| (a) Purpose. This section establishes the requirements
for homemaker services, a service provided under the Older Americans
Act and funded, in whole or in part, by DADS.
(b) Eligibility. A AAA must ensure that a program participant
who receives homemaker services is:
(1) 60 years of age or older; and
(2) functionally impaired in the ability to perform
instrumental activities of daily living as described in DADS Program
Instruction AAA - PI 310 Activities of Daily
Living/Instrumental Activities of Daily Living NAPIS Mapping Requirements.
(c) Type of provider. A AAA may provide homemaker services
as an agency managed service or as a consumer directed service, or
as both.
(1) Agency managed. Homemaker services that are agency
managed are provided only by a vendor.
(2) Consumer directed. Homemaker services that are
consumer directed are provided by furnishing vouchers to a program
participant, allowing the program participant to select a homemaker,
establish a work schedule and payment rate, and provide the homemaker
information and training on the program participant's needs.
(d) Informing program participant of options. If a
AAA provides homemaker services as both an agency managed service
and as a consumer directed service, the AAA must inform a program
participant that he or she may choose to receive homemaker services
in either of those two ways.
(e) Service authorization. Before homemaker services
are provided by a vendor to a program participant, the AAA must ensure
that the vendor obtains prior written authorization for the services
from the AAA in accordance with §83.3(o)(2)(B) of this title
(relating to System of Access and Assistance).
(f) Homemaker services. Homemaker services include:
(1) cleaning for the program participant, including:
(A) cleaning after a program participant's personal
care tasks;
(B) emptying and cleaning a program participant's bedside
toilet;
(C) cleaning a program participant's bathroom;
(D) changing a program participant's bed linens and
making the program participant's bed;
(E) cleaning the floor of a program participant's living
area;
(F) dusting an area used by a program participant;
(G) taking a program participant's trash to an outside
receptacle and moving the receptacle to a location for pick-up;
(H) cleaning a program participant's stovetop and counters;
(I) washing a program participant's dishes; and
(J) cleaning a program participant's refrigerator and
stove;
(2) doing a program participant's laundry, including:
(A) washing a program participant's laundry by hand
or machine;
(B) gathering and sorting laundry;
(C) loading and unloading the washing machine and dryer
in the program participant's residence;
(D) using laundromat machines;
(E) hanging laundry to dry; and
(F) folding and putting away laundry;
(3) shopping for the program participant, including:
(A) preparing a shopping list;
(B) going to the store and purchasing or picking up
items;
(C) picking up medication; and
(D) storing the purchased items;
(4) assisting a program participant in organizing and
completing a home management routine;
(5) performing necessary reading and writing tasks
as directed by the program participant;
(6) preparing meals for the program participant, including:
(A) assisting in planning menus that are appropriate
for the program participant's needs;
(B) shopping for and storing food;
(C) preparing and serving meals; and
(D) utilizing sanitary practices for handling and preparing
food; and
(7) accompanying a program participant to obtain health
care services and other necessary items and services unless prohibited
by subsection (g)(7) of this section.
(g) Prohibited activities. Homemaker services do not
include the following:
(1) personal assistance services described in §85.305(e)(1)
- (2), (4) - (10), and (12) of this subchapter (relating to Personal
Assistance Services);
(2) repairs to the program participant's residence;
(3) pet grooming;
(4) yard maintenance;
(5) moving heavy objects;
(6) performing services for members of the household
other than the program participant;
(7) transporting the program participant in a vehicle
unless proof of liability insurance covering such transportation has
been verified, in writing, by the vendor;
(8) performing tasks beyond the scope of the service
authorization required by subsection (e) of this section;
(9) accepting gifts from the program participant;
(10) bringing persons to the program participant's
residence who are not providing homemaker services to the program
participant;
(11) taking personal property from the program participant's
residence; or
(12) assuming control of the financial or personal
affairs of the program participant or his or her estate including
serving as power of attorney, guardian, or conservator.
(h) Staffing qualification requirements for an agency-managed
service.
(1) A AAA must ensure that a vendor that has a program
supervisor for homemaker services requires the program supervisor
to:
(A) meet one of the following criteria:
(i) be a licensed nurse;
(ii) have completed two years of full-time study in
social or behavioral sciences at an accredited college or university;
or
(iii) have:
(I) a high school diploma or high school equivalency
certificate; and
(II) have one of the following:
(-a-) the equivalent of two years experience as a full-time
employee in a supervisory capacity in a health care facility, health
care agency, or other health care organization; or
(-b-) the equivalent of one year experience as a full-time
employee in a supervisory capacity in a health care facility, health
care agency, or other health care organization and have completed
one year of full-time study in social or behavioral sciences at an
accredited college or university; and
(B) have experience in:
(i) housekeeping or home management; and
(ii) meal preparation activities.
(2) A AAA must ensure that a vendor requires a homemaker
(that is, the person who provides homemaking services to the program
participant):
(A) to be an adult;
(B) to have the ability to follow oral and written
instructions and keep records;
(C) to have previous experience providing care to a
person 60 years of age or older or a disabled adult;
(D) to demonstrate competency to perform homemaker
services;
(E) to not be the spouse or legal guardian of the program
participant; and
(F) to not live with the program participant.
(i) Training and documentation requirements for an
agency managed service. A AAA must ensure that a vendor:
(1) trains homemakers to recognize and report changes
in a program participant's health condition that may require emergency
procedures or health services;
(2) maintains documentation demonstrating compliance
with paragraph (1) of this subsection; and
(3) determines the need for, and requires homemakers
to receive, other training as appropriate.
(j) Information and assistance requirements for a consumer
directed service. A AAA must:
(1) give a program participant written information
to assist the program participant in performing the following activities:
(A) interviewing potential homemakers;
(B) requiring potential homemakers to provide references;
(C) checking references of homemakers;
(D) selecting a homemaker who meets the qualifications
described in subsection (h)(2) of this section;
(E) deciding upon, in discussion with the homemaker,
an hourly, daily, or weekly rate to be paid to the homemaker;
(F) informing or training the homemaker on the specific
needs of the program participant;
(G) ensuring proper payment for homemaker services
by recording the number of hours or days homemaker is used and the
total amount claimed against the voucher;
(H) ensuring federal tax guidelines for household employees
are followed in accordance with IRS Publication 926;
(I) notifying the AAA if the program participant's
address changes;
(J) monitoring the quality of the homemaker service
provided; and
(K) notifying the AAA if the program provider is dissatisfied
with a homemaker; and
(2) assist a program participant in finding a homemaker
if such assistance is requested by the program participant.
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| Source Note: The provisions of this §213.207 adopted to be effective September 1, 2008, 33 TexReg 7293; transferred effective November 15, 2020, as published in the Texas Register October 30, 2020, 45 TexReg 7721 |
