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TITLE 40SOCIAL SERVICES AND ASSISTANCE
PART 1DEPARTMENT OF AGING AND DISABILITY SERVICES
CHAPTER 83AREA AGENCY ON AGING ADMINISTRATIVE REQUIREMENTS
RULE §83.3System of Access and Assistance

(a) Purpose and Goals. This rule establishes the requirements for implementation by area agencies on aging of the system of access and assistance. Each area agency on aging shall establish and maintain a system of access and assistance. The program shall incorporate necessary strategies and activities to meet the following goals:

  (1) to provide persons age 60 years and older efficient access to needed services;

  (2) to conduct effective screening and assessment of individual needs and preferences;

  (3) to efficiently and effectively target resources so that persons most in need receive assistance; and

  (4) to establish a strong local role and clear identity of the area agency on aging as a source of access and assistance for eligible persons and/or their family members or other caregivers.

(b) Outcomes.

  (1) The area agency on aging shall achieve the following system outcomes.

    (A) The area agency on aging will conduct outreach and marketing efforts to inform eligible persons and/or their family members or other caregivers of available services.

    (B) The area agency on aging shall serve as a source of connection to comprehensive information on services, benefits and opportunities.

    (C) The area agency on aging system of access and assistance shall meet specific local needs and take advantage of specific local strengths and resources including volunteers.

    (D) Access and assistance services are accessible, flexible, coordinated and designed to support an individual's highest level of functioning in the least restrictive environment.

    (E) Access and assistance services are available to persons age 60 years and older and/or his/her family member or other caregiver regardless of income.

    (F) The area agency on aging system of access and assistance shall have the capability to respond to racially, culturally and ethnically diverse groups.

  (2) The area agency on aging shall achieve the following client outcomes.

    (A) Eligible persons and/or their family members or other caregivers served are provided sufficient information to make informed decisions about services.

    (B) People in need are connected with existing benefits and services.

    (C) Clients are provided an opportunity to express their level of satisfaction with access and assistance services received.

    (D) Services are provided so that clients maintain hope, dignity, respect and independence.

(c) The area agency on aging system of access and assistance shall include:

  (1) Information, Referral and Assistance;

  (2) Benefits Counseling;

  (3) Care Coordination; and

  (4) Ombudsman Services.

(d) Professional Staffing. The area agency on aging shall strive to maintain an adequate level of professional access and assistance staff who possess necessary general and specialized knowledge. Where applicable, access and assistance staff must complete the training and certification requirements set forth by the Department.

(e) System Integration.

  (1) The system of access and assistance shall strive to develop cooperative working relationships with local service providers to build an integrated service delivery system which ensures broad access to and information about community services, maximizes the utilization of existing resources, avoids duplication of effort and gaps in services and facilitates the ability of people who need services to easily find the most appropriate provider.

  (2) Coordination with the Texas Department of Human Services. Area agency on aging access and assistance staff shall work with the local Texas Department of Human Services (TDHS) staff to ensure any person who may be eligible for TDHS services will be referred to that agency. The area agency on aging may provide services to persons who are eligible for TDHS services in the following instances:

    (A) the person is on an interest list for TDHS services;

    (B) the person is in need of immediate service provision and awaiting determination of eligibility for TDHS services; or

    (C) the person is in need of immediate service provision and awaiting location and placement of a TDHS family care or primary home care service provider.

(f) Client Eligibility. Eligible clients include any person age 60 years and older and/or his/her family member or other caregiver .

(g) Client Intake. The intake process varies with the type of service indicated. For all clients, access and assistance staff will determine client needs and preferences. If clients have multiple or complex needs, access and assistance staff will gather identifying information to determine eligibility for services funded by the area agency on aging or other agencies.

(h) Prohibited Service Activities. Access and assistance staff will not perform or participate in any of the following activities:

  (1) accepting gifts from a client;

  (2) lending or borrowing money or articles to or from a client;

  (3) transporting a client in an access and assistance staff person's automobile unless appropriate liability insurance is in force; and

  (4) driving or riding in a client's automobile.

(i) Confidentiality of Client Records. Area agency on aging access and assistance staff shall comply with the requirements described in 40 TAC §270.1(d), regarding confidentiality of client records.

(j) Release of Client Information. When referrals are made, access and assistance staff must obtain and clearly document the consent of the client for release of confidential information to other service provider agency(ies). This consent may be obtained from the client verbally or in writing.

(k) Client Contributions.

  (1) Area agency on aging access and assistance staff must comply with the requirements described in 40 TAC §270.1(j), regarding client contributions.

  (2) Care management clients who meet the criteria identified in Human Resources Code 101, Subchapter C relating to Options for Independent Living shall be encouraged to contribute towards the cost of their care through a suggested contribution schedule.

(l) Conflicts of Interest. The area agency on aging shall ensure that any conflicts of interest between the function of access and assistance and the provision of direct client services are disclosed to the Department. The intent is to separate the function of access and assistance from the provision of other client services.

(m) Reporting. The area agency on aging must comply with the reporting requirements identified in §260.1(c)(2) of this title (relating to programmatic reports).

(n) Information, Referral and Assistance. The information, referral and assistance process consists of activities such as assessing the needs of the inquirer, evaluating appropriate resources, assessing appropriate response modes, identifying organizations capable of meeting those needs, providing enough information about each organization to help inquirers make an informed choice, helping inquirers for whom services are unavailable by locating alternative resources, when necessary, actively participating in linking the inquirer to needed services and following up on referrals to ensure the service was received or provided.

  (1) Target Population.

    (A) Information, referral and assistance services shall be provided to any person age 60 years and older and/or his/her family member or other caregiver.

    (B) Information, referral and assistance services shall be provided to Medicare beneficiaries of any age under the provisions of funds received from the Centers for Medicare and Medicaid Services.

  (2) Access and assistance staff shall provide telephone, electronic or walk-in information, referral and assistance services in which the inquirer has one-to-one contact with an information, referral and assistance specialist. In accordance with §260.1 of this title, the published phone number will be answered "Area Agency on Aging" when the call is received.

  (3) Service providers shall coordinate with emergency response organizations, such as local law enforcement agencies or other existing agencies/activities as appropriate to provide the necessary coverage.

  (4) The area agency on aging telephone messaging system will provide callers with appropriate emergency phone numbers when calls are received after hours.

  (5) Resource Information.

    (A) Access and assistance staff shall develop criteria for the inclusion or exclusion of agencies and programs in the resource database or use criteria developed by other information, referral and assistance entities. These criteria shall be uniformly applied and published so that staff and the public will be aware of the scope and limitations of the database.

    (B) A standardized profile shall be developed for each organization that is part of the community service delivery system.

    (C) Information in the resource database shall be indexed and accessible in ways that support the information, referral and assistance process.

    (D) Access and assistance staff shall use the AIRS/Infoline Taxonomy to facilitate retrieval of community resource information and to promote the reliability and consistency of information across the service region and across the state.

    (E) The resource database shall be updated through continuous revision or at intervals sufficiently frequent to ensure accuracy of information and comprehensiveness of its content.

  (6) Information, Referral and Assistance Log.

    (A) Access and assistance staff shall maintain a system for collecting and organizing inquirer information that facilitates appropriate referrals and provides a basis for describing requests.

    (B) A unit of service is a client's initial request for information or assistance. The area agency on aging shall have a system for recording both initial inquiries and follow-up contacts made by either the client or the agency.

    (C) The area agency on aging shall use information it records to identify service gaps and overlaps, assist with needs assessments, support the development of products, identify issues for staff training, facilitate the development of the resource information system.

  (7) Cooperation with Local Information and Referral (I&R) Providers.

    (A) In communities with comprehensive and/or specialized information and referral (I&R) providers, including Area Information Centers, when applicable, the area agency on aging shall develop cooperative working relationships to build an integrated system of information, referral and assistance which ensures broad access to services, maximizes the utilization of existing resources, avoids duplication of effort and encourages seamless access to community resource information.

    (B) If the area agency on aging is designated by the Texas Information and Referral Network as an Area Information Center, the area agency on aging must meet the expectations of the designation.

  (8) Professional Conduct.

    (A) Access and assistance staff providing information, referral and assistance services shall adhere to the standards of conduct set forth by the Alliance of Information and Referral Systems which are adopted by reference.

    (B) Area agencies on aging are encouraged to seek and maintain agency accreditation with the Alliance of Information and Referral Systems.

(o) Care Coordination. The purpose of care coordination is to assess the needs of a client and effectively plan, arrange, coordinate and follow-up on services which most appropriately meet the identified needs as mutually defined by access and assistance staff, the client, and where appropriate, a family member(s) or other caregiver.

  (1) Program Design. The operational design of care coordination is dictated by the needs of the area agency on aging service area and includes a combination of levels of care. These levels of care coordination include:

    (A) Service Authorization without an assessment;

    (B) Service Authorization requiring an assessment; and

    (C) Care Management, which includes the model of case management as defined by the program entitled, Options for Independent Living, as required by in Human Resources Code Chapter 101, Subchapter C.

  (2) Service Authorization. A process which identifies a need for a service(s) and uses the direct purchase of service procedures to obtain and initiate one or more services. There are two types of service authorization. They include service authorization without an assessment and service authorization requiring an assessment.

    (A) Service Authorization Without an Assessment.

      (i) Service authorization without an assessment may be used to procure all services except home delivered meals, homemaker, personal assistance, residential repair and respite services .

      (ii) Service authorization without an assessment may be performed by any area agency on aging-approved access and assistance staff member either by phone or in person.

Cont'd...

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