Assisted Living - First Nations Social Development Society

Report
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FIRST NATIONS SOCIAL
DEVELOPMENT SOCIETY
BSDW TRAINING:
SOCIAL DEVELOPMENT POLICY AND PROCEDURES MANUAL
AANDC - BC REGION
VOLUME 2: ASSISTED LIVING PROGRAM
FNSDS.ORG
July 2014
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FNSDS CONTACT INFORMATION
• FNSDS: (P)604-983-9820 (F)604-983-9822 (TF)1-800-991-7099
• MELENNIA POINT , EXECUTIVE DIRECTOR
[email protected]
• GINA GEORGE, FINANCE/ PWD MANAGER
[email protected] (P)1-877-985-5565 (F)604-983-9122
• TAMI OMEASOO, PROGRAM OFFICER
[email protected]
• CHRIS LECHKOBIT, PROGRAM OFFICER
[email protected]
• CHELSEY GEORGE, PWD ADMIN ASSISTANT
[email protected]
July 2014
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MAIN OBJECTIVE AND PROGRAM
DESCRIPTION
NATIONAL SOCIAL PROGRAMS MANUAL (AANDC, JAN. 2012)
“ THE AL PROGRAM PROVIDES FUNDING FOR NON-MEDICAL SOCIAL
SUPPORT SERVICES THAT MEET THE SPECIAL NEEDS OF SENIORS,
ADULTS WITH CHRONIC ILLNESS, AND CHILDREN AND ADULTS WITH
DISABILITIES (MENTAL & PHYSICAL) WITH THE OBJECTIVE OF
MAINTAINING FUNCTIONAL INDEPENDENCE AND GREATER SELFRELIANCE.”
“ THE AL PROGRAM IS AVAILABLE TO ALL PERSONS RESIDING ONRESERVE, OR ORDINARILY RESIDENT ON-RESERVE, WHO HAVE BEEN
FORMALLY ASSESSED BY A QUALIFIED PROFESSIONAL (IN A MANNER
COMPARABLE TO THE RELEVANT PROVINCE OR TERRITORY) AS
REQUIRING NON-MEDICAL SOCIAL SUPPORT SERVICES AND WHO DO
NOT HAVE THE MEANS TO OTHERWISE OBTAIN THESE SERVICES .”
July 2014
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FOUR MAJOR SERVICE COMPONENTS
NATIONAL SOCIAL PROGRAMS MANUAL (AANDC, JAN. 2012)
HOMEMAKER SERVICES – PROVIDES FINANCIAL ASSISTANCE FOR NONMEDICAL PERSONAL CARE FOR ADULTS WHO NEED ASSISTANCE WITH
ACTIVITIES OF DAILY LIVING. SERVICES RANGE FROM HOUSEKEEPING,
MEAL PREPARATION, AND ATTENDANT CARE TO COMMUNITY
SUPPORTS, SUCH AS ADULT CARE, MEALS ON WHEELS, PSYCHO -SOCIAL
PROGRAMS, SHORT-TERM RESPITE CARE FOR CAREGIVERS, AND NON HEALTH TRANSPORTATION.
ADULT FAMILY CARE HOMES – PROVIDES FUNDING FOR SUPERVISION
AND CARE FOR ADULTS IN A FAMILY-LIKE SETTING WHO DO NOT
REQUIRE 24-HOUR CARE BUT ARE UNABLE TO LIVE ON THEIR OWN.
July 2014
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FOUR MAJOR SERVICE COMPONENTS 2
INSTITUTIONAL CARE – REIMBURSES FOR SOME EXPENSES RELATED TO
TYPE I AND TYPE II CARE IN DESIGNATED FACILITIES FOR ADULTS.
ASSISTED LIVING DISABILITIES INITIATIVE, PROVIDES FUNDING TO
FIRST NATION ORGANIZATIONS FOR PROJECTS TO IMPROVE THE
COORDINATION AND ACCESSIBILITY OF EXISTING DISABILITY PROGRAMS
AND SERVICES ON RESERVES. ACTIVITIES MAY INCLUDE SUCH THINGS AS
ADVOCACY, PUBLIC AWARENESS, OR REGIONAL WORKSHOPS
• In BC this program funds the BCANDS disability case management
program
July 2014
DEFINITIONS
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NATIONAL SOCIAL PROGRAMS MANUAL (AANDC, JAN. 2012)
CONTINUING CARE – THE RANGE OF HOLISTIC MEDICAL AND SOCIAL
SUPPORT SERVICES FOR THOSE WHO DO NOT HAVE, OR WHO HAVE
LOST, SOME CAPACITY TO CARE FOR THEMSELVES .
• BC does not have a medical component of continuing care – Homemaker
Services only provides non-medical service
• For medical continuing care refer to FNHA Home and Community Care –
see your Nation’s Health Dept.
DISABILITIES INITIATIVE – AN AANDC INITIATIVE TO FUND PROJECTS TO
IMPROVE THE COORDINATION AND ACCESSIBILITY OF EXISTING
DISABILITY PROGRAMS AND SERVICES ON RESERVES, SUCH AS
ADVOCACY, PUBLIC AWARENESS AND REGIONAL WORKSHOPS.
• Re: BCANDS
July 2014
DEFINITIONS 2
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HOME SUPPORT – COMPONENT OF THE AL PROGRAM PROVIDING
HOMEMAKER SERVICES TO HELP PEOPLE WITH THEIR DAILY ACTIVITIES,
THEREBY CONTRIBUTING TO THEIR INDEPENDENCE AND TO THEIR
ABILITY TO REMAIN IN THEIR HOMES.
• Non-medical services only
INSTITUTIONAL CARE – CARE PROVIDED IN AN ADULT CARE FACILITY,
SUCH AS PERSONAL CARE HOMES, ELDERS LODGES AND SUPPORTIVE
LIVING HOMES, ETC..
July 2014
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DEFINITIONS: ORDINARILY RESIDENT
NATIONAL SOCIAL PROGRAMS MANUAL (AANDC, JAN. 2012)
ORDINARILY RESIDENT ON RESERVE - FOR THE PURPOSE OF PROVIDING
INCOME ASSISTANCE AND ASSISTED LIVING PROGRAMS AND SERVICES,
“ORDINARILY RESIDENT” MEANS THAT AN INDIVIDUAL CLIENT:
-LIVES AT A PERMANENT ADDRESS ON-RESERVE MORE THAN 50% OF
THE TIME; OR,
-IN THE CASE OF CHILDREN IN JOINT CUSTODY, LIVES MORE THAN 50%
OF THE TIME ON-RESERVE;
-DOES NOT HAVE A PRIMARY RESIDENCE OFF-RESERVE;
-IS AN INDIVIDUAL WHO IS OFF-RESERVE FOR THE PURPOSE OF
OBTAINING CARE NOT AVAILABLE ON-RESERVE OR WHO IS OFF-RESERVE
FOR THE PRIMARY PURPOSE OF ACCESSING SOCIAL SERVICES BECAUSE
THERE IS NO REASONABLY COMPARABLE SERVICE AVAILABLE ON RESERVE
July 2014
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AANDC BC REGION
VOLUME 2: ASSISTED LIVING PROGRAM
THERE ARE THREE MAIN SERVICE COMPONENTS TO ASSISTED LIVING IN
BC. WE WILL LOOK AT THESE COMPONENTS WITH A PROGRAM
SUMMARY (PRINCIPLE AND ELIGIBILITY), PROCEDURAL GUIDE, REVIEWS,
AND POLICY SUMMARY. THE MANUAL - VOLUME 2, ALSO HAS A
INTRODUCTION CHAPTER.
CHAPTER 1, INTRODUCTION
CHAPTER 2, HOMEMAKER SERVICES
CHAPTER 3, ADULT INSTITUTIONAL CARE SERVICES
CHAPTER 4, ADULT FAMILY CARE HOMES
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CHAPTER 2 HOMEMAKER SERVICES
PRINCIPLE (2.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
“HOMEMAKER SERVICES MEANS THE MINIMUM SET OF HOUSEHOLD
TASKS REQUIRED TO MAINTAIN A SAFE AND SUPPORTIVE ENVIRONMENT
FOR THE CLIENT. SERVICES MAY INCLUDE: CLEANING, LAUNDRY AND
MEAL PREPARATION AND BY EXCEPTION, TRANSPORTATION, BANKING
OR SHOPPING. SERVICES DO NOT INCLUDE MAJOR HOME REPAIRS.
• HOMEMAKER SERVICES IS A FIXED BUDGET PROGRAM – CARE IS
NEEDED WHEN APPROVING AND ASSIGNING SERVICES
July 2014
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CHAPTER 2 HOMEMAKER SERVICES
PRINCIPLE 2 (2.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
“ THE OBJECTIVE OF THE HOMEMAKER SERVICES PROGRAM IS TO
SUPPORT AND ENHANCE THE DIGNITY AND INDEPENDENCE OF
PHYSICALLY DISABLED, MENTALLY DISABLED OR ELDERLY ADULTS , AND
TO ASSIST THEM TO REMAIN IN THEIR OWN COMMUNITIES WITH
FAMILY AND FRIENDS, THEREBY AVOIDING INSTITUTIONALIZATION.”
• NON-MEDICAL SERVICES ONLY – MEDICAL IS HOMECARE
• HOMEMAKERS ASSIST DOMESTICALLY BUT ARE NOT MAIDS!
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
PRINCIPLE 3 (2.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
“HOMEMAKER SERVICES ARE INTENDED TO:
• ASSIST CLIENTS TO LIVE IN THEIR OWN HOMES AS LONG AS IT IS
PRACTICAL AND IN THE BEST INTERESTS OF THE CLIENTS AND THEIR
FAMILIES;
• SUPPLEMENT, BUT NOT REPLACE, THE CARE PROVIDED BY FAMILIES,
OTHER UNPAID CAREGIVERS AND COMMUNITIES;
• PROMOTE THE INDEPENDENCE AND WELL-BEING OF CLIENTS, THEIR
FAMILIES AND OTHER UNPAID CAREGIVERS; AND,
• PROVIDE RESPITE CARE TO THE FAMILY MEMBER OR OTHER
CAREGIVER ORDINARILY CARING FOR THE PERSON IN THE PERSON’S
HOME.“
* RESPITE FOR FAMILIES PROVIDING CARE IS POSSIBLE!
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
ELIGIBILITY (2.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
AGE: MUST BE 19 OR OLDER
RESIDENCY: MUST BE RESIDENT ON RESERVE AT TIME OF APPLICATION
HEALTH: FOR PERSONS WHO CANNOT LIVE INDEPENDENTLY DUE TO
HEALTH ISSUES THAT DO NOT REQUIRE ACUTE OR REHABILITATION CARE
• OF AT LEAST THREE MONTHS DURATION; AND,
• DUE TO A PROGRESSIVE AND /OR CHRONIC CONDITION.
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
ELIGIBILITY 2 (2.1)
ACCESS TO SERVICES IS BASED ON:
1) THE CLIENT’S HEALTH AND FUNCTIONAL STATUS; AND,
2) THE AVAILABILITY OF FAMILY AND OTHER COMMUNITY SUPPORTS.
• PRIORITY FOR SERVICE PROVISION IS TO BE GIVEN TO CLIENTS WHO
HAVE BEEN ASSESSED AS HAVING THE HIGHEST CARE NEEDS OR THOSE
WHO ARE LIVING WITH THE HIGHEST LEVELS OF RISK
* CLIENT DOES NOT HAVE TO BE ELIGIBLE FOR SOCIAL ASSISTANCE TO
RECEIVE ASSISTED LIVING SERVICES, ALTHOUGH USER FEES APPLY.
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
ELIGIBILITY 3 (2.1)
FAMILY MEMBERS EXCLUDED FROM PROVIDING HOMEMAKER
SERVICES:
WITHIN THE LIMITS OF THEIR MEANS AND CAPACITY, INDIVIDUALS AND
THEIR RELATIVES HAVE PRIMARY RESPONSIBILITY FOR HOME
MANAGEMENT AND SUPPORTS. PAYMENT MAY NOT BE ISSUED WHERE A
FAMILY MEMBER CAN BE EXPECTED TO PROVIDE HOMEMAKING SERVICE
• THIS ALSO MEANS THAT FAMILY MEMBERS WHO RESIDE WITH THE
APPLICANT CANNOT BE PAID TO PROVIDE HOMEMAKER SERVICES IN
THEIR OWN HOME
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
APPLICATION PROCEDURES (2.2)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
THERE ARE 7 STEPS TO TAKE WHEN SETTING UP A HOMEMAKER
SERVICE:
1) CLIENT ENQUIRES ABOUT HOMEMAKER SERVICES OR IS REFERRED TO
BSDW IN THE COMMUNITY WHERE THEY LIVE
2) BSDW PROVIDES FORM SA-215 HOMEMAKER SERVICES APPLICATION
TO CLIENT AND INFORMS CLIENT TO COMPLETE SECTION A AND B TO
START THEIR FILE
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
APPLICATION PROCEDURES 2 (2.2)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011 )
3) ONCE CLIENT COMPLETES THEIR SECTIONS AND RETURNS SA-215
AND BSDW ARRANGES FOR AN ASSESSOR TO VISIT THE CLIENT TO
DETERMINE CLIENT’S CARE REQUIREMENTS
* THE ASSESSOR MAY BE A PUBLIC HEALTH NURSE, A COMMUNITY
HEALTH NURSE, A COMMUNITY HEALTH REPRESENTATIVE OR OTHER
PERSON CAPABLE OF MAKING AN ACCURATE ASSESSMENT OF THE
APPLICANT’S CARE NEEDS.
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
APPLICATION PROCEDURES 3 (2.2)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
4) THE ASSESSOR VISITS AS ARRANGED AND COMPLETES FORM 901-30
HOMEMAKER SERVICES EVALUATION FORM
5) AFTER THE ASSESSMENT, THE ASSESSOR AND BSDW MEET TO REVIEW
THE APPLICATION AND MAKE A DECISION ON APPROPRIATE PROVISION
OF HOMEMAKER SERVICE. IF APPROVED, BSDW STARTS MAKING
ARRANGEMENTS WITH CLIENT TO SET UP CARE AS ASSESSED
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
APPLICATION PROCEDURES 4 (2.2)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011 )
6) BSDW COMPLETES SECTION C OF SA-215 HOMEMAKER SERVICES
APPLICATION BASED ON THE ASSESSMENT
7) BSDW MEETS WITH APPLICANT TO EXPLAIN THE TERMS OF SERVICE
AND COMPLETE SECTION D OF SA-215 HOMEMAKER SERVICES
APPLICATION. BSDW MUST ENSURE CLIENT UNDERSTANDS THE
PURPOSE AND CONTENT OF THE FORM, PARTICULARLY AROUND
PAYMENT
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
REVIEWS (2.5)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
“REVIEWS ARE DOCUMENTED FOLLOW-UP VISITS FOR THE PURPOSE OF
RE-EVALUATING THE CLIENT’S HEALTH STATUS AND CARE
REQUIREMENTS.”
• MUST BE IN-PERSON WITH ASSESSOR AND BSDW
• MUST BE AT LEAST EVERY 6 MONTHS, OR AT THE REQUEST OF THE
CLIENT OR RECOMMENDATION OF THE HOMEMAKER
* ALL FORMS MUST BE RE-DONE (SA-215 AND 901-30)
ROLE OF THE ASSESSOR:
• FOLLOWS UP ON CLIENT’S HEALTH AND CIRCUMSTANCES TO
DETERMINE IF THE ASSESSMENT IS STILL VALID – I.E. SA-215 FORM
• TO RECORD ANY CHANGES IN CLIENT’S HEALTH AND CIRCUMSTANCES
TO INFORM CHANGES TO CARE AND SERVICE PLANS
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
REVIEWS CONTINUED (2.5)
ROLE OF THE BSDW:
• REVIEWS NEW SA-215 HOMEMAKER SERVICES APPLICATION TO
DETERMINE IF FINANCIAL ARRANGEMENTS SHOULD CHANGE
• MAKES THE DECISION TO CONTINUE OR DISCONTINUE HOMEMAKER
SERVICES AS PER THE ASSESSOR’S REVIEW
REVIEW COMPONENTS:
• HOME VISIT
• DISCUSSION WITH CLIENT, FAMILY AND HEALTHCARE PROFESSIONALS
ABOUT CLIENT’S HEALTH AND CIRCUMSTANCES
• EXAMINATION OF RECORD OF CARE
• CONTACT SERVICE PROVIDERS REGARDING PLAN AND ANY CHANGES
• DOCUMENTATION AND UPDATING CLIENT’S FILE
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
ADDITIONAL POLICIES
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
2.6 MONTHLY REPORTS: REPORTING IS NOW DONE QUARTERLY OR
ANNUALLY VIA THE ASSISTED LIVING REPORT DCI 455937 – DISREGARD
DIRECTION TO THE SDSFR (SA-700) IN POLICY
2.3 SERVICE PROVIDER RATES AND PAYMENT METHODS
• RATES: PREVAILING RATE OF CONTRACTED AGENCY, COMPARABLE
RATES NEGOTIATED WITH QUALIFIED PROVIDER, MINIMUM WAGE IF
NO LOCAL AGENCY OR QUALIFIED PROVIDER EXISTS
• METHODS: ADMINISTERING AUTHORITY PAYS HOMEMAKER DIRECTLY;
OR IF CLIENT IS RESPONSIBLE FOR A PORTION OF THE CHARGE, THEY
ALSO PAY DIRECTLY
* HOMEMAKER IS RESPONSIBLE FOR PREPARING A STATEMENT OF
ACCOUNT THAT IS VALIDATED BY CLIENT PRIOR TO PAYMENT
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
ADDITIONAL POLICIES 2
2.7 OTHER SUPPORT SERVICES: WITHIN BUDGET LIMITATIONS AND
AVAILABLE RESOURCES, ASSISTED LIVING MAY HAVE OTHER PROGRAMS
DESIGNED TO PROMOTE THE INDEPENDENCE OF THE CLIENT
• I.E. COUNSELLING, MEALS, PSYCHO-SOCIAL, NON-MEDICAL, ETC.
* ADMINISTERING AUTHORITY MUST CONTACT THE FSO REGARDING
ANY REPORTING REQUIREMENTS
2.4 CLIENT USER CHARGES: DEPENDING ON INCOME, CLIENTS MAY BE
RESPONSIBLE FOR A PORTION OF THEIR USER FEE. ALL EARNED AND
UNEARNED INCOME MUST BE ACCOUNTED, AS WELL AS ASSETS.
• CLIENT DOES NOT HAVE TO PAY IF THEY RECEIVE ANY OF:
GIS/OAS/WIDOW’S PENSIONS
• AANDC INCOME ASSISTANCE, PPMB OR PWD
• A WAR VETERAN’S ALLOWANCE
July 2014
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CHAPTER 2 HOMEMAKER SERVICES:
CLIENT USER CHARGES PROCEDURES
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
• IT IS EASIEST TO FOLLOW THE INSTRUCTIONS ON FORM SA 215 –
HOMEMAKER SERVICES APPLICATION THAN USE PROCEDURES IN 2.4
CLIENT-USER CHARGES
1) ADD CLIENT’S (AND SPOUSE) NET INCOME ON TAX RETURN -LINE 236
2) MINUS THE TAX PAID AS REPORTED ON LINE 435 OF TAX RETURN
3) MINUS THE ANNUAL EARNED INCOME UP TO $ 15000 MAX –LINES
101, 104, 135, 137, 139, 141, 143
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CHAPTER 2 HOMEMAKER SERVICES:
CLIENT USER CHARGES PROCEDURES 2
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011 )
4) MINUS THE “ALLOWABLE DEDUCTION FOR CALCULATION OF THE
CLIENT’S REMAINING ANNUAL INCOME” THAT CORRESPONDS WITH THE
CLIENT’S FAMILY UNIT SIZE.”
5) MULTIPLY THE REMAINING ANNUAL INCOME BY 0.00138889 TO GET
CLIENT’S MAXIMUM DAILY USER CHARGE
6) CALCULATE CLIENT’S RESPONSIBILITY FOR PAYMENT
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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PRINCIPLE (3.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
“ THE ADULT INSTITUTIONAL CARE SERVICES PROGRAM PROVIDES
ASSISTANCE TO ELIGIBLE RESIDENTS LIVING ON -RESERVE WHO, BY
REASON OF INCAPACITY, REQUIRE PLACEMENT IN A LICENSED
CONTINUING CARE FACILITY.
ELIGIBILITY CRITERIA ARE SET BY THE PROVINCIAL MINISTRY OF HEALT H
SERVICES AND DIAND, BC REGION.
• THIS MEANS THAT ASSESSMENTS ARE CONTINGENT UPON THE LOCAL
HEALTH AUTHORITY.
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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PRINCIPLE (3.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
IT IS THE RESPONSIBILITY OF THE LOCAL HEALTH AUTHORITY TO
DETERMINE THE NATURE, AMOUNT, COST AND DURATION OF THE
SERVICE TO BE PROVIDED TO THE CLIENT.
• THE HEALTH AUTHORITY MAKES THE PLACEMENT AND
RECOMMENDATIONS ON CARE.
• AANDC WILL NOT NORMALLY AUTHORIZE CARE ARRANGEMENTS
THAT ARE NOT THOSE RECOMMENDED BY THE HEALTH AUTHORITY
ADMINISTERING AUTHORITIES WILL BE REIMBURSED BY DIAND FOR
CLIENTS PLACED IN DESIGNATED CONTINUING CARE FACILITIES, SUBJECT
TO THE CLIENTS MEETING THE ELIGIBILITY CRITERIA.”
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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ELIGIBILITY (3.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
AGE: MUST BE 19 OR OLDER
RESIDENCY: MUST BE RESIDENT ON RESERVE AT TIME OF APPLICATION
HEALTH: FOR PERSONS WHO CANNOT LIVE INDEPENDENTLY DUE TO
HEALTH ISSUES THAT DO NOT REQUIRE ACUTE OR REHABILITATION CARE
• OF AT LEAST THREE MONTHS DURATION; AND,
• DUE TO A PROGRESSIVE AND /OR CHRONIC CONDITION.
* TO PROVIDE SERVICES APPROPRIATE TO CLIENTS’ LONG TERM NEEDS
* CLIENT DOES NOT HAVE TO BE ELIGIBLE FOR SOCIAL ASSISTANCE TO
RECEIVE ASSISTED LIVING SERVICES, ALTHOUGH USER FEES APPLY.
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES (3.2)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
1) REFERRAL IS MADE TO BSDW AND FILE IS OPENED
2) BSDW ASKS CLIENT TO COMPLETE SA-115 MEDICAL RELEASE AND
REPORT
3) BSDW CONTACTS LOCAL HOME AND COMMUNITY CARE AT THE
HEALTH AUTHORITY (I.E. VIHA, INTERIOR HEALTH) AND REQUESTS AN
ASSESSMENT
• YOUR NATION’S LOCAL COMMUNITY NURSE OR OTHER EMPLOYEES
CANNOT ACT AS THE ASSESSOR
• THE ASSESSOR MUST BE EMPLOYED BY THE LOCAL HEALTH
AUTHORITY AS A HOME AND COMMUNITY CARE MANAGER AND
THEY WILL BRING ALL REQUIRED FORMS
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 2 (3.2)
4) ASSESSOR VISITS CLIENT, COMPLETES FORMS, DISCUSSES CARE
NEEDS AND ALTERNATIVES.
5) ASSESSOR MAKES RECOMMENDATION ABOUT CLIENT’S ELIGIBILITY,
LEVEL OF CARE, SERVICE DELIVERY PLAN, INSTITUTIONAL PLACEMENT
• RECOMMENDATION IS OUTLINED ON FORM LTC 1 APPLICATION AND
ASSESSMENT
• HOWEVER SOME HEALTH AUTHORITIES WILL ONLY USE ONE OF LTC 1,
HLTH 1.1, OR THE INTER SYSTEM (I.E. INTER-RAI, INTER-HDS, ETC.)
6) REFERRAL MAY BE MADE TO AN ASSESSMENT TEAM FOR REVIEW
BEFORE SERVICE LEVEL AND CARE PLAN IS FINALIZED
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 3 (3.2)
7) IF THE CLIENT IS DETERMINED AS REQUIRING PLACEMENT IN A
CONTINUING CARE FACILITY AT INTERMEDIATE LEVELS 1, 2, OR 3, THE
ASSESSOR WILL VISIT CLIENT AND EXPLAIN THE DECISION AND PLAN
FOR CARE.
• IF THE CLIENT AND/OR FAMILY DOES NOT AGREE, AANDC LIKELY WILL
NOT PAY FOR THEIR PREFERRED PLACEMENT.
8) POST-ASSESSMENT, BSDW SENDS A COPY OF SA-115 MEDICAL
RELEASE AND REPORT TO THE LOCAL HEALTH AUTHORITY AND
REQUESTS A COPY OF CLIENT’S LTC 1 APPLICATION AND ASSESSMENT
AND HLTH 1.6 FINANCIAL PROFILE AND CALCULATIONS FORMS
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 3 (3.2)
9) IF CLIENT CANNOT PAY THEIR USER CHARGES, BSDW WILL ASSESS FOR
INCOME ASSISTANCE ELIGIBILITY.
IF CLIENT RECEIVES ANY OF THE FOLLOWING THEY DO NOT PAY. THE
WHOLE USER CHARGE IS PAID BY THROUGH SOCIAL ASSISTANCE
• CLIENT DOES NOT HAVE TO PAY IF THEY RECEIVE ANY OF:
GIS/OAS/WIDOW’S PENSIONS
• AANDC INCOME ASSISTANCE, PPMB OR PWD
• A WAR VETERAN’S ALLOWANCE
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 4 (3.2)
10) PRIOR TO ADMISSION TO A DESIGNATED CONTINUING CARE
FACILITY, THE BAND SOCIAL DEVELOPMENT WORKER WILL:
• ASK THE ADMINISTRATOR OF THE CARE FACILITY TO COMPLETE PART
A OF THE ADULT INSTITUTIONAL CARE & FAMILY CARE HOMES CLIENT
ADMISSION FORM, INDICATING THE FACILITY’S PER DIEM COST
• ASK THE APPLICANT OR AN INDIVIDUAL WITH POWER OF ATTORNEY
TO COMPLETE PART B OF THE ADULT INSTITUTIONAL CARE & FAMILY
CARE HOMES CLIENT ADMISSION FORM, ACKNOWLEDGING CLIENT
USER CHARGES. IF THIS IS $0, STILL ENTER $0 AS THE VALUE
• BSDW COMPLETES PART C OF THE ADULT INSTITUTIONAL CARE &
FAMILY CARE HOMES CLIENT ADMISSION FORM, TO CONFIRM
CLIENT’S RESIDENCY AND ADMINISTERING AUTHORITY’S PAYMENT
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 5 (3.2)
11) THE ADMINISTERING AUTHORITY WILL FAX A COPY OF THE
COMPLETED:
• ADULT INSTITUTIONAL CARE & ADULT FAMILY CARE HOMES CLIENT
ADMISSION FORM,
• THE PROVINCIAL APPLICATION AND ASSESSMENT (LTC 1) FORM AND
• THE PROVINCIAL FINANCIAL PROFILE AND CALCULATIONS (HLTH 1.6)
FORM,
ATTENTION: AANDC, BC REGION DATA SERVICES UNIT AND THE LOCAL
FUNDING SERVICES OFFICER. THE DEDICATED REPORTING FAX NUMBER
IS 604-775-7400.
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 5 (3.2)
12) AANDC WILL SEND A CONFIRMATION LETTER TO THE
ADMINISTERING AUTHORITY INDICATING APPROVAL OR DENIAL. IF
APPROVED, THE LETTER WILL STATE THE PAYMENT START DATE
• NOTE THAT CLIENTS LIKELY WILL NOT BE REIMBURSED IF ENTERING A
CARE FACILITY BEFORE APPROVAL.
• TO DO SO MAY ALSO COMPLICATE THE ASSESSMENT PROCESS. –
CLIENT MAY NOT BE PLACED IN THE SAME FACILITY AFTER THEIR
ASSESSMENT
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 6 (3.2)
13) BSDW WILL ENSURE THE CLIENT’S FILE IS COMPLETE, INCLUDING:
•
•
•
•
•
•
•
•
DIAND MEDICAL RELEASE AND REPORT (SA 115)
PROVINCIAL APPLICATION AND ASSESSMENT (LTC 1) FORM
PROVINCIAL MINI MENTAL STATUS EXAMINATION (MMSE) FORM
A PROVINCIAL FINANCIAL PROFILE AND CALCULATIONS (HLTH 1.6)
FORM
DIAND ADULT INSTITUTIONAL CARE & ADULT FAMILY CARE HOMES
CLIENT ADMISSION FORM
DIAND, BC REGION’S CONFIRMATION LETTER TO THE ADMINISTERING
AUTHORITY THAT THE CLIENT’S ADMISSION FORM HAS BEEN
APPROVED FOR FUNDING
CASE NOTES
OTHER DOCUMENTATION AS REQUIRED
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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APPLICATION PROCEDURES 7 (3.2)
14) BSDW REQUIREMENTS:
• SUBMIT AN ASSISTED LIVING REPORT AS PER THE ADMINISTERING
AUTHORITY’S FUNDING AGREEMENT
• REPORT ANY RATE CHANGES FROM THE LOCAL HEALTH AUTHORITY
ON THE ASSISTED LIVING REPORT. MUST ATTACH A COPY OF THE
RATE CHANGE NOTIFICATION
• REPORT THE END OF CARE DATE ON THE ASSISTED LIVING REPORT
• CONTINUE TO MONITOR CLIENT’S ELIGIBILITY AND FUNDABILITY FOR
CLIENT USER CHARGES
* BSDW FACILITATES THE PROCESS, MONITORS CLIENT ELIGIBILITY, AND
KEEPS THE FILE UP TO DATE
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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REVIEWS (3.2)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
REVIEWS MAY BE REQUESTED BY:
• THE CLIENT
• A SERVICE PROVIDER
• A FAMILY MEMBER
• A PHYSICIAN
• A HEALTH CARE PROFESSIONAL
* REVIEWS ARE CONDUCTED BY THE LOCAL HEALTH AUTHORITY’S HOME
AND COMMUNITY CASE MANAGER AS WITH THE ORIGINAL ASSESSMENT
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
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ADDITIONAL POLICIES
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
3.3 RESPONSIBILITY OF THE ADMINISTERING AUTHORITY
JURISDICTION: ENSURE CLIENT FALLS WITHIN RESIDENCY OR
ORDINARILY RESIDENT REQUIREMENTS
SUPPORT SERVICES: MUST PROVIDE PRIOR TO ADMISSION:
• INCREASED AVAILABLE AND FLEXIBLE COMMUNITY HEALTH
SUPPORTS AND HOMEMAKER SERVICES
• CRISIS MANAGEMENT PLANNING
• PREPARATION AND COUNSELLING FOR ADMISSION
*UPON ADMISSION, MUST PROVIDE ADMINISTRATOR OF FACILITY:
- CONTRIBUTION RATES FOR AA AND CLIENT, BILLING PROCEDURES, AND
CONTACT INFO OF WORKER FOR REQUIRED FOLLOW -UP SERVICES
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
40
ADDITIONAL POLICIES 2
3.4 LEVELS OF CARE
* AANDC STILL USES OLD BC REGIMES OF LEVELS OF CARE. AANDC HAS
AN AGREEMENT WITH BC MINISTRY OF HEALTH TO STILL USE THIS
REGIME FOR ON-RESERVE CLIENTS DURING ASSESSMENTS
• PERSONAL LEVEL OF CARE: PERSON IS INDEPENDENTLY MOBILE,
REQUIRES MINIMAL ASSISTANCE AND WITH COMMUNITY SUPPORTS,
SHOULD NOT REQUIRE INSTITUTIONAL PLACEMENT
• INTERMEDIATE CARE LEVELS: RECOGNIZES A NEED FOR CARE
PLANNING AND SUPERVISION BY HEALTH CARE PROFESSIONALS
• EXTENDED CARE LEVELS: RECOGNIZES A SEVERE CHRONIC DISABILITY
WITH RESULTING FUNCTIONAL DEFICIT THAT REQUIRES 24 HOUR
CARE BUT NOT THE RESOURCES OF AN ACUTE CARE HOSPITAL
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CHAPTER 3 ADULT INSTITUTIONAL CARE:
41
ADDITIONAL POLICIES 3
3.7 RESPONSIBILITY FOR PAYMENT OF… PER DIEM
FACILITY PER DIEM COSTS ARE ESTABLISHED BY THE LOCAL HEALTH
AUTHORITY
INTERMEDIATE LEVELS OF CARE: AANDC IS RESPONSIBLE FOR ANY
CHARGES NOT BILLED TO THE USER
EXTENDED CARE LEVEL: COVERED BY PROVINCE OR FIRST NATIONS
HEALTH AUTHORITY – NON-INSURED HEALTH BENEFITS
RESIDENTS ON DESIGNATED COMMERCIAL PROPERTIES: NON-STATUS
CLIENTS ON DESIGNATED COMMERCIAL PROPERTY APPLY TO MSDSI
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
42
ADDITIONAL POLICIES 4
3.8 FINANCIAL EXEMPTIONS AND ALLOWANCES
ELIGIBILITY IS BASED ON CONTINUING FINANCIAL ELIGIBILITY FOR
SOCIAL ASSISTANCE
EARNED INCOME: RESIDENTS OF CARE FACILITIES ARE ELIGIBLE FOR
EARNINGS EXEMPTIONS RELEVANT TO THEIR IA CLIENT CLASS
INCENTIVE/CVS: RESIDENTS OF CARE FACILITIES ARE ELIGIBLE
COMFORTS AND CLOTHING ALLOWANCE: ELIGIBLE FOR RESIDENTS OF
CARE FACILITIES WITH NO OTHER MEANS OF PROVIDING FOR PERSONAL
AND RECREATIONAL NEEDS
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
43
ADDITIONAL POLICIES 5
3.9 OTHER SERVICES
MEDICAL SERVICES:
• STATUS PERSONS ARE COVERED THROUGH NON-INSURED HEALTH
BENEFITS, ANY REQUEST OR BILLING SHOULD BE DIRECTED TO FNHA
• IF CLIENT MEETS INCOME ASSISTANCE ELIGIBILITY, NON -STATUS
PERSONS ARE COVERED BY AANDC VIA VOLUME 1, INCOME
ASSISTANCE – CHAPTER 10 NON-STATUS HEALTH BENEFITS
TEMPORARY ABSENCE:
• IF A CLIENT RESIDES IN A CARE FACILITY AND IS HOSPITALIZED, THE
ADMINISTERING AUTHORITY CAN CONTINUE TO PAY FOR RESIDENCE
AT THE FACILITY IF IT IS EXPECTED THAT CLIENT WILL RETURN
• IF A CLIENT RESIDING IN A CARE FACILITY IS VISITING FRIENDS OR
FAMILY, IT IS APPROPRIATE TO CONTINUE PAYMENT.
July 2014
CHAPTER 3 ADULT INSTITUTIONAL CARE:
44
PER DIEM/ USER CHARGES
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
3.5 CONTINUING CARE FACILITY PER DIEM COSTS
A CARE FACILITY MUST BE LICENSED BY THE PROVINCE UNDER THE
COMMUNITY CARE AND ASSISTED LIVING ACT
PER DIEM COST RATES ARE SET BY THE LOCAL HEALTH AUTHORITY FOR
THE VARIOUS LEVELS OF CARE
* DOES NOT COVER PERSONAL ITEMS (SEE COMFORT ALLOWANCE)
3.6 CLIENT USER CHARGES
CLIENTS WHO CAN AFFORD TO PAY MUST CONTRIBUTE
THE LOCAL HEALTH AUTHORITY CALCULATES USER CHARGES BASED ON
CLIENT INCOME
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
45
PRINCIPLE (4.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
“ THE OBJECTIVE OF A FAMILY CARE HOME IS TO PROVIDE A PROTECTIVE
AND SUPPORTIVE ENVIRONMENT WITHIN A PRIVATE FAMILY HOME TO
ELIGIBLE ON-RESERVE ELDERLY OR DISABLED PERSONS AS AN
ALTERNATIVE TO ADMISSION TO A LONG TERM CARE INSTITUTION .
FAMILY CARE HOMES ARE SINGLE FAMILY RESIDENCES LOCATED ON RESERVE, INTENDED FOR ON-RESERVE ADULTS WHO REQUIRE 24 HOUR
SUPERVISION OUTSIDE THEIR OWN HOME, AND WHO CHOOSE TO
REMAIN IN THEIR HOME COMMUNITIES. THE FAMILY CARE HOME
PROVIDES A HOMELIKE ATMOSPHERE, MEALS, AND OTHER
HOUSEKEEPING SERVICES, ALONG WITH CARING SUPPORT AND
ASSISTANCE WITH THE ACTIVITIES OF DAILY LIVING TO THE ELDERLY OR
DISABLED CLIENT.”
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
46
PRINCIPLE 2 (4.1)
• SCREENING, MONITORING AND APPROVAL IS THE RESPONSIBILITY OF
THE ADMINISTERING AUTHORITY; HOWEVER, AANDC MUST GIVE
AGREEMENT BEFORE TO ENSURE FUNDING IS AVAILABLE
• AANDC WILL REIMBURSE PER DIEM AND RESPITE COSTS BASED ON
CLIENT’S ASSESSED LEVEL OF CARE BY THE LOCAL HEALTH
AUTHORITY
* NOTE: OPERATION OF HOME IS CLIENT SPECIFIC AND PLACEMENT
DEPENDS ON MATCH OF OPERATOR AND CLIENT
* NOTE: AANDC DOES NOT GUARANTEE OCCUPANCY OF THE HOME
ELIGIBILITY:
AGE: MUST BE 19 OR OLDER
RESIDENCY: MUST BE RESIDENT ON RESERVE AT TIME OF APPLICATION
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
47
ROLES AND RESPONSIBILITIES (4.1)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011 )
THE ADMINISTERING AUTHORITY:
• APPROVES FAMILY CARE HOME BASED ON INFORMATION PROVIDED
DURING THE SCREENING PROCESS
• ENSURES THAT THE SERVICE PROVIDER AGREEMENT IS COMPLETED
AND SIGNED BY FAMILY CARE HOME OPERATOR
• PROVIDES ONGOING MONITORING OF THE HOME
• ENSURES COLLECTION OF CLIENT DAILY USER FEE
• REIMBURSES THE OPERATOR BASED ON SUBMITTED CLAIMS FOR THE
NUMBER OF DAYS OF OCCUPANCY AT THE RATE ESTABLISHED FOR
THE CLIENT’S ASSESSED LEVEL OF CARE
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CHAPTER 4 ADULT FAMILY CARE HOMES:
48
ROLES AND RESPONSIBILITIES 2 (4.1)
THE BAND SOCIAL DEVELOPMENT WORKER:
• COMPLETES THE FAMILY CARE HOME OPERATOR APPROVAL FORM
(DK02-01) AND ADULT FAMILY CARE HOME APPROVAL CHECKLIST
(DK02-02)
• IDENTIFIES ELIGIBLE CLIENTS, AND MATCHES CLIENT AND FAMILY
CARE HOME OPERATOR
• COMPLETES NEEDS TEST, MONITORS CARE OF INDIVIDUAL AND
SERVES AS LINK BETWEEN CLIENT, FAMILY, AND SERVICE PROVIDER
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
49
ROLES AND RESPONSIBILITIES 3 (4.1)
THE CONTINUING CARE CASE MANAGER:
• PROVIDES ASSESSMENT AND ESTABLISHES LEVEL OF CARE OF
PROSPECTIVE CLIENT
• MAY ASSIST ADMINISTERING AUTHORITY PERSONNEL TO COMPLETE
THE FAMILY CARE HOME OPERATOR APPROVAL FORM (DK02-01) AND
ADULT FAMILY CARE HOME APPROVAL CHECKLIST (DK02-02)
• IN COOPERATION WITH BAND SOCIAL DEVELOPMENT WORKER, MAY
ASSIST IN THE ASSESSMENT OF THE COMPATIBILITY OF HOME AND
PROSPECTIVE CLIENT
• MAY ASSIST WITH ONGOING MONITORING, AS APPROPRIATE
AANDC:
• PROVIDES AGREEMENT TO PROCEED BASED ON AVAILABLE FUNDING
• APPROVES REIMBURSEMENT OF PER DIEM AND CHARGES
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
50
PROCEDURES (4.2)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
4.2 RECRUITMENT AND SCREENING
• OPERATORS ARE RECRUITED TO MATCH WITH CLIENTS
• BSDW COMPLETES FORM DK02-01 FAMILY CARE HOME OPERATOR
APPROVAL FORM AS PART OF SCREENING PROCESSES
OPERATOR SCREENING COVERS:
• REFERENCES
- HEALTH
• TRAINING/ EXPERIENCE
- TRANSPORTATION
• PERSONAL SUITABILITY
• FINANCIAL
• CRIMINAL RECORD SEARCH
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
51
PROCEDURES 2 (4.3)
4.3 APPROVAL OF HOMES
THE FOLLOWING DOCUMENTATION MUST BE COMPLETED:
• FAMILY CARE HOME OPERATOR APPROVAL FORM (DK02-01)
• ADULT FAMILY CARE HOME APPROVAL CHECKLIST (DK02-02)
• LETTERS OF REFERENCE
• CRIMINAL RECORD SEARCHES
• FAMILY CARE HOME SERVICE PROVIDER AGREEMENT (DK02-04)
* REMEMBER THAT APPROVAL IS BASED ON AVAILABLE FUNDING
* REQUIRES A SERVICE PROVIDER AGREEMENT FOR OPERATOR AND A
COMPREHENSIVE FUNDING AGREEMENT BETWEEN AANDC AND THE
ADMINISTERING AUTHORITY, WHICH AANDC MAY TERMINATE
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CHAPTER 4 ADULT FAMILY CARE HOMES:
52
PROCEDURES 3 (4.3)
BASED ON FORM DK02-02 ADULT FAMILY CARE HOME APPROVAL
CHECKLIST THE HOME MUST BE ACCEPTABLE IN THE FOLLOWING AREAS:
• FIRE SAFETY
• OUTDOOR ENVIRONMENT
• GENERAL SAFETY
• GENERAL CLEANLINESS
• LIVING SPACE
• BASIC NUTRITION, FOOD PREPARATION, AND MEAL PLANNING
• WASHING AND TOILET FACILITIES
• BEDROOMS
• FURNISHINGS
• INSURANCE
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
53
PROCEDURES 4 (4.5)
4.5 PLACEMENT OF CLIENT
MUST BE LESS THAN 3 CLIENTS PER HOME TO COMPLY WITH THE
COMMUNITY CARE AND ASSISTED LIVING ACT
•
MOST HOMES WILL ONLY HAVE 1 CLIENT, HOWEVER 2 MAY BE
CONSIDERED IF IT WOULD BE BENEFICIAL TO THE CLIENT AND THE
OPERATOR IS DEEMED CAPABLE OF CARING FOR 2 CLIENTS AND BOTH
CLIENTS AGREE
•
CLIENTS CANNOT BE PLACED WITH AN IMMEDIATE FAMILY MEMBER
CONSIDERATIONS:
-
LIFESTYLES AND COMPATIBILITY
-
BEHAVIOURAL PROBLEMS (CLIENT)
-
SAFEKEEPING AND FINANCIAL AFFAIRS
-
RIGHT TO REFUSE PLACEMENT
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
54
OPERATION OF HOME (4.6)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011)
4.6 OPERATION OF HOME
• ADMINISTERING AUTHORITY IS RESPONSIBLE FOR ENSURING THAT
OPERATORS DELIVER HIGH QUALITY SERVICE AND SUPPORTING THEM
• BSDW SHALL VISIT THE HOME MONTHLY TO ENSURE OPERATOR
ADHERES TO THEIR RESPONSIBILITY
• IF THE ADMINISTERING AUTHORITY SUSPECTS RISK TO THE CLIENT
THEY MUST IMMEDIATELY TAKE STEPS TO RESOLVE THE SITUATION
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
55
OPERATION OF HOME 2 (4.6)
VOLUME 2: ASSISTED LIVING PROGRAM (AANDC, JUNE. 2011 )
TEMPORARY CLIENT ABSENCES: IF CLIENT IS HOSPITALIZED, THE
ADMINISTERING AUTHORITY MAY CONTINUE TO PAY THE PER DIEM IF
THE CLIENT IS REASONABLY EXPECTED TO RETURN
• UP TO 30 DAYS PER CALENDER YEAR. ANYTHING OVER 3 DAYS MUST
BE APPROVED BY FSO.
• DAYS WITH UNAUTHORIZED ABSENCES WILL NOT BE REIMBURSED
FUNDED RESPITE: CAN BE IN-HOME, OUT-OF-HOME, ADULT DAY CARE
• THIS IS FUNDED WITH A SPECIAL QUARTERLY ADJUSTMENT FROM
AANDC THAT ALLOWS THE ADMINISTERING AUTHORITY TO
PURCHASE RESPITE.
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
56
OPERATION OF HOME 3 (4.6)
OPERATORS RESPONSIBILITY: (MUST NOT BE CHARGED TO CLIENT)
• MEDICATION
• MEALS/ THERAPEUTIC DIETS
• DIET SUPPLEMENTS
• LAUNDRY SERVICE
• GENERAL HYGIENE SUPPLIES
• MEDICAL SUPPLIES
• INCONTINENCE CARE
• PHYSICAL, SOCIAL AND RECREATIONAL ACTIVITIES
• TRANSPORTATION
* THIS IS NOT EXHAUSTIVE AND OTHER RESPONSIBILITIES MAY OCCUR
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
57
OPERATION OF HOME 4 (4.6)
CLIENT RESPONSIBILITY
• PERSONAL HYGIENE AND GROOMING SUPPLIES
• PERSONAL DRY CLEANING
• PERSONAL PHONE AND TV
• PERSONAL NEWSPAPER, PERIODICALS, AND SMOKING MATERIALS
• TRANSPORTATION (FOR INDIVIDUAL PURPOSES)
• EXTRA CRAFT SUPPLIES AND ACTIVITIES
• PERSONAL EQUIPMENT (MEDICAL)
* CLIENT IS RESPONSIBLE FOR PAYMENT OF ALL ITEMS AND SERVICES
NOT INCLUDED IN THE REIMBURSEMENT RATE. OPERATOR CANNOT
CHARGE AND ADMINISTRATION FEE FOR THESE ITEMS
* NOTE: THIS IS NOT AN EXHAUSTIVE LIST
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
58
CLOSURE OF HOME (4.7)
4.7 CLOSURE OF HOME: IMPOSED CLOSURE MAY BE FOR 2 REASONS:
• CLIENT AT RISK
• Administering Authority notified of possible risk. If risk is assessed as real,
Chief and Council is notified and Client is immediately removed
• Notify FSO immediately to stop the comprehensive funding agreement
• UNSATISFACTORY SERVICE
1) BSDW TELLS OPERATOR OF AREAS TO IMPROVE WITH DEADLINE
2) WRITTEN NOTIFICATION GIVEN WITHIN 3 DAYS
3) BSDW VISITS HOME TO ENSURE IMPROVEMENT
4) WITHOUT IMPROVEMENT, BSDW GIVES LAST WRITTEN WARNING
5) ADMINISTERING AUTHORITY NOTIFIED FOR INVESTIGATION
6) BSDW AND AA AGREE, OPERATOR IS GIVEN 14 DAYS NOTICE TO CLOSE
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
59
FINANCIAL REQUIREMENTS (4.4)
4.4 FINANCIAL REQUIREMENTS
PER DIEM RATES:
• BASED ON CLIENTS ASSESSED LEVEL OF CARE DETERMINED BY THE
LOCAL HEALTH AUTHORITY
• RATES ARE BASED ON LOCAL HEALTH AUTHORITIES’ SCHEDULE
• BILLING IS PRO-RATED ON NUMBER OF CARE DAYS PROVIDED
• BASED ON COMPREHENSIVE FUNDING AGREEMENT AND
AUTHORIZED BY AANDC FUNDING SERVICES OFFICER
July 2014
CHAPTER 4 ADULT FAMILY CARE HOMES:
60
FINANCIAL REQUIREMENTS 2 (4.4)
4.4 FINANCIAL REQUIREMENTS
ELIGIBILITY IS BASED ON CONTINUING FINANCIAL ELIGIBILITY FOR
SOCIAL ASSISTANCE
EARNED INCOME: RESIDENTS OF HOMES ARE ELIGIBLE FOR EARNINGS
EXEMPTIONS RELEVANT TO THEIR IA CLIENT CLASS
INCENTIVE/CVS: RESIDENTS OF CARE HOMES ARE ELIGIBLE FOR THE CVS
COMFORTS AND CLOTHING ALLOWANCE: ELIGIBLE FOR RESIDENTS OF
CARE FACILITIES WITH NO OTHER MEANS OF PROVIDING FOR PERSONAL
AND RECREATIONAL NEEDS
July 2014

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