOL’s
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responsibility review may consider any available information, including the
organization’s history with regard to the management of other grants awarded by
the DOL or by other Federal agencies. 1
(k) The circumstances that the DOL may reject an application are:
(1) The DOL may question any proposed project component of an application if it
believes that the component will not serve the purposes of the program. The
DOL may reject the application if the applicant does not submit or negotiate an
acceptable alternative.
(2) The DOL may reject any application that the Grant Officer determines
unacceptable based on the content of the application, rating score, past
performance, fiscal management, or any other factor the Grant Officer believes
serves the best interest of the program, including the application’s comparative
rating in a competition.
(l) If an applicant’s application is rejected, the course of action is:
(1) Any entity whose application is rejected in whole or in part will be provided a
timely notice as well as an explanation, or debriefing, of the DOL’s basis for its
rejection. Notifications will include an explanation of the DOL’s decision and
suggestions as to how to improve the applicant’s position for future competitions.
(2) Incumbent grantees will not have an opportunity to cure in an open
competition because that will create an inequity in favor of incumbents which
already have opportunities to correct deficiencies through technical assistance,
provided by the DOL, under OAA, Section 514(e)(2)(A).
(3) If the Administrative Law Judge (ALJ) rules that the organization should have
been selected, in whole or in part, and the organization continues to meet the
requirements of this part, the matter must be remanded to the Grant Officer. The
Grant Officer must, within 10 working days, determine whether the slots which
are the subject of the ALJ’s decision will be awarded, in whole or in part, to the
organization and the timing of the award. In making this determination, the Grant
Officer must take into account disruption to participants, disruption to grantees
and the operational needs of the SCSEP.
(4) The Grant Officer must return the decision to the ALJ for review. In the event
that the Grant Officer determines that it is not feasible, the successful appellant
will be awarded its bid preparation costs or a pro rata share of those costs if
Grant Officer’s finding applies to only a portion of the funds that would be
awarded to the successful appellant. An applicant so selected is not entitled to
the full grant amount but will only receive the funds remaining in the grant that
have not been expended by the current grantee through its operation of the grant
and its subsequent closeout. The available remedy in a non-selection appeal is
the right to be selected in the future as an SCSEP grantee for the remainder of
the current grant cycle. Neither retroactive nor immediately effective election
status may be awarded as relief in a non-selection appeal under this section and
1
Older Americans Act, Section 514(d)(1) and (2)
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the grievance procedure. Any organization selected and/or funded as an SCSEP
grantee is subject to having its slots reduced or to being removed as an SCSEP
grantee of an ALJ decision so orders. The Grant Officer provides instructions on
transition and closeout to both the newly designated grantee and to the grantee
whose slots are affected or which is being removed. All parties must agree to the
provisions of this paragraph as a condition of being an SCSEP grantee.
(m) The Governor may make recommendations to the DOL on grant applications in the
following manner:
(1) Each Governor will have a reasonable opportunity to make comments on any
application to operate a project located in the Governor’s State before the DOL
makes a final decision on a grant award. The Governor’s comments should be
directed to the DOL and may include the anticipated effect of the proposal on the
overall distribution of program positions within the State; recommendations for
redistribution of positions to underserved areas as vacancies occur in previously
encumbered positions in other areas; and recommendations for distributing any
new positions that may become available as a result of an increase in funding for
the State. The Governor’s recommendations should be consistent with the State
Plan for Indiana.
(A) Under noncompetitive conditions, the Governor may make the
authorized recommendations on all applications. However, under
competitive conditions, the Governor has the option of making the
authorized recommendations on all applications or only on those
applications proposed for award following the rating process. It is
incumbent on each Governor to inform the DOL of his or her intent to
review the applications before or after the rating process.
(n) grants are awarded competitively in the following manner:
(1) The DOL must hold a competition for funds when a grantee (national
grantee, national grantee in a State, or State grantee) fails to meet its
performance measures; the eligibility requirements; or the responsibility tests
established by Section 514 of the Older Americans Act.
(2) The DOL may hold a full and open competition before the beginning of a new
grant period, or if additional grantees are funded. The details of the competition
will be provided in a Solicitation for Grant Applications published in the Federal
Register. The DOL believes that full and open competition is the best way to
assure the highest quality of services to eligible participants.
9008.4 FINANCIAL QUARTERLY REPORT TO THE DOL-269
Financial report for SCSEP expenditures due to DOL 30 days following the end of each
quarter (quarters defined as: July-September, October to December, January-March,
and April to June).
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9008. 5 CLOSE OUT FINANCIAL REPORT TO THE DOL-due 90 days following the end of
the program year (program year ends June 30).
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CHART 26 Tips for Success
FSSA DA
SubGrantee
Tips for Success
1. The FSSA DA will
mail and track serial
numbered surveys,
which are assigned
to each subgrantee.
1. Subgrantee
notifies verbally &
in-writing qualified
employer at time of
placement that
survey will be
coming
1. Employer is selected only if it is
NOT also a host agency and if the subgrantee has a substantial
communication with the employer in
connection with the placement
2. Employer is surveyed only ONCE
each year
3. Self-employed participants and host
agencies who become employers do
not receive an employer survey
2. The FSSA DA
will send subgrantees a supply of
surveys in
numerical
sequence, preprinted reply
envelopes, and
blank mailing
envelopes.
3. The FSSA DA
will monitor for
compliance.
2. Subgrantee must
use the material in
numerical
sequence. Subgrantee takes next
survey in numerical
order and enters
survey number into
database (Field 23)
3. Sub-grantee
assembles survey
packet – cover
letter, survey, return
Monitoring
envelope (with
Corrective Actions
postage stamp
may include, but are affixed) -- and, if
not limited to the
possible, delivers it
following:
to employer contact
Requests for
in person -- at time
correction
of 30-day follow-up
Re-review
(Follow-up number
Corrective Action
1). Please sign the
survey letter in blue
Plans
ink and affix
Loss of slots &
postage (stamped
funding
Other sanctions as
not through a
determined by
postage meter).
FSSA DA
Mailing of the
survey is permitted,
but strongly
4. Technical assistance will be
provided and sub-grantee is
encouraged to contact FSSA DA as
often as needed. We will promptly
respond
6. Sub-grantee must have sufficient
computer capability to assimilate new
program changes & should insure that
they have sufficient system technical
support to ensure program compliance
with all reporting and data
requirements
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4. The FSSA DA
will provide prompt
technical
assistance, and will
document all
technical assistance
provided into a
written Q & A that
will be distributed
periodically to subgrantees
discouraged, due to
the requirement for
maintaining solid
relationships with
employers and for
future wage data.
Personal contact is
always encouraged.
4. Sub-grantee
enters date of
mailing into
database (Field 24)
Website references:
Charter Oak Group -- primary
program info, some data
www.charteroakgroup.org
click on
Mathematica -- primary
data/database info
@mathematica-mpr.com
US Department of Labor
www.doleta.gov/Seniors
Veteran's info -- DD 214
(requesting the DD-214)
www.usgovinfo.about.com/bldd214.htm
Social Security Administration
www.ssa.gov
5. Sub-grantee
enters survey
number and other
necessary
information into
Excel spreadsheet
tracking form to
facilitate tracking of
survey response
6. Sub-grantee
sends copy of
tracking form to
FSSA DA (via FAX
or e-mail) to notify it
that survey has
been delivered
7. Vendor will notify
sub-grantee weekly
of all surveys
completed. Subgrantee monitors
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vendor e-mail for 2
full weeks after
delivery of first
survey (i.e. 2 weeks
after the week in
which the survey is
delivered, and
checks survey
numbers of
completed surveys
against vendor
tracking form)
8. If survey
received. Subgrantee updates
tracking form (Field
26f ) and the
database and then
notifies the FSSA
DA of completed
survey (via FAX or
e-mail)
9. If 2nd or 3 rd
surveys needed:
Follow same steps
as first survey, for
the 2 nd & 3 rd
surveys--except
coordinator must
enter new survey
serial numbers, new
dates, and wait 2
weeks for the 2nd
attempt and 4
weeks for the 3rd
attempt.
9009 DOL PERFORMANCE STANDARDS FOR THE GRANTEE (FSSA DA)
Before the beginning of each program year, the DOL will negotiate and set baseline
levels of negotiated performance for each measure with the FSSA DA, taking into
consideration the need to promote continuous improvement in the program overall as
well as past performance. The negotiated performance standard goals will be
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provided to the subgrantees at the beginning of each program year.1
9009.1 INDIANA PERFORMANCE MEASURES FOR THE PROGRAM YEAR
(a) For the program year, Indiana will be held accountable for collecting information on
the 7 performance measures mandated by the OAA Amendments and the implementing
regulations. The following are the performance measures:
(1) Placement Rate
(2) Service Level
(3) Service to Most-in-Need
(4) Community Service Provided
(5) Employment Retention
(6) Customer Satisfaction for Employers, Participants, and Host Agencies
(7) Earnings Increase
(b) Descriptions of the performance measures and the expected Program Year are as
follows:
(1) Placement Rate
(A) The Placement Rate will be calculated by dividing the number of SCSEP
participants placed in unsubsidized employment by the number of each grantee’s
authorized community service positions. Consistent with the OAA Amendments,
placement may be in either full- or part-time employment.
(B) A placement requires 30 days of employment, not necessarily continuous,
with 1 or more employers within the first 90 days of exit. Each day that a
participant is on the payroll of an employer counts towards the 30-day
requirement, regardless of whether the participant actually performs services on
that day.
(C) Thus a participant who exits SCSEP for unsubsidized employment on
September 1 st, and remains employed with the same employer through
September 30 th, has achieved a placement. The baseline level of negotiated
performance for “placement into public or private subsidized employment” is set
at 20 percent. 2
(2) Service Level
(A) The Service Level is defined as the number of a subgrantee’s
participants divided by the number of the subgrantee’s authorized
positions.
1
2
Added 4/10/06
Older Americans Act, Section 513 ( a)(2)(C)
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The DOL will maintain the current program requirement for state and
national grantees to serve a total number of eligible individuals that is at
least 140 percent of the number of authorized community service positions
– this is comparable to the Government Performance and Results Act of
1993 (GPRA) goal for the program.
(3) Service to Most-in-Need
(A) The FSSA DA has determined that Service to Most-in-Need will reflect the
percentage of total participants who are 60 years of age or older and meet at
least 1 of the following criterion:
(1) Have an income level at or below the poverty line; 1
(2) Have physical or mental disability; language barrier (limited English
speaking or illiteracy); and/or cultural, social, or geographical isolation,
including isolation caused by racial or ethnic status, that restricts the
ability of the individual to perform normal daily tasks, or threatens the
capacity of the individual to live independently; 2 or
(3) Have poor employment history or prospects (for example, displaced
homemakers3); or other social barriers.
(4) Community Service
(A) In addition to the goal of placement in unsubsidized employment, an equally
important goal of the Title V program is to benefit communities through
community service assignments.
(B) The Community Service measure provides a tracking method with respect to
accomplishments in meeting the community benefit goal. The FSSA DA decided
to measure Community Service by obtaining information on the number of hours
of community service provided. The goal is defined as the total number of
community service hours worked by all participants compared to the
subgrantee’s community service goal expressed in hours.
(5) Retention Rate
(A) Section 513(b)(3) of the OAA Amendments requires performance indicators
to include “placement into and retention in unsubsidized public or private
employment.” The FSSA DA will treat these 2 outcomes separately.
1
Older Americans Act, Section 102(27)
Older Americans Act, Section 102 (28)
3
A displaced homemaker is defined as an individual who has been providing unpaid services to family
members in the home and who: (1) has been dependent on the income of another family member but is no
longer supported by that income; and (2) is unemployed or underemployed and is experiencing difficulty in
obtaining or upgrading employment).
2
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(B) The OAA Amendments define “retention in public or private unsubsidized
employment” in Section 513(c)(2)(B) as: “full- or part-time paid employment in the
public or private sector by an participant under this Title for 6 months after the
starting date of placement into unsubsidized employment without the use of
funds under this title or any other Federal or state employment subsidy program.”
(C) The FSSA DA plans to measure retention at 6 months by determining which
participants who have been placed into unsubsidized employment are employed
by any employer on the 180 th day after first starting unsubsidized employment
with any employer.
(6) Customer Satisfaction for Employers, Participants, and Host
Agencies
(A) Section 513(b)(4) of the OAA Amendments states that indicators of SCSEP
performance must include satisfaction of the participants, employers, and host
agencies with their experience with SCSEP.
(B) The FSSA DA interprets this provision as requiring 3 separate and distinct
measures of Customer Satisfaction – a customer satisfaction measure for
participants, a measure for employers, and a measure for host agencies.
(C) For the employer customer satisfaction survey, the Division of Aging’s goal is
to have sub-grantees deliver a survey form to every employer at a mandatory
follow-up interview within 90 days after a placement. Subgrantees will be
responsible for distributing written survey instruments and using a methodology
established by the Division of Aging to ensure uniformity.
(D) For all 3 surveys, the targeted return rate is 70%. Subgrantees (AAAs) are
instructed to deliver as many as 3 surveys in order to reach the 70% mark. The
completed surveys will be sent to a central collection point for collation and
analysis by a contractor selected by the FSSA DA.
(E) Beginning in PY 2004, Customer Satisfaction for all 3 groups will be surveyed
using the American Customer Satisfaction Index (ACSI). The ACSI will allow
SCSEP to look at its own performance and also to benchmark its performance
against other entities within and outside of the employment and training system.
The ACSI is useful in tracking change over time, making it an ideal way to gauge
progress in continuously improving performance. The survey uses a set of 3
required questions. The responses to these questions are then used to form a
customer satisfaction “index.
(F) The questions are:
(1) Using a scale of 1 to 10 where “1” means “Very Dissatisfied” and “10"
means “Very Satisfied” what is your overall satisfaction with the services
provided by ___________?
(2) Considering all of the expectations you may have had about the
services, to what extent have the services met your expectations? “1”
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now means “Falls Short of Your Expectations” and “10” means “Exceeds
Your Expectations”
(3) Now think of the ideal program for people in your circumstances. How
well do you think the services you received compare with the ideal set of
services? “1” now means “Not Very Close to the Ideal” and “10” means
“Very Close to the Ideal.”
(G) The ACSI score is obtained by combining scores from these three specific
questions that address different dimensions of customers’ experiences. In order
for the ACSI survey to yield meaningful results under the prescribed
methodology, the survey questions cannot be modified in any significant way.
(H) Only the ACSI score will be used to determine a grantee’s performance on
this measure. However, the FSSA DA will be adding additional questions,
beyond those required for the ACSI, to inform subgrantees and the Division of
Aging of customers’ evaluations of the services they have received.
(I) Indiana will be expected to have a combined rating of 80% satisfaction with
the SCSEP services provided to participants, employers and host agencies.
(7) Earnings Increase
(A) The FSSA DA has elected to add Earnings Increase to the measures
mandated by OAA legislation. Earnings Increase is one of the Common
Measures that were developed in a Government-wide initiative and adopted by
the FSSA DA for all DOL-funded employment and job training programs. The
purpose of the common measures initiative is to compare the performance of a
variety of Federal programs that have similar goals and operations.
(B) The Job Training Common Performance Measures apply to over thirty
separate programs administered by different Federal Agencies. For job training
programs that serve adults, there are 4 Common Measures:
(1) Entered Employment Rate;
(2) Retention in Employment;
(3) Earnings Increase (as a result of program participation); and
(4) Program Efficiency (cost per participant).
(C) Although only Earnings Increase is being adopted as a sanctionable SCSEP
measure, the FSSA DA will collect data on the other common measures listed
above. The program efficiency measure, applies to the aggregate results of the
entire program and not to individual subgrantees.)
(D) OMB will evaluate the overall effectiveness of SCSEP based on these
measures and will require that data be collected. The Retention, Earnings
Increase, and Program Efficiency measures are new to SCSEP; and the Entered
Employment Rate is calculated by a different methodology from the one that
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SCSEP grantees used for “placement into unsubsidized public or private
employment” – the SCSEP Placement Rate.
(E) The FSSA DA has used its discretionary authority, specified in the OAA,
Section 513(b)(5), to select the measure ‘Earnings Increase’ as a required
performance indicator for SCSEP, in 2004. The ‘Earnings Increase’ measure has
2 separate components:
(i) Earnings Increase ONE (“pre-post”) is defined as follows: “Of those
who are employed in the 1st quarter after program exit, earnings in the
first quarter after exit minus earnings in the quarter prior to registration
divided by earnings in the quarter prior to registration.”
(ii) Earnings Increase TWO (“post-post”) is defined as follows: “Of those
who are employed in the 1st quarter after program exit, earnings in the 3rd
quarter after exit minus earnings in the 1st quarter after exit divided by
earnings in the 1st quarter after exit.”
(F) The standard for Indiana shall be:
(i) Earnings Increase ONE (pre-post) shall be 25% higher than the preprogram earnings
(ii) Earnings Increase TWO (post-post) shall be 10% higher than Earnings
Increase 1.
(iii) Upon Department notification, Indiana will begin this standard. This
goal will be sanctionable as of July 1 st, 2005 and those subsequent years
thereafter.
(c) Performance levels (or standards) for the first 6 performance measures will be set on
July 1st, 2005, for every State grantee and national grantee organization. The FSSA DA
plan is to base the performance levels for each of these indicators on data to be
collected by the SCSEP system in PY 2004. Baseline data on the earnings increase
measure will be collected during PY 2004 and PY 2005, and the performance levels for
this measure will be effective on July 1 st, 2006.
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CHART 27
PERFORMANCE MEASURES
Performance Measures
1.The number of persons served is defined by
comparing the total number of participants served to
a grantee’s authorized number of positions adjusted
for the differences in wages required to be paid in a
State or area (baseline 140%).
2.The number of persons served, with the greatest
social need or with poor employment history or
prospects, and those over 60 years old is defined by
comparing the total number of participants served to
the total number of participants who: are over age
60 and have an income level at or below the poverty
line; or have physical and mental disabilities,
language barriers, isolation, factors that restrict
individual ability to perform normal daily tasks or
threaten independent living capability or have poor
employment history or prospects.
3.Community services provided is defined as the
number of hours of community service provided by
SCSEP participants.
4.Placement into unsubsidized public or private
employment is defined by comparing the number of
participants placed into unsubsidized employment to
the total number of authorized positions.(Minimum
20%, GPRA 35%).
5.Retention in public or private unsubsidized
employment means the number of participants
retained in unsubsidized employment, compared to
the total number of the first quarter after exit-(6
months).
6.Satisfaction of participants means the results
accumulated as the results of surveys of the
participant customer group of their satisfaction with
their experiences and the services provided.
7. Satisfaction of employers means the results
accumulated as the results of surveys of the
employer customer group of their satisfaction with
their experiences and the services provided.
8. Satisfaction of host agencies means the results
accumulated as the results of surveys of the host
agency customer group of their satisfaction with
their experiences and the services provided.
9. Earnings increase means the percentage change
in earnings pre-registration to post-program, and
between the first quarter after exit and the third
quarter after exit.
Common Measures
1. Entered employment, defined as the
percentage employment in the first quarter after
program exit. The percent of exiters not employed
prior to program employment who were employed
in the quarter after quarter of exit.
2. Retention in employment, defined as the
percentage of those employed in the first quarter
after exit who were still employed in the second
quarter after exit.
3. Earnings (Gain 1) increase defined as the
percentage change in earnings pre-registration to
post program, and between the first quarter after
exit and the third quarter after exit.
st
rd
4. Earnings (Gain 2-post-program 1 quarter to 3
quarter) defined as the percent change in
earnings in the first quarter after exit, the
st
rd
difference in earnings between the 1 and 3
quarters after exit.
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9010 DOL PERFORMANCE MEASURES SANCTIONS
(a) If the FSSA DA meets 80-100% for the aggregate of all the performance measures,
there will be no sanctions.
(b) If the FSSA DA fails to meet 80-110% for the aggregate of all the performance
measures during the first year, the sanctions will involve a corrective plan of action 160
days after the end of the program year to meet the performance measures as well as
receiving technical assistance from the Department of Labor.
(c) If the FSSA DA fails to meet 80-100% for the aggregate of all the performance
measures after the second year, 25% of the grant funds must be put up for competitive
bids.
(d) If the FSSA DA fails to meet 80-100% for the aggregate of all the performance
measures after the third year, 100% of the grant funds must be put up for competitive
bids.
(e) Sanctions will be passed down to the subgrantees (AAAs) based on the following:
(1) failure to meet 80-100% for the aggregate of all the performance measures.
(2) poor program assessment.
(3) grant funds are reduced resulting in loss of authorized positions.
(f) Based on a combination of items (see Section 9011 (e)(1) and (2)) positions may be
taken from a subgrantee as a result of poor performance. The positions eliminated will
be in a county that is over-served (based on the current the DOL’s Equitable Distribution
Report). Positions may be awarded to another subgrantee as a reward for overperformance and must be utilized in a county that is under-served.
(g) If sanctions are in effect or grant funds have been reduced which resulted in a loss of
authorized positions, any subgrantee with a combination of poor program assessment
and a failure to meet 80-100% of the grant funds may be reduced positions and the
positions may be eliminated from a county that is over-served.
9011 APPEALS POLICY AND PROCEDURES FOR PARTICIPANTS (SAME AS FOR CLIENT)
A participant has the right to appeal decisions regarding eligibility and services.
(1) The appeals procedure is as follows:
(A) Step One Informal Review
(i) An informal review with the subgrantee (AAA) will be conducted, to first
discuss any questions, concerns, or problems regarding eligibility and services.
This informal meeting may take place either at the host agency site (if required),
the office of the subgrantee or at the participant’s home or another neutral site.
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(ii) Within 5 working days of the date of the informal meeting, the subgrantee
shall inform the participant in writing:
(I) of the decision reached on the issues raised at the meeting; and
(II) that the participant may request the FSSA DA review to the
subgrantee's executive director or designee within 18 calendar days of
the date of the decision.
(B) Step Two: Subgrantee Review
(i) The subgrantee review process begins when a participant, within 18 calendar
days of the date of the decision, requests a review following the requirements of
Step One. The participant and subgrantee supervisor shall attend the review.
(ii) The participant will be given the opportunity to testify, present supporting
materials, explain the participant's reasons for disagreement with the action or
decision, and present an appropriate alternative. The subgrantee supervisor may
testify and explain the reasons for the decision or action taken.
(iii) Following the review, the subgrantee executive director or the designee
conducting the review shall consider the comments of the participant and the
subgrantee supervisor.
(iv) Within 5 working days from the date of the Subgrantee Review, the
subgrantee's executive director or designee shall prepare the subgrantees final
decision in writing that will include findings of fact and the specific reason for the
decision. The decision shall inform the participant of the participant's right to have
an administrative hearing under Step 3 if the participant is dissatisfied with the
subgrantee's final decision. The participant shall be sent a copy of the decision
by registered or certified mail, return receipt requested within 14 calendar days.
(C) Step Three: Administrative Hearing
(i) If a client is dissatisfied with the decision reached at the subgrantee review,
the participant may appeal the decision by requesting an administrative hearing.
The participant shall make the request for an administrative hearing in writing to
the Director of the FSSA DA within 18 calendar days of the date of the decision
from the subgrantee review. The request shall include a statement regarding the
issues the participant wishes reviewed and contain the participant’s signature
and the date.
(ii) Administrative hearings shall be conducted by Administrative Law Judges or
hearing officers appointed by the DDRS director. The Administrative Law Judge
shall, at least five working days in advance of the hearing, notify all involved
persons by registered or certified mail, return receipt requested, of the date, time,
and location of the hearing. The subgrantee shall forward all written case
documentation to the Administrative Law Judge (ALJ) prior to the hearing. The
hearing will be conducted in accordance with Indiana Code 4-21.5.
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(iii) Testimony will be taken under oath or affirmation, and the proceedings will be
tape recorded. The participant, any other witnesses that a party chooses to
present, and the subgrantee supervisor will each be given an opportunity to
place written material into evidence, present additional written or oral statements,
and ask questions of any party. If the participant wishes to have a transcript of
the hearing, DDRS will transcribe the tape at the participant's expense.
(iv) The Division may waive this cost in exceptional circumstances. Immediately
following the hearing but not later than five working days, the Administrative Law
Judge shall prepare the proposed decision that will include a report of the
findings of fact and the reasons for the decision based on those findings of fact.
This proposed decision shall be forwarded to the DDRS director.
(v) A copy of the proposed decision shall be sent to the subgrantee, and the
participant, by registered or certified mail, return receipt requested. The DDRS
director shall affirm, modify, or dissolve the Administrative Law Judge's proposed
decision. The subgrantee and the participant shall be notified of the director's
final order by registered or certified mail, return receipt requested.
(D) Step Four: Review
(i) The DOL will not review final grantee determinations, except to determine
whether the grantee’s appeals procedures were followed. Within 60 calendar
days of the result of Step 3, a participant may appeal to the DOL based on the
following:
(I) If an appeal alleges violation of federal law, an appeal may be filed
with:
U.S. Department of Labor, Employment and Training
Administration, Division of Older Worker Programs
200 Constitution Avenue, NW
Washington, D. C. 20210
(II) If an appeal alleges a violation of, the non-discrimination requirements
of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation
Act of 1973, section 188 of the Workforce Investment Act of 1998 (WIA),
or their implementing regulations, the appeal may be directed to:
Director
Civil Rights Center
U.S. Department of Labor
Room N-4123
200 Constitution Avenue NW
Washington, D. C. 20210
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More Information can be found at:
Indiana Administrative Code 460, IAC 1- 4-10
SCSEP Final Rule
Code of Federal Regulations, 20 CFR Part 641
641.800-641.884
Code of Federal Regulations, 29 CFR, Part 93 Prohibited Activities
Code of federal Regulations, 29 CFR, Part 97(States) OMB Circular A-102 "Grants
and Cooperative Agreements with States and Local Governments"
Code of Federal Regulations, 20 CFR, Part 95(Non-Profits) OMB Circular A-110,
OMB A-122
Code of Federal Regulations, 20 CFR, Part 99(Vendors and subrecipients)
OMB Circular A-133 Financial and Compliance audit
OMB Circular A-87
Older Americans Act of 1965, as amended in 2000
Section 501(b)(1)(O)(R)
Section 502(c)(1)(2)(3)(4)(5)(6)(A)(B)
Section 502(e)
Section 503(f)(2)(3)
Section 514
Section 515(b)(c)
SCSEP Final Rule
Code of Federal Regulations, 20 CFR Part 641
641.800-641.884
Code of Federal Regulations, 29 CFR, Part 93 Prohibited Activities
Code of federal Regulations, 29 CFR, Part 97(States) OMB Circular A-102 "Grants
and Cooperative Agreements with States and Local Governments"
Code of Federal Regulations, 20 CFR, Part 95(Non-Profits) OMB Circular A-110,
OMB A-122
Code of Federal Regulations, 20 CFR, Part 99(Vendors and subrecipients)
OMB Circular A-133 Financial and Compliance audit
OMB Circular A-87
Older Americans Act of 1965, as amended in 2000
Section 501(b)(1)(O)(R)
Section 502(c)(1)(2)(3)(4)(5)(6)(A)(B)
Section 502(e)
Section 503(f)(2)(3)
Section 514
Section 515(b)(c)1
SCSEP Final Rule
Code of Federal Regulations, 20 CFR Part 641 and 641.800-641.884
Older Americans Act of 1965, as amended in 2000
1
Added 4/10/06
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Section 501(b)(1)(O)(R)
Section 502(c)(1)(2)(3)(4)(5)(6)(A)(B)
Section 502(e)
Section 503(f)(2)(3)
Section 514
Section 515(b)(c)1
SCSEP Final Rule
Code of Federal Regulations, 20 CFR Part 641 and 641.800-641.884
1
Added 4/10/06
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SECTION 10 - RESERVED FOR COMMUNITY AND HOME OPTIONS TO
INSTITUTIONAL CARE FOR THE ELDERLY AND DISABLED PROGRAM
(CHOICE)
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SECTION 11
11000 - RESIDENTIAL CARE ASSISTANCE PROGRAM (RCAP)
Table of Contents
11000 RESIDENTIAL CARE ASSISTANCE PROGRAM (RCAP) - PURPOSE
11001 CLIENT ELIGIBILITY
11001.1 Financial Eligibility
11001.2 Non-Financial Eligibility
11002 THE ROLE OF FSSA DA
11003 CASE PROCESSING
11003.1 Budgeting
11004 PROVIDER INFORMATION
11004.1 Provider Services
11004.2 Reimbursement
11004.3 Payment for Provider Services
11004.4 Claims Management Process
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11000 RESIDENTIAL CARE ASSISTANCE PROGRAM (RCAP) PURPOSE
(a) The Residential Care Assistance Program (RCAP) is a state funded program
that is composed of two parts; Room and Board Assistance (RBA) and Assistance
to Residents in County Homes (ARCH).
(b) RBA provides financial assistance contingent on availability of funds, to
eligible persons who reside in county owned and operated residential facilities or
Christian Science facilities certified by the Commission for Accreditation of
Christian Science Nursing Organizations/Facilities, Incorporated.1
(c) ARCH provides financial assistance contingent on availability of funds, to
eligible persons who reside in county owned and operated residential facilities.2
11001 CLIENT ELIGIBILITY
(a) The RCAP applicant must meet Indiana residency requirements by being a
resident or potential resident of a facility contracted by FSSA DA to provide RCAP
services.
(b) The RCAP applicant must also meet at least one of the following categorical
eligibility requirements3:
(1) AGED - must be 65 years of age or older;
(2) BLIND - The degree of blindness is determined by the FSSA Medical
Review Team (MRT) based upon a visual exam, unless both eyes are
missing, applicant receives SSI based upon blindness, or eligibility has
previously been established under Medicaid Blind (MA B category) The
client also must be at least eighteen (18) years of age; or
(3) DISABLED – Disability is determined by the Medical Review Team (MRT)
based upon social and medical information. The client also must be at least
eighteen (18) years of age. Physical exam is required unless:
(A) the applicant is receiving SSI based upon disability;
(B) the MRT has previously established eligibility and required no
progress report; or
(4) CURRENT MEDICAID FOR THE BLIND (MA D) recipient.
(c) The RCAP applicant has the responsibility of furnishing all information
necessary to determine eligibility. The DFR caseworker has the responsibility of
verifying all eligibility requirements.
1
Indiana Code, 12-10-6-2.1
Indiana Code, 12-10-6-1
3
Indiana Code, 12-10-6-1(a)1)(2)
2
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11001.1 FINANCIAL ELIGIBILITY
(a) Resources:
(1) All resources must be verified.
(2) All countable resources must be available 1 to the client(s).
(3) For RCAP eligibility determination the resources of the
applicant/recipient (A/R) AND the spouse if they are both living in the RCAP
facility are counted.
(4) For RCAP eligibility determination, the resources owned solely by the
spouse not in the RCAP facility are not counted. (For RCAP related
Medicaid (MAR) the resources of the applicant/ recipient AND the
resources of the spouse at home are to be counted).
(5) Current month's income is not counted as a resource.
(6) A resource remains a resource even after liquidation.
(7) Resource limitation for a single A/R is $1,500 and $2,250 for a couple
both living in the facility.
(8) Equity value of all non-exempt personal property is counted.
(9) Examples of personal property are:
(A) cash;
(B) contents of a safety deposit box;
(C) stocks/bonds;
(D) bank accounts;
(E) cash surrender value of life insurance owned by the A/R and
his/her spouse who also lives in the RCAP facility;
(F) automobiles; and
(G) recreational vehicles.
(10) Some personal property is exempt. Examples of exempt personal
property are:
(A) one automobile needed for employment, medical treatment, or
1
“Availability” means the owner of a resource has the ability to liquidate or dispose of the
resources. A resource can be solely or jointly owned. See ICES Program Policy Manual, Section
2605.10.00 and 2605.10.05 for more information.
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modified for a handicapped person;
(B) irrevocable burial trust;
(C) cash surrender value of life insurance policies with total face
value of $1,400 or less if provision has been made for payment of
the funeral expenses of the A/R from the proceeds of the insurance,
the $1,400 limitations is reduced by any amount in an irrevocable
burial trust or an irrevocable prepaid funeral agreement;
(D) all personal effects;
(E) personal property used to produce income (if the income is more
than the expenses); and
(F) proceeds or any interest earned on the proceeds of casualty
insurance received as a result of damage, destruction, loss or theft
of exempt real or personal property for a period of no more than 9
months.
(11) Real property is considered based upon whether or not it is exempt.
Examples of exempt real property are:
(A) the home if it is the residence of the A/R's spouse, child(ren)
under 18; or child(ren) over 18 if blind/disabled;
(B) income producing property (if income is greater than expenses
of ownership); and
(C) burial spaces.
(12) Non-exempt real property must be offered for rent or sale at a fair
market value (FMV).
(13) Excess resources on the first day of the month render an A/R ineligible
for the whole month.
(14) A life care contract may render an individual ineligible for RCAP unless
the facility can prove that it is no longer able to fulfill the legal
responsibilities under the contract.
(b) Income:
(1) Monthly income is considered in the month it is received. (Exception:
When a direct deposited income check is received early, the amount of the
direct deposit must be counted for the month it was intended.)
(2) Fluctuating income is to be averaged on a three month basis.
(3) Income received less often than monthly is to be prorated by the
number of months to be covered.
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(4) Regular income is to be converted to a monthly amount as follows:
(A) Weekly income is multiplied by 4.3;
(B) Bi-weekly income is multiplied by 2.15; and
(C) Semi-monthly income is multiplied by 2.
(5) Unearned income is income not received from an employer, such as SSI
(Supplemental Security Income), RSDI (Retirement, Survivors, and
Disability Insurance), pensions and other types of income. Gross income is
counted.
(6) Earned income is payment received in cash from an employer; such as
wages, salaries or commissions, or income from rental property.
(7) Allowable deductions from earned income are as follows:
(A) sixteen dollars for each employed person (not per job);
(B) all mandatory payroll deductions;
(C) transportation expense to and from work;
(D) mandatory meals; and
(E) any other mandatory expenses.
(8) For sheltered workshop earnings, divide the net income by two (after
allowing applicable expenses).
(9) Refer to ICES Program Policy Manual (IPPM), Section 3420.00 regarding
the treatment of rental income.
(10) Disregarded income includes:
(A) educational funds designated for tuition, books, and fees;
(B) tax refunds; and
(C) tax liabilities for state and local income taxes;
(D) Holocaust victim's settlement payment.1
(11) SSI is not exempt or disregarded as income for an RCAP A/R.
(d) Appeals – If the applicant/ recipient is not satisfied, an appeal may be
requested. Refer to Hearings and Appeals Process - Section 3000 for appeal
procedures.
1 Indiana Code, 12-10-6-1(f) Added 4/10/06
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11002 THE ROLE OF FSSA DA
(a) FSSA DA will assign a person to the RCAP as a coordinator.
(b) The RCAP Coordinator will:
(1) develop policies in coordination with all stakeholders to include other
State staff and FSSA Division of Family Resources;
(2) provide guidance and training as needed;
(3) receive and attempt to resolve problems/ complaints in coordination
with other stakeholders;
(4) monitor all aspects of the program to include timeliness and accuracy
of the intake/eligibility process which includes taking periodic random
samples of cases submitted by DFR caseworkers to verify timeliness and
accuracy, and contacting DFR caseworkers to provide technical advice
when inaccurate or incomplete documentation is received by FSSA Claims
Management;
(5) coordinate problem solving with the State office of DFR;
(6) review Housing with Services Establishments Disclosure form
submission;
(7) develop a monitoring tool in coordination with DFR staff and all other
stakeholders;
(8) make on-site monitoring visits; and
(9) utilize written and face-to-face interviews to determine client
satisfaction with services.
11003 CASE PROCESSING
(a) Case processing is completed by the DFR caseworker in the counties where
RBA and/or ARCH facilities are located or in the county where the applicant
resides.
(b) Applications must be processed and the State Form 5B Assistance to
Residents in County Homes/Room and Board Assistance Budget and
Recommendation must be completed and submitted to FSSA claims processing
within twenty working days from the date of receipt of all requested
documentation.
(c) Acceptance and processing of RCAP applications includes the following
steps:
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(1) The DFR caseworker shall gather documentation verifying the applicant
meets the eligibility criteria;
(2) If found eligible, the client will be placed on the RCAP, if state funding is
available.
(3) If found eligible and funding for additional slots is not available, the
applicant shall be advised to check again after the beginning of the next
State Fiscal Year. RCAP does not keep a waiting or inquiry list.
(d) All applications must be complete and must be signed and dated by the
applicant or someone acting on their behalf. If the application is signed in the
presence of a DFR caseworker, the application is valid of that date. If the
application is not signed in the presence of the caseworker, the signature must be
notarized. In such cases, the valid date is the date the application was notarized.
(e) During the application process, the following shall be completed:
(1) an applicant must inform the DFR caseworker of their choice of facility
and the facility's willingness to accept the applicant as a resident. If the
applicant does not have a facility that will accept the applicant, no
application will be taken.
(2) potential applicants are to complete an Application for the Residential
Care Assistance Program at their local DFR.
(3) the DFR caseworker will determine eligibility of applicants for RCAP and
Medicaid program or State Medical Assistance, if applicant will be entering
a County Home.
(4) when an applicant has been determined eligible for RCAP, the DFR
caseworker will send the recommendation form and budget
recommendation (see appendix) to FSSA Claims Management. The DFR
caseworker will enroll the applicant in the Medicaid program pending RCAP
or State Medical Assistance, if the applicant will be entering a county
home.
(5) FSSA Claims Management will send a Certificate of Action indicating
the eligibility date of the applicant based on the date of application, to the
respective DFR, the FSSA Division of Aging (FSSA DA) and two copies to
the facility, one of which is to be given to the resident.
(f) Denials/Terminations
(1) When an applicant is denied or terminated from the RCAP by the DFR, a
Budget Recommendation Form will be sent to the FSSA Claims
Management. After appropriate action, FSSA Claims Management will
send a Certificate of Action indicating the change to the respective DFR
and two copies to the respective facility, one of which is to be given to the
resident.
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(g) Continuing Program Eligibility
(1) The DFR caseworker is responsible for determining that each resident
continues to meet all eligibility requirements. There must be a redetermination completed annually. The DFR caseworker will send an
annual Recommendation Form to FSSA Claims Management. FSSA Claims
Management will send a certificate of action indicating any changes to the
respective DFR, the FSSA DA and two copies to the respective facility, one
of which is to be given to the resident.
(h) Ceasing the Acceptance of New Applications
(1) The FSSA DA will monitor the RCAP budget to determine if funds are
available to support new applicants.
(2) If such a level of encumbrance is reached that warrants suspension of
accepting new RCAP applications, the FSSA DA will send a notice to all
DFR to discontinue taking new applications. The DFR will post this notice
in a public place in their offices.
(3) The FSSA DA will send a copy of the notice to discontinue taking
applications to all RCAP providers.
(4) All residents currently enrolled will continue to receive RCAP funding.
(5) Any applications that are pending at DFR or FSSA Claims Management,
prior to the effective date of the notice to discontinue, will be processed
(Prior to the effective date means by the close of business on the day
before the date indicated on the Termination Notice)
(i) Resumption of Accepting and Processing RCAP Applications
(1) If FSSA DA determines that funds are available to re-open the
application process, a notice will be sent to all DFR informing them that
they are to resume accepting and processing new applications for RCAP.
The DFR will post this notice in a public place in their office.
(2) The FSSA DA will send a copy of the notice to all RCAP Providers.
(j) Case Numbering
(1) The RBA or ARCH case number is separate and distinct from the
Medicaid number. Each client will have an RBA or Arch number in addition
to his/her Medicaid number.
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(2) Each Case Number must consists of ten symbols;
(A) A 2 letter prefix that identifies the category of service;
MA = RBA Aged
RA = ARCH
MD = RBA Disabled
RD = ARCH Disabled
MB = RBA Blind
RB = ARCH Blind
(B) a two digit county number; and
(C) a six digit case number
(3) Case number examples:
RA49001234 = ARCH aged client, Marion County, case number 1234
MB01000312 = RBA blind client, Adams County, case number 312
(4) Case numbers must be unique to the individual case. The DFR must
assure that case numbers within each of the two categories of service
(ARCH and RBA) remain separate and in numerical order, i.e.:
(5) Examples:
ARCH Cases 123, 124, 125
RBA Cases 123, 124, 125
11003.1 BUDGETING
(a) General Explanations:
(1) Personal Needs Allowance (PNA)
(A) Each RCAP client is allowed to keep from their monthly gross
income an amount specified in state law (IC 12-10-6-1) to meet their
monthly personal needs (Personal Needs Allowance or PNA). The
balance of their income (liability) goes to the facility. In cases where
the individual has no income, the state provides the required PNA
amount to the individual.
(B) Current PNA amount as established by the legislature is fifty-two
dollars.1
(2) Supplemental Security Income (SSI)
(A) When an individual who receives SSI in the community enters an
RBA facility, the individual will continue to receive SSI benefits.
(B) When the SSI recipient moves into an ARCH facility the Social
Security Administration (SSA) totally discontinues the SSI benefits.
1
Indiana Code, 12-10-6-1(d)(1)
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(b) Budgeting Income of Single RCAP Recipient includes the following steps:
(1) Determine countable income;
(2) Subtract the PNA;
(3) The unrounded remainder is the liability amount.
(4) Subtract the RCAP rate from the liability. The RCAP monthly rate is
computed by multiplying the facility’s daily rate by 365 and dividing by 12
months equaling the monthly per diem. The RBA per diem rate is $39.35/
day. The ARCH per diem rate is $27.00/day.
(5) If the resultant amount is a deficit, this will be the amount of the RBA
award.
(6) If there is a surplus, the applicant is ineligible RCAP.
(7) If there is a surplus for a current recipient, due to an increase in income,
the individual is eligible only if the surplus does not exceed the facility’s
private rate and the recipient is willing to pay the excess income to the
facility.
(8) The liability for the RCAP facility is not a Medicaid liability and is not
computed by ICES or entered into the system. It is computed manually by
the caseworker.
(c) Budgeting Income for Applicant and Spouse.
(1) Both applicant and spouse must be living in the RCAP facility.
(2) Consider each spouse’s eligibility as directed in the budgeting
procedure for a single applicant.
(3) If one spouse is eligible and one is ineligible, all or part of the ineligible
spouse’s income is considered to be available to the other spouse.
(4) Determine the ineligible, spouse’s average monthly medical expenses
(See Table 1 Spousal Allotment on State Form 31759/(R25-96/BAIS0005B).
(5) Subtract these expenses from his/her surplus income.
(6) The result is the amount of available (deemed) income for the other
spouse.
(7) Add the amount of deemed income to the eligible spouse liability.
(8) If the eligible spouse’s liability does not equal or exceed the facility’s
RCAP rate, the case is approved.
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(9) If the eligible spouse is a recipient, she/he remains eligible as long as
the liability does not equal or exceed the private pay rate.
(d) Budgeting For Partial Month of Admission.
(1) If an applicant enters the RCAP facility on a day other than the first day
of the month, eligibility for that month is based upon the RCAP daily rate
multiplied by the number of days remaining in the month. The current
licensed facility or RBA rate is $39.35/day and ARCH is $27.00/day.
(e) Special Circumstances
(1) When a Medicaid (Title XIX) recipient has a spend-down and enters an
RCAP facility after the first day of the month, the Medicaid eligibility is
based on the RCAP eligibility.
(2) RCAP per diem cannot be used to meet Medicaid Spend-Down
(3) RCAP clients may not pay a Spend-down to be eligible for the RCAP
program to meet spend-down.
(4) RCAP clients may not pay a on the RCAP program.
(5) A Medicaid recipient who enters an RCAP facility directly from a nursing
home after the first day of the month.
(6) An RCAP recipient who leaves the RCAP facility and goes to a nursing
home is expected to pay the RCAP facility for the days he/she resides
there.
(7) Nursing home liability should be computed for no later than the second
subsequent month.
(8) An RCAP recipient who leaves the RCAP facility and returns to the
community is expected to pay the per diem charges up to the liability for
the days he/she resided in the RCAP facility.
(9) An RCAP recipient who leaves the RCAP facility and returns to the
community is expected to pay the per diem charges up to the liability for
the days the individual resided in the RCAP facility.
11004 PROVIDER INFORMATION
(a) To be a RCAP Provider, a facility must be:
(1) licensed by the State Department of Health as a residential care facility
under IC 16-28; or
(2) an accredited Christian Science facility; or
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(3) a facility owned and operated by an Indiana County Government office;
and
(4) have a contractual agreement with the FSSA DA to provide services.
(b) An accredited Christian Science facility or a facility owned and operated by an
Indiana County Government office must:
(1) meet all applicable fire safety codes and receive regular fire safety
inspections from the State Fire Marshall’s office or local fire department
(and)
(2) have regular health inspections by the appropriate local entity.
(c) All RCAP Providers are classified as "housing with services establishments"
and must file the “Disclosure For Housing With Services Establishments” form
annually in accordance with Indiana Code 12 -10-15. Housing with services
establishments include any freestanding facilities and/ or part of a campus or
complex (Independent living, nursing facility, apartment complex, hospital and/or
continuing care facility. If a disclosure form is not submitted, the business shall
not:
(1) enter into or extend the term of the contract with an individual to reside
in a housing with services establishment; or
(2) use the term "assisted living" to describe the housing with services
establishment's services and operations to the public. See the form titled Disclosure For Housing With Services Establishments - which can be
accessed on the FSSA website. The web address is http://www.in.gov/fssa.
11004.1 PROVIDER SERVICES
(a) An RCAP Provider must provide room and board, housekeeping, laundry and
minimal supervision to RCAP clients. Also, the following requirements must be
met:
(1) Facilities must be clean and as homelike as possible;
(2) Residents will have clean linens and clothing available at all times; and
(3) Supervision will be conducted in such a way as to maximize a client's
potential for autonomy and decision making.
(b) Client Intake Option:
(1) RCAP providers may assist applicants in completing an application for
RCAP Services. The applications will be processed by the local DFR office
under the following circumstances:
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(A) The application is signed and dated by the applicant in the
presence of a notary public;
(B) There are RCAP slot vacancies available. (See Section 11003 (g)
- Ceasing Acceptance of Applications); (and)
(C) The application is received in the DFR office within 10 working
days of the date it was signed and notarized.
(c) Required Administrative Activities
(1) RCAP Providers are required to notify the DFR office of any change in a
client's RCAP status within 10 days of change. RCAP Status changes
include:
(A) change in income;
(B) no longer eligible for RCAP;
(C) moved from the facility;
(D) voluntarily withdrew from program; and
(E) hospital stay exceeding number of paid days available.
(F) Short-term nursing home stay
(G) Death (Always include date of death.)
(2) Follow-up to application change of status report:
(A) The RCAP provider should follow-up on any application or
change of status report if there has been no resulting action after 45
days. First contact should be with the DFR caseworker assigned to
work with the facility. Should further action be needed, the FSSA DA
RCAP Program Coordinator should be contacted.
11004.2 REIMBURSEMENT
(a) Reimbursement for services established by FSSA DA (IC12-10-6-1). The current
rate is $39.35/day for licensed facilities. The current rate for unlicensed facilities is
$27.00/day.
(b) Payment to an RCAP provider will not exceed lower of the maximum rate
established by FSSA DA or the facilities private pay rate.
(c) See Section 11003(a) for payment for client personal needs allowance.
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11004.3 PAYMENT FOR PROVIDER SERVICES
(a) Payment is made on a per client, per day basis.
(b) Payment will be made to hold a place for a RCAP client under the following
circumstances for the maximum time indicated:
(1) Hospital stay - 15 days paid per visit.
(2) Vacation days - 18 days paid every 6 months (Based on the RCAP
effective date).
(A) Vacation days may be used for extended hospital or rehab staysA change of RCAP status form must be completed and sent to DFR
by the provider.
(3) Rehabilitation days - 15 days non-paid per visit.
11003.4 CLAIMS MANAGEMENT PROCESS
(a) Family and Social Services Administration (FSSA) Claims Management (CM)
receives the application packet or updating documentation with case information,
the DFR caseworker's signature as verifying verification of the information. (Note:
all payments are based on information submitted by caseworkers.)
(b) If the applicant has been determined not eligible, or another adverse action has
been determined, FSSA Claims Management sends a Certificate of Action (COA)
denying services to the applicant, the chosen provider and the DFR caseworker.
The mailing will include a notice of the appeal procedure.
(1) If the applicant has been determined eligible or another positive action
ahs been determined and all forms are determined complete and correct by
the FSSA, Claims Management enters the date in the claims management
data system (CMS) and sends a Certificate of Action to the applicant, the
chosen provider, the DFR Caseworker stating date of client’s eligibility.
(2) Enter information from the packet into the Claims Management Data
System (CMS).
(3) FSSA Claims Management sends information necessary to authorize
payment for services and to authorize payment of appropriate PNA to
clients to the State Auditor’s Office monthly. The State Auditor’s office
cuts the checks and returns them to Claims Management.
(4) Payment is issued monthly, by the State Auditor’s Office.
(c) Handling of Incomplete or Incorrect Information submitted by the DFR
caseworker:
(1) When Claims Management receives incomplete or questionable
information from a DFR Caseworker or when the information conflicts with
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client or provider information already in the CMS; Claims Management will
forward the information to FSSA DA RCAP Program Coordinator for followup.
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12000 - MEDICAID NURSING FACILITY LEVEL OF CARE HOME AND
COMMUNITY-BASED SERVICES WAIVERS
Table of Contents
12000 Medicaid Waiver
12000.1 Aged and Disabled Waiver (A&D)
12000.2 Assisted Living
12000.3 Traumatic Brain Injury (TBI)
12000.4 Medically Fragile Children’s Waiver (MFC)
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12000 MEDICAID NURSING FACILITY LEVEL OF CARE HOME AND COMMUNITY-BASED
SERVICES WAIVERS
(a) Policy.
At the State level, the four Nursing Facility (NF) Level of Care Medicaid
Waivers shall be administered by Waiver Services within the FSSA DA. The
Waiver Services administered by the FSSA DA include the following:
12000.1 Aged and Disabled Waiver (A&D)
Serves clients who meet Medicaid guidelines and are either 65 years old or
have disabilities. Clients must meet level of care standards of a skilled or
intermediate nursing facility. The client has chosen to receive services in a
home setting.
12000.2 Assisted Living Waiver (AL)
Serves clients who meet Medicaid guidelines and are at least 18 years old.
Clients must meet level of care standards for intermediate (can not be
assessed at a skilled level of care) nursing facility. The client has chosen to
receive services in an Assisted Living Facility.
12000.3 Traumatic Brain Injury Waiver (TBI)
Serves clients who meet Medicaid guidelines and are either 65 years old or
have disabilities. Clients must meet level of care standards of a skilled or
intermediate nursing facility. In addition the client must have an injury to
the brain arising from external forces, including closed or open head
injuries, toxic chemical reactions, anoxia, near drownings, and focal brain
injuries. The client must demonstrate significant physical, cognitive,
emotional, and/or behavioral impairment.
12000.4 Medically Fragile Children Wavier (MFC)
Serves clients who meet Medicaid guidelines and are under the age of 18
years. Clients must meet level of care standards of a skilled nursing
facility. Medically fragile means a severe, chronic physical condition which
results in a prolonged dependency on medical care or technology to
maintain health and well-being. The client has chosen to receive services in
a home setting.
(b) Authority.
42 CFR 430(c)
Social Security Act, Section 1915(c)
(c) Procedure.
On the local level, the point of entry for the above mentioned waivers shall
be the local AAA in the PSA of the client’s residency.
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(d) Traumatic Brain Injury (TBI)
Individuals meeting the Level of Care and Medicaid eligibility requirements
must also meet the following criteria in order to receive services through
this Waiver:
Aged (Age 65 and older)
Disabled
Traumatic Brain Injured
The following services are available to individuals through the Traumatic
Brain Injury Medicaid Waiver:
Case Management
Homemaker
Respite Care
Adult Day Services
Residential Habilitation
Structured Day Program
Supported Employment
Environmental Modification
Health Care Coordination
Transportation
Specialized Medical Equipment
Personal Emergency Response System
Attendant Care
Occupational Therapy
Speech Therapy
Behavior Management
Vehicle Modifications
(e) Medically Fragile Children (MFC)
Individuals meeting Level of Care and Medicaid eligibility requirements
must also meet the following criteria in order to receive services through
this Waiver:
Disabled
Under age 18
Severe and chronic physical condition which results in prolonged
dependency on Medical care or technology
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The following services are available to individuals through the Medically
Fragile Children Medicaid Waiver:
Case Management
Respite Care
Environmental Modifications (maintenance)
Attendant Care
Vehicle Modifications
(f) Aged and Disabled (AD)
Waiver Specific Eligibility Criteria
Individuals meeting Level of Care and Medicaid eligibility requirements
must also meet at least one of the following criteria in order to receive
services through this waiver:
Aged (Age 65 and older)
Disabled
Services Available:
Case Management
Homemaker
Respite Care
Adult Day Services
Environmental Modifications
Transportation
Specialized Medical Equipment
Personal Emergency Response System
Attendant Care
Adult Foster Care
Congregate Care
Home Delivered Meals
Nutritional Supplements
Pest Control
Community Transition Services
Vehicle Modifications
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(h) Assisted Living (AL)
Individuals meeting the Level of Care and Medicaid eligibility requirements
must also meet the following criteria in order to receive services through
this Waiver:
Age 18 and older
Disabled
The following services are available to individuals through the Assisted
Living Medicaid Waiver:
Case Management
Assisted Living Services
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APPENDIX I
STATE PLAN PROVISIONS
OLDER AMERICANS ACT
45 CFR 1321.17
Sec. 1321.17 Content of State plan.
To receive a grant under this part, a State shall have an approved State plan as prescribed in
section 307 of the Act. In addition to meeting the requirements of section 307, a State plan shall
include:
a. Identification by the State of the sole State agency that has been designated to develop
and administer the plan.
b. Statewide program objectives to implement the requirements under Title III of the Act and
any objectives established by the Commissioner through the rulemaking process.
c. A resource allocation plan indicating the proposed use of all title III funds administered by
a State agency, and the distribution of title III funds to each planning and service area.
d. Identification of the geographic boundaries of each planning and service area and of area
agencies on aging designated for each planning and service area, if appropriate.
e. Provision of prior Federal fiscal year information related to low income minority and rural
older individuals as required by sections 307(a) (23) and (29) of the Act.
f. Each of the assurances and provisions required in sections 305 and 307 of the Act, and
provisions that the State meets each of the requirements under Secs. 1321.5 through
1321.75 of this part, and the following assurances as prescribed by the Commissioner:
1. Each area agency engages only in activities which are consistent with its
statutory mission as prescribed in the Act and as specified in State policies under
Sec. 1321.11;
2. Preference is given to older persons in greatest social or economic need in the
provision of services under the plan;
3. Procedures exist to ensure that all services under this part are provided without
use of any means tests;
4. All services provided under title III meet any existing State and local licensing,
health and safety requirements for the provision of those services;
5. Older persons are provided opportunities to voluntarily contribute to the cost of
services;
6. Area plans shall specify as submitted, or be amended annually to include, details
of the amount of funds expended for each priority service during the past fiscal
year;
7. The State agency on aging shall develop policies governing all aspects of
programs operated under this part, including the manner in which the
ombudsman program operates at the State level and the relation of the
ombudsman program to area agencies where area agencies have been
designated;
8. The State agency will require area agencies on aging to arrange for outreach at
the community level that identifies individuals eligible for assistance under this
Act and other programs, both public and private, and informs them of the
availability of assistance. The outreach efforts shall place special emphasis on
reaching older individuals with the greatest economic or social needs with
particular attention to low income minority individuals, including outreach to
identify older Indians in the planning and service area and inform such older
Indians of the availability of assistance under the Act.
9. The State agency shall have and employ appropriate procedures for data
collection from area agencies on aging to permit the State to compile and
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10.
11.
12.
13.
transmit to the Commissioner accurate and timely statewide data requested by
the Commissioner in such form as the Commissioner directs; and
If the State agency proposes to use funds received under section 303(f) of the
Act for services other than those for preventive health specified in section 361,
the State plan shall demonstrate the unmet need for the services and explain
how the services are appropriate to improve the quality of life of older individuals,
particularly those with the greatest economic or social need, with special
attention to low-income minorities.
Area agencies shall compile available information, with necessary
supplementation, on courses of post-secondary education offered to older
individuals with little or no tuition. The assurance shall include a commitment by
the area agencies to make a summary of the information available to older
individuals at multipurpose senior centers, congregate nutrition sites, and in other
appropriate places.
Individuals with disabilities who reside in a non-institutional household with and
accompany a person eligible for congregate meals under this part shall be
provided a meal on the same basis that meals are provided to volunteers
pursuant to section 307(a)(13)(I) of the Act.
The services provided under this part will be coordinated, where appropriate, with
the services provided under title VI of the Act.
14.
i.
The State agency will not fund program development and coordinated
activities as a cost of supportive services for the administration of area
plans until it has first spent 10 percent of the total of its combined
allotments under Title III on the administration of area plans;
ii.
State and area agencies on aging will, consistent with budgeting cycles
(annually, biannually, or otherwise), submit the details of proposals to
pay for program development and coordination as a cost of supportive
services, to the general public for review and comment; and
iii.
The State agency certifies that any such expenditure by an area agency
will have a direct and positive impact on the enhancement of services for
older persons in the planning and service area.
15. The State agency will assure that where there is a significant population of older
Indians in any planning and service area that the area agency will provide for
outreach as required by section 306(a)(6)(N) of the Act.
Sec. 1321.19 Amendments to the State plan.
a. A State shall amend the State plan whenever necessary to reflect:
1. New or revised Federal statutes or regulations,
2. A material change in any law, organization, policy or State agency operation, or
3. Information required annually by sections 307(a) (23) and (29) of the Act.
b. Information required by paragraph (a)(3) of this section shall be submitted according to
guidelines prescribed by the Commissioner.
c. If a State intends to amend provisions of its plan required under Secs. 1321.17 (a) or (f),
it shall submit its proposed amendment to the Commissioner for approval. If the State
changes any of the provisions of its plan required under Sec. 1321.17 (b) through (d), it
shall amend the plan and notify the Commissioner. A State need only submit the
1
amended portions of the plan.
1 Added 5-13-05
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APPENDIX II
FSSA DA SERVICE CODES
NAME CODE
OLDER HOOSIER FUNDS
IN HOME CASE MANAGEMENT---EXPANSION
IN HOME ADMINISTRATION---EXPANSION
IN HOME DISABLED---EXPANSION
IN HOME ELDERLY---EXPANSION
IN HOME CASE MANAGEMENT---GRANDFATHERED
IN HOME ADMINISTRATION---GRANDFATHERED
IN HOME DISABLED---GRANDFATHERED
IN HOME ELDERLY---GRANDFATHERED
SSBG CASE MANAGEMENT
SSBG ADMINISTRATION
SSBG CLIENT SERVICES
ADULT GUARDIANSHIP SERVICES
TITLE III-A ADMINISTRATION
TITLE III-B SUPPORTIVE SERVICES
TITLE III-C1 CONGREGATE MEALS
TITLE III-C2 HOME DELIVERED MEALS
TITLE III-D IN HOME
USDA
TITLE III-F PREVENTIVE HEALTH
TITLE VII OMBUDSMAN SUPPLEMENT
TITLE VII PENSION COUNSELING
TITLE V ADMINISTRATION
TITLE V ENROLLEE WAGES AND FRINGES
TITLE V OTHER ENROLLEE COSTS
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2503
2504
2505
2506
2513
2514
2515
2516
2600
2601
2602
2700
3100
3200
3300
3400
3500
3600
3700
3800
3801
5005
5006
5007
1
APPENDIX III - NOTIFICATION OF CLIENT RIGHTS
As a person applying for or receiving services through an Area Agency on Aging, you have
the right to disagree with decisions made about your care. These decisions would include:
·
being found ineligible for services;
·
having services denied to you;
·
having services discontinued or reduced; or
·
having services provided which you feel are not in your best
interests.
If you have such a complaint, you may appeal according to the following steps:
STEP 1: INFORMAL REVIEW WITH CASE MANAGER AND CASE MANAGER SUPERVISOR
Discuss any complaints informally with the case manager and case manager supervisor
working for the Area Agency on Aging (AAA) where you applied or have received federal
or state funded services. This discussion may take place either at your home or at your
AAA. You may choose a representative to come with you. The case manager supervisor
must issue a decision regarding your complaint, in writing to you within 5 working days of
the date of your meeting. The case manager supervisor shall inform you that you may
request, in writing, an ‘Agency Review’ to the AAA executive director or designee, within
18 calendar days of the date of the case manager supervisor’s decision.
STEP 2: AGENCY REVIEW
If discussing the matter with your case manager and case manager
Supervisor does not provide you with a satisfactory decision, you may make a request in
writing for an ‘Agency Review’. Send your written request to the executive director of your
AAA asking for an Agency Review of the case manager supervisor's decision. This
request must be made within 18 calendar days of the date of the case manager
supervisor's decision. The executive director of the AAA or designee, will then conduct the
Agency Review at your home or the AAA office, whichever you request. You, your
representative (if you require one), the case manager or the case manager’s supervisor
shall attend the review. You or your representative will be given the chance to testify,
present supporting materials, and explain why you disagree with the action or decision and
what you would view as an appropriate alternative. The case manager or the case
manager supervisor may testify and explain the reasons for the decision or action taken.
Immediately following the review, the executive director or designee conducting the review
shall consider your comments or the comments of your representative and the comments
of the case manager or the case manager’s supervisor. Within 5 working days, the
executive director, or designee after consulting with the executive director, shall prepare
the AAA’s final decision, in writing, including the specific reason for the decision. You or
your representative shall be sent a copy of the decision by registered or certified mail,
return receipt requested. The decision shall inform you of your rights to have an
‘Administrative Hearing”, if dissatisfied with the final decision.
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STEP 3: ADMINISTRATIVE HEARING
If you are dissatisfied with the decision resulting from the Agency Review, you may
request an ‘Administrative Hearing’ by writing to the Deputy Director, Division of Aging
Services, Division of Disability, and Rehabilitative Services. Your written request must
be signed and dated. You must send this request to the deputy director within 18 calendar
days of the date of the decision from the Agency Review. The Division of Aging and
Rehabilitative Services (DDRS) Director will appoint an Administrative Law Judge (ALJ)
who will notify you of the date, time, and location of your hearing, and conduct the hearing.
This hearing is conducted under oath and will give you, the AAA, and anyone else whom
you may choose to accompany you to the hearing an opportunity to present written
material into evidence as well as present additional information and ask questions. The
ALJ will issue the findings and decision, which will be sent to you and to the Director of
DDRS. The DDRS Director will make a final decision in writing after reviewing the ALJ's
proposed findings and decision and notify you of that decision. If you are dissatisfied with
the Director's decision, then you may request a Judicial Review by filing an action in the
Circuit or Superior Court of the county where you live, Marion County, or of the county
where the decision is to be enforced, within 30 days of receipt of the Director's decision.
CONTINUATION OF SERVICES DURING AN APPEAL
If you appeal a decision which stopped your service(s), those services will usually resume
until the appeal is resolved. The Division of Disability and Rehabilitative Services
reserves the right to end or deny, at any time, services which would be harmful to you or
which violate state or federal law, regulations or policies.
LEGAL COUNSEL AND INTERPRETER SERVICES
The State will not pay for your legal counsel any time during the appeal process.
Interpreter services will be made available to assist you, if you are deaf or non-English
speaking, if you request. Reader services will be made available to you if you are blind
and if you make a request. If you require these services to participate in the Agency
Review or the Administrative Hearing, prior to the date of the review or hearing, you
must make arrangements with your AAA case manager. 1
1
Added 5-13-05
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Nutrition Services - Appendix A - Menu Standards
(a) The purpose of Menu Standards is to sustain and improve client health through the provision
of safe and nutritious meals using specific guidelines 1.
(b) All contracts, and open solicitations for meals should incorporate the Dietary Guidelines for
Americans, The FSSA Division of Aging Dietary Reference Intakes (DRIs) Requirements, and
incorporate the Meal Planning Guidance below.
DIETARY GUIDELINES FOR AMERICANS
Part 1
(a) Meals provided through the program shall comply with the Dietary Guidelines for Americans,
published by the Secretary of Health and Human Services and the Secretary of Agriculture. The
Dietary Guidelines for Americans provide science-based advice to promote health and to reduce
the risk for major chronic diseases through diet and physical activity. 2
(b) The guidelines include such things as:
(1) consuming a variety of foods within and among the basic food groups while staying
within energy needs;
(2) controlling calorie intake to manage body weight;
(3) being physically active each day;
(4) increasing daily intake of fruits and vegetables, whole grains, and nonfat or low-fat
milk and milk products;
(5) choosing fats wisely for good health;
(6) choosing carbohydrates wisely for good health;
(7) choosing and preparing foods with little salt; and
(8i) keeping food safe to eat.
THE DIETARY REFERENCE INTAKES (DRIS)
Part 2
(a) The Dietary Reference Intakes (DRIs) are a set of dietary references based on the
Recommended Dietary Allowances for essential vitamins and minerals and, in selected groups,
protein. The name “RDI” replaces the term “U.S. RDAs”. They are established by the National
Academy of Sciences. They are updated periodically to reflect current scientific knowledge. 3
1
Maryland Office on Aging, Menu Standards For The Senior Nutrition Program, Effective FY97.
Source: Part A: Executive Summary, 2005 Report of the Dietary Guidelines Advisory Committee, page 1
3
Source: Kurtzwell, Paula, “‘Daily Values’ Encourage Healthy Diet”, U.S. Food and Drug Administration,
www.fda.gov.
2
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(b) According to the 2005 Report of the Dietary Guidelines Advisory Committee, the committee
recommends that food guidance (planning) aim to achieve the most recent Recommended
Dietary Allowances (RDAs), Adequate Intakes (AIs), and Acceptable Macronutrient Distribution
Ranges (AMDRs) considering the individual‘s life stage, gender, and activity level. The
committee also recommends that the guidance consider the Tolerable Upper Intake Levels
(Uls).1
(1) Recommended Dietary Allowances (RDA) and Adequate Intakes (AI) - RDAs
and AIs may both be used as goals for individual intakes. RDAs are set to meet the
needs of all most (97 to 98 percent) individuals in a group. For Healthy breastfed
infants, the AI is the mean intake. The AI for other life stage and gender groups is
believed to cover the needs of all individuals in the group, but lack of data prevent being
able to specify with confidence the percentages of individuals covered by this intake. 2
(2) Acceptable Macronutrient Distribution Range (AMDR) – Is the range of intake for
a particular energy source that is associated with reduced risk of chronic disease while
providing intakes of essential nutrients. 3
(3) Upper Limit (UL) – The maximum level of daily nutrient intake that is likely to pose
no risk of adverse effects. 4
THE DIVISION OF AGING DIETARY REFERENCE INTAKES (DRIS) REQUIREMENTS
PART 3
(a) The Indiana Senior Nutrition Program menus are to adhere to the specific nutrient guidance
found in the FSSA DA Dietary Intakes (DRIs) Requirements (see chart on next page). The basis
for the nutrients selected include the following:
(1) Studies and publications by The National Academies 5, and the 2005 Dietary
Guidelines Advisory Committee Report; 6
(2) The State of Aging and Health in America 2004 report, released by The Merck
Institute of Aging & Health (MIAH), the Centers for Disease Control and Prevention
(CDC) and the Gerontological Society of America (GSA). The report, assess the health
status of the growing number of older Americans and makes recommendations to
2
Part D: Science Base, 2005 Report of the Dietary Guidelines Advisory Committee, page 2.
Part D: Science Base, 2005 Report of the Dietary Guidelines Advisory Committee.
4
Part D: Science Base, 2005 Report of the Dietary Guidelines Advisory Committee.
5
Part D: Science Base, 2005 Report of the Dietary Guidelines Advisory Committee.
5
The National Academies - copyright 2001, 2002 and 2004
· Dietary Reference Intakes: Water, Potassium, Sodium, Chloride, and Sulfate, February 11, 2004
· Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino
Acids, September 5, 2002
· Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron,
Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc, January 9, 2001
· Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium, and Carotenoids, August 3, 2000
· Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid,
Biotin, and Choline, June 2000
· Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, 1-1-97
6
2005 Dietary Guidelines Advisory Committee Report
3
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improve the mental and physical health of all Americans in their later years; 1
(3) Dietary Guidelines for Americans 2005 – specifically, Total Fat, Sodium, Iron,
Calcium, and Fiber; 2
(4) The Center For Safety and Applied Nutrition, U.S. Food and Drug Administration,
Nutrition Food Labeling. Specifically addressed nutrients currently required to be
included on food labels (consumer based). 3
1
The State of Aging and Health in America 2004, The Merck Institute of Aging & Heath
Dietary Guidelines for Americans 2005, U.S.D.A
3
The Center For Safety and Applied Nutrition, U.S. Food and Drug Administration, Nutrition Food Labeling
www.fda.gov/label.html
2
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DRIS – PART 4
FSSA Division of Aging
Dietary Reference Intakes (DRIs) Requirements
(A) Macronutrients
Requirement
CALORIES¹
A minimum of 684 Kcals./meal 2 for both Entrée Choice
One and Two.
TOTAL FAT
Limit Total Fat to no less than 20% of total calories and
no more than 35% of total calories/meal 6 for both Entrée
Choice One and Two.
FIBER¹
A minimum of 10.0 g/meal 3 for both Entrée Choice One
and Two.
Fiber is best obtained from foods such as, whole grains,
fruits, and vegetables rather than fiber supplements,
therefore, use of fiber supplements, isolated or synthetic
fiber and fiber laxatives is prohibited.
(B) Elements
Requirement
CALCIUM¹
A minimum of 400.0 mg/meal 3 not to exceed weekly
average of 833.3 mg/meal 5for both Entrée Choice One
and Two.
(C) Electrolytes
Requirement
SODIUM¹
A minimum of 400 mg/meal 4 not to exceed weekly
average of 800 mg/meal 6 for both Entrée One and Two.
TABLE DEFINITIONS AND ABBREVIATIONS
(d) g = gram
(e) Kcals. = Kilocalories (Recommended energy allowances are stipulated as kilocalories (kcal)
per day of physiologically available energy (i.e., the amount of potential food energy that can be
absorbed and utilized).
(f) mg = milligram
1
A minimum of one-third (1/3) of the RDA per meal daily for both Entrée Choice One and Two
2
Based on 1/3 DRI: RDA or AI 70+ Male
3
Based on 1/3 DRI: RDA 70+ Male
4
Based on 1/3 DRI: AI 70+ Male
5
Based on 1/3 DRI: AI - UL 70+ Male
6
Nutrition and Your Health: Dietary Guidelines for Americans – United States Department of
Agriculture and United States Department of Health and Human Services
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MEAL PLANNING GUIDANCE
PART 5
(a) Due to the Older Americans Act (as amended in 2000) requirements that provided meals
comply with the current Dietary Guidelines for Americans and the DRIs, standardized meal
patterns are disallowed. However, providers still must plan individual meals based on the
recommendations of the Dietary Guidelines For Americans.
(b) This includes consumption of foods from each of the following basic food groups; 1
(1) fruits
(2) vegetables
(3) grains
(4) milk, yogurt, and cheese
(5) meat, poultry, fish, dry beans, eggs, and nuts
(c) Consumption of a variety of food commodities within each of those food groups --since
higher energy intake is strongly associated with greater variety and higher nutrient intake,
attention also should be given to food group choices that maintain appropriate energy balance. 2
1
Question 2: What Dietary Pattern is Associated With Achieving Recommended Nutrient Intakes?, Section 10: Major
Conclusions, Part D: Science Base, 2005 Report of the Dietary Guidelines Advisory Committee, page 1.
2
Question 2: What Dietary Pattern is Associated With Achieving Recommended Nutrient Intakes?, Section 10: Major
Conclusions, Part D: Science Base, 2005 Report of the Dietary Guidelines Advisory Committee, page 1.
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MENU PLANNING
PART 6
(a) Meat, Poultry, Fish, Dry Beans, Eggs, & Nut Group:
The meal shall contain no less than 2 ounces of cooked edible portion of cooked lean meat,
poultry, or fish1 or 2 ounces of Meat Alternate (iii)2
(1) Meat
(A) Meat serving weight is the edible portion, not including skin, bone, or coating.
(B) Since older adults and people with weakened immune systems are at higher
risk for listeriosis, the Food and Drug Administration is advising these individuals
not to consume (and FSSA DA is advising AAAs not to serve) the following:
(i) raw meat or poultry, unheated hot dogs and luncheon meats, cold cuts,
fermented and dry sausage, and other deli-style meat and poultry
products unless these products are reheated until steaming hot; 3
(ii) refrigerated pates or meat spreads. Canned or shelf-stable pates and
meat spreads may be eaten;
(iii) refrigerated smoked seafood, unless it is contained in a cooked dish,
such as a casserole. Refrigerated smoked seafood, such as salmon,
trout, whitefish, cod, tuna, or mackerel, is most often labeled as “novastyle,” “lox,” “kippered,” “smoked,” or “jerky.” Canned or shelf-stable
smoked seafood may be eaten;
(iv) raw fin fish and shellfish, including oysters, clams, mussels, and
scallops.
(C) If an AAA chooses to disregard the above FDA advisory and FSSA DA
guidance, the AAA must adhere to the Indiana State Department of Health, Retail
Food Establishment Sanitation Requirements – Title 410 IAC 7-24, Section 196,
which outlines specific Consumer Advisory procedures.
(2) Wild Game (wild animals and birds) is not allowed to be served. Game species
raised on U.S. farms under appropriate regulations may be served, however, the game
must be USDA inspected and documentation must be kept by the nutrition service
provider (please note, USDA inspection is voluntary for certain food products from game
species).4
1
Appendix A-2 USDA Food Guide, Lean Meat and Beans (2000 – 2200 Calorie Level). Page 53, Dietary
Guidelines For Americans, 2005, U.S. Department of Health and Human Services, and USDA.
2
Table 1. Sample USDA Food Guide and DASH Eating Plan at the 2,000-Calorie Level. Dietary
Guidelines For Americans, 2005, U.S. Department of Health and Human Services, and USDA.
3
Source: Consumer Advisory: “How to Safely Handle Refrigerated Ready-To-Eat Foods and Avoid
Listeriosis”, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, October 2003
and To Your Health! Food Safety for Seniors, FDA, October 2000.
4
Source: Food Safety of Farm-Raised Game: Food Safety Focus, Food Safety and Inspection Service,
USDA, Washington, D.C., April, 2004
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(A) Large game animals include such things as antelope, buffalo, bear, caribou,
deer, elk, moose, reindeer, wild boar and other species.
(B) Small game animals include such things as alligator, rabbit, squirrel, beaver,
muskrat, opossum, raccoon, armadillo, porcupine, and other species.
(C) Game birds include grouse, guinea fowl, partridge, squab (young pigeon),
quail, pheasant, wild ducks, wild geese, wild turkey, ratites (emu, ostrich, and
rhea) and other species. Rock Cornish hens, thought by many consumers to be
game birds are actually young domesticated chickens.
(3) Meat Alternate for One Ounce of Cooked Lean Meat:
(A) Servings - The following counts as a serving:
(i) ½ cup of cooked dry beans, peas or lentils;
(ii) ½ cup of tofu;
(iii) 2 ½ ounce soy-burger;
(iv) 1 ½ ounces of natural cheese (pasteurized only);
(v) ½ cup of cottage cheese (pasteurized only);
(vi) 1 medium egg (pasteurized only); or
(vii) 2 tablespoons of peanut butter or 1/3 cup of nuts.
(4) Dry Beans, Peas, and Lentils
(A) Dried beans, peas and lentils include: black beans, great northern beans,
kidney beans, lima beans, mixed beans (two or more varietal types of beans in
any proportions), navy beans, pink beans, pinto beans, red beans, yellow eye
beans, black-eyed peas or field peas, garbanzos or chick-peas, green split peas,
yellow split peas, brown lentils, red lentils.
(B) Dry beans, peas, and lentils may be counted as servings in either the Meat,
Poultry, Fish, Dry Beans, Eggs, & Nut Group or the Starchy Vegetables under
the Bread, Cereal, Rice, and Pasta Group. As a Starchy Vegetable, ½ cup of
cooked, dry beans, peas, and lentils counts as 1 serving. Dry beans, peas, and
lentils may not be counted as a Meat, Poultry, Fish, Dry Beans, Eggs, & Nut
Group serving and a Starchy Vegetable in the same meal.
(C) Cheese – Please refer to Milk, Yogurt, and Cheese Group.
(D) Eggs - Since older adults and people with weakened immune systems are at
higher risk for Salmonella Enteritidis (SE) the Food and Drug Administration is
advising these individuals not to consume any foods containing raw eggs.
Therefore, these products are not allowed to be served. Please note foods made
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from commercially pasteurized eggs are safe to eat. 1
This includes “health food” milk shakes made with raw eggs, Caesar salad,
Hollandaise sauce, and any other foods like homemade mayonnaise, ice cream,
or eggnog made from recipes in which the egg ingredients are not cooked. 2
(5) Nuts/Seeds – Whole or coarsely chopped nuts and seeds tend to be more difficult to
chew, and could present a choking hazard. (Due to thepossibility of food allergy,
providers may only serve one food item containing nuts/seeds per meal. It should be
indicated on the posted menu which food item contains nuts/seeds.)
(6) Combination Foods - Meat, Poultry, Fish, Dry Beans, Eggs, and Nuts Group items
may be combined to fulfill the serving requirement, such as 1 ounce of ham and ½ cup
of cooked dry navy beans (as food items in ham and beans), 1 ½ ounces of cheddar
cheese and 1 ounce of ham (as food items in macaroni and cheese with ham), or 1 ½
ounce soy-burger with 1 1/2 ounces of American cheese on a bun.
(b) Vegetable Group
(1) Servings - The following counts as a serving:
(A) 1cup of raw leafy vegetables
(B) ½ cup of other vegetables- cooked (drained) or raw (pieces, shredded,
chopped)
(C) ¾ cup vegetable juice (pasteurized only)
(2) For Starchy Vegetable list and restrictions, please refer to Bread, Cereal, Rice and
Pasta Group, Starchy Vegetables.
(3) Since older adults and people with weakened immune systems are at higher risk for
Salmonella and E. Coli the Food and Drug Administration is advising these individuals
not to consume (and FSSA DA is advising AAAs not to serve), raw sprouts (alfalfa,
clover, and radish).3
(4) If an AAA chooses to disregard the above FDA advisory and FSSA DA
guidance, the AAA must adhere to the Indiana State Department of Health, Retail
Food Establishment Sanitation Requirements – Title 410 IAC 7-24, Section 196,
which outlines specific Consumer Advisory procedures.
1
Source: To Your Health! Food Safety for Seniors, U.S. Food and Drug Administration, Center for Food
Safety and Applied Nutrition, October 2000.
2
Source: Focus on Shell Eggs, Food Safety and Inspection Service, USDA, Washington, D.C., February
2003 and To Your Health! Food Safety for Seniors, U.S. Food and Drug Administration, Center for Food
Safety and Applied Nutrition, October 2000.
3
Source: To Your Health! Food Safety for Seniors, U.S. Food and Drug Administration, Center for Food
Safety and Applied Nutrition, October 2000 and FDA Talk Paper, Food and Drug Administration, Interim
Advisory on Alfalfa Sprouts, August 31, 1998.
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(5) The following products do not qualify as vegetable and may not be credited toward
meeting the vegetable requirement in any meal served:
(A) snack-type foods made from vegetables, such as potato chips;
(B) deep-fried vegetable products, such as french fries, potato rounds, hash
browns, vegetable sticks, mushrooms, cauliflower, etc;
(C) home canned products (for food safety reasons); or dehydrated vegetables
used for seasoning.
(c) Fruit Group
(1) Servings - The following counts as a serving:
(A) whole fruit such as 1 medium apple, banana, orange, pear;
(B) ¾ cup of 100 % fruit juice (pasteurized only);
(C) ½ cup of berries;
(D) ¼ cup dried fruit;
(E) ½ cup of chopped, cooked or canned fruit;
(F) ½ cup fruit puree;
(G) a grapefruit half; or
(H) a melon wedge.
(2) A serving of canned fruit may include the juice or syrup in which the fruit is
packed.
(3) The following products do not qualify as fruit and may not be credited
toward meeting the fruit requirement in any meal served:
(A) snack-type foods made from fruits, such as banana chips; jam, or
jelly; or
(B) home canned products (for food safety reasons)
(C) Plum puree may not count as fruit when it is used to replace fat in a
food item.
(d) Bread, Cereal, Rice, and Pasta Group
(1) All grains/breads items must be enriched or whole-grain, made from enriched
or whole-grain meal and/or flour. If using a cereal it must be whole-grain,
enriched, or fortified.
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(2) Servings - The following counts as a serving:
(A) 1 small tortilla, 6” diameter;
(B) 1 slice of bread;
(C) ½ sandwich bun or English muffin small roll, biscuit, or muffin;
(D) 1 piece of cornbread (2 ½ in. x 2 ½ in. x 1 ½ in.);
(E) 5-6 small or 3-4 large crackers;
(F) about 1 cup of ready-to-eat cereal;
(G) ½ cup cooked cereal, grits, rice or pasta;
(H) ½ cup bread dressing/stuffing;
(I) 2 inch cube of corn bread;
(J) 2 pancakes, 4” diameter;
(K) ½ bagel;
(e) Starchy Vegetables (1) Green peas, corn, potatoes, dried beans, peas and lentils, yams, squash,
and plantains.
(2) If a starchy vegetable is served, limit to 1 serving per meal.
(3) Serving - ½ cup cooked counts as a serving.
(f) Milk, Yogurt, and Cheese Group - Choose fat-free or reduced-fat dairy products
most often.
(1) Servings - The following counts as a serving:
(A) 1/2 pint or 8-10 ounces of pasteurized fluid milk and/or pasteurized
plain yogurt;
(B) 1½ cup of pasteurized cottage cheese;
(C) 1½ ounces of pasteurized natural cheese (such as cheddar;
mozzarella, swiss); or
(D) 2 ounces of pasteurized processed cheese (such as American).
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(2) Milk (A) Includes (fortified with Vitamin D): whole milk, 2% low fat milk, 1%
low fat milk, fat-free skim milk, buttermilk, low-fat chocolate milk, or
lactose-reduced milk, lactose-free milk.
(3) Cheese (A) Includes reduced fat, low fat, nonfat, and lite versions of cheese,
cheese food, and cheese spread.
(B) Since older adults and people with weakened immune systems are at
higher risk for listeriosis the Food and Drug Administration is advising
these individuals not to consume, soft cheese such as Feta, Brie, and
Camembert cheeses, blue-veined cheeses, and Mexican-style cheese
such as queso blanco fresco and Panela unless it is labeled as made with
pasteurized milk.1 Therefore, unless pasteurized, the above listed
products are not allowed to be served.
(C) Any item labeled with the wording “imitation” cheese or cheese
“product” does not meet the requirements for use in food-based menu
planning approaches and are not creditable towards meal pattern
requirements.
(4) Cheese Substitutes (A) “Cheese Substitute,” “cheese food substitute,” and “cheese spread
substitute must meet FDA standard of identity for substitute foods and be
labeled as “_______ Cheese Substitute,” “cheese food substitute,” or
“cheese spread substitute.” The standard requires that a “cheese
substitute” is not nutritionally inferior to the standardized cheese for which
it is substituting.
(g) Fats, Oils & Sweets (1) Fats (Butter or fortified Margarine) (if appropriate)
(A) One teaspoon should be served with each meal.
(B) Oil, butter or margarine used in cooking and any butter or fortified
margarine offered at the table (one teaspoon) must be calculated into
the meal’s total fat and saturated fat analysis.
(g) Beverages (1) It is recommended that a glass of water be served with each congregate
meal.
1
Source: Consumer Advisory: “How to Safely Handle Refrigerated Ready-To-Eat Foods and Avoid
Listeriosis”, Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, October 2003.
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(2) The following items may not be provided as part of the program meal:
(A) alcoholic beverages including beer, liquor and wine; or
(B) soft drinks and colas.
(3) Coffee, tea, decaffeinated beverages, and/or fruit flavored drinks (not
fortified with vitamins or minerals) may be provided, but, may not be counted
as fulfilling any part of the meal requirements, nor may NSIP funds be used to
purchase such items.
SPECIAL MEALS, MODIFIED MEALS, MEDICAL FOODS, T HERAPEUTIC DIETS AND
ALTERNATIVE DESSERT OFFERINGS
PART 7
(a) The AAA must provide meals that to the maximum extent practicable, are adjusted to
meet any special dietary needs of program participants. 1
(1) FSSA DA recommends that each AAA have a written policy outlining if
the agency offers special meals, modified meals, medical foods,
therapeutic diets, and/or an alternate dessert. The Older American’s Act of
1965 as amended in 2000 and the FSSA Division of Aging do not mandate
AAAs to provide these meals, diets, and/or desserts.
(2) For agencies choosing not to offer modified meals, medical foods,
and/or therapeutic diets, but may or may not offer an alternate dessert the
following is recommended;
(A) Congregate Meal Site Participants
(i) The AAA should develop a disclaimer for posting at all
congregate meal sites outlining the AAA offered meal,
including any offered alternate dessert option.
(ii) EXAMPLE: Meal Served
“Each day’s meal is planned to contain a minimum of 684
calories, 20 to 35 percent of total calories from fat, a minimum
of 10.0 gm of dietary fiber, a minimum of 400.0 mg of calcium,
and 400 mg of sodium - not to exceed weekly average of
800 mg of sodium. For those participants following a
physician prescribed diet, please confer with your physician
prior to starting meals to ensure offered meal meets dietary
restrictions.”
1
Older Americans Act (as amended in 2000), Part C-Nutrition Services: Subpart 3-General
Provisions, Section 339(2)(A)
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(iii) EXAMPLE: Alternate Dessert
“The AAA does offer an alternate dessert option to the
standard dessert listed on the menu. Typically, the alternate
dessert is lower in calories, fat, and simple (refined)
carbohydrates. Examples include fresh fruit, sugar-free
gelatin and pudding, small servings (typically limited to one
time per week) of angel food cake, sponge cake without icing,
gingersnaps, vanilla wafers or similar items. Please see the
Site Manager for the AAA’s alternate dessert option.”
(Please note it is up the individual AAA to determine a
definition of their offered alternate dessert).
(B) Home Delivered Meal Participants
(i) The AAA should develop a disclaimer, for homebound
participant and/or legal guardian signature (if following a
modified meal, medical food, and/or therapeutic diet prior to
starting AAA meals) outlining the AAA offered meal,
including any offered alternate dessert option.
(ii) The disclaimer is to inform each participant and/or legal
guardian of what type of meal is offered by the AAA and let
the participant and/or legal guardian confer with the
participant’s physician to ensure the meal will meet the
participant’s needs without causing undo harm; or
(iii) The AAA should develop a letter to be sent to the
homebound participant’s physician (for participants following
a modified meal, medical food, and/or therapeutic diet prior to
starting AAA meals) outlining the offered AAA meal,
including any offered alternate dessert option. The intent of
the letter is to confirm with the participant’s physician if the
AAA meal will meet the participant’s needs without causing
undo harm.
(iv) For agencies choosing to offer modified meals, medical
foods, and/or therapeutic diets, but may or may not offer an
alternate dessert the following is recommended:
(C) Home Delivered Meal Participants and Congregate Meal
Participants (if meals, foods, and/or diets are offered)
(i) The AAA should develop a letter to be sent to the
individual participant’s physician (for participants following a
modified meal, medical food, and/or therapeutic diet prior to
starting AAA meals) specifically listing the AAA offered
modified meals, medical foods, and/or therapeutic diets,
including any offered alternate dessert option by the AAA.
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The intent of the letter is to confirm with the participant’s
physician if the AAA meal will meet the participant’s needs
(iii) The diet order must have a date, diagnosis, and expiration
date, and should be reviewed annually or sooner if deemed
appropriate (i.e., diet order change or other significant
change).
(iv) In addition, the AAA must establish specific written
policies and procedures (for case management, AAA nutrition
services, and the nutrition service provider) with regard to the
documenting, preparing, handling, processing and
monitoring of said meals and diets.
(b) Special Meals
(1) The AAA may require their nutrition service providers to provide ethnic and
religious meals when feasible and appropriate (“maximum extent practicable”), to
meet the particular dietary needs arising from the ethnic backgrounds, or
religious requirements of program participants. To determine feasibility and
appropriateness, the AAA should use the following criteria:
(A) there are sufficient numbers of participants who request the ethnic
and religious meals to make the provision practical;
(B) the food and skills necessary to prepare the menus are available n the
planning and service area;
(C) all menus comply with the menu planning requirements and menu
standards (Appendix A); and
(D) proper preparation and service of the menus is assured by thorough
documented training of personnel.
(C) MODIFIED MEALS
(1) The AAA may require their nutrition service providers to provide modified
meals when feasible and appropriate (“maximum extent practicable”), to meet the
particular dietary needs arising from the health requirements of program
participants. To determine feasibility and appropriateness, the AAA should use
the following criteria:
(A) There are sufficient numbers of participants who require the meals to
make the provision practical;
(B) The AAA has the services of a registered dietitian to provide guidance
to help coordinate proper preparation, service and oversight of modified
meals;
(C) The food and skills necessary to prepare the meals are available in
the planning and service area;
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(D) Proper preparation and service of the menus is assured by thorough
documented training of personnel; or
(E) The menus/meal must comply with the Menu Planning
Requirements and Menu Standards. (Appendix A).
(d) MEDICAL FOODS AND THERAPEUTIC DIETS
(1) The AAA may require their nutrition service providers to provide medical
foods and therapeutic diets when feasible and appropriate (“maximum extent
practicable”), to meet the particular dietary needs arising from health
requirements of program participants. To determine feasibility and
appropriateness, the AAA should use the following criteria:
(A) there are sufficient numbers of participants who require the meals to
make the provision practical;
(B) the AAA has the services of a registered dietitian to guidance to help
coordinate proper preparation, service and oversight of medical foods and
therapeutic diets;
(C) the food and skills necessary to prepare the meals are available in the
planning and service area; and
(D) proper preparation and service of the menus is assured by thorough
documented training of personnel.
(e) ALTERNATE DESSERT
(1) The AAA may require their nutrition service providers to provide
alternate desserts when feasible and appropriate (“maximum extent
practicable”), to meet the particular dietary needs arising from health
requirements of program participants. To determine feasibility and
appropriateness, the AAA should use the following criteria:
(A) there are sufficient numbers of participants who require the
alternate dessert to make the provision practical;
(B) the AAA has the services of a registered dietitian to provide
guidance to help the AAA define what constitutes the AAAs
alternate dessert option, and to help coordinate proper selection
and service of alternate desserts;
(C) the food and skills necessary to prepare the dessert are available
in the planning and service area; and
(D) proper preparation and service of the dessert item is assured by
thorough documented training of personnel
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