Homemaker Service 525-05-30-35

(Revised 1/1/21 ML #3607)

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Purpose

The purpose of Homemaker Service is to complete intermittent or occasional environmental tasks that an elderly or disabled individual is not able to complete him or herself in order to maintain that individual's home.

 

Service Eligibility Criteria for

The individual receiving homemaker service will meet the following criteria:

  1. Must be eligible for the Medicaid Waiver for Home and Community Based Services, SPED, or ExSPED.
  2. Needs assistance with environmental tasks that are within the scope of this service.
  3. Has no informal network or other agency available/capable/willing to complete environmental task(s)/activities. The client must live-alone or the person(s) living with the client is/are not capable or obligated to complete the task(s) unless administrative approval has been received. Homemaking services cannot be approved when they are completed for the benefit of both the client and the provider.

    For live-in providers (other than those defined in the definition of “family home care” or former spouse), the tasks of laundry, shopping, housekeeping, meal preparation, money management, and communication are not allowed unless administrative approval has been received. Approval will only be granted for these tasks when the service exclusively benefits the consumer.

Conditions that would exclusively benefit the consumer would include, but are not limited to: maintenance of non-shared spaces such as a private bathroom or bedroom; completion of laundry if there is a documented reason it must be completed separately (example: frequent incontinence); meal preparation (for example pureeing food if the consumer requires a pureed diet); and shopping for essential items for the benefit of the client (example: food items for meals that are prepared separately).

If the live-in provider is a relative as defined in the definition of "family home care" or is a former spouse, the tasks of laundry, shopping, housekeeping, meal preparation, money management or communication CANNOT be authorized; except the department may provide essential homemaking activities such as meal preparation if the adult not receiving care who resides in the home is unavailable due to employment.

  1. For a client who lives with an able-bodied adult, prior approval for Homemaker Service must be obtained from the HCBS Program Administrator.
  2. The need for environmental tasks/activities is intermittent or occasional.
  3. Occasionally the provision of Homemaker Service tasks/activities may impact other family members. When this occurs it must be considered insignificant or must be inseparable from tasks/activities provided to the client (e.g. cooking, cleaning).
  4. The department may provide essential homemaking tasks such as meal preparation if the adult not receiving care who resides in the home is unavailable due to employment. Prior approval for these tasks must be obtained from the HCBS Program Administrator.
  5. The funding cap applies to a household and may not be exceeded regardless of the number of clients reside in the home.

EXAMPLE: If a husband and wife both qualify for homemaker services and the max funding cap must be shared by both clients. The total number of units should be divided between the individuals in the home and included on each individual care plan but the cap cannot be exceeded.

Service Tasks/Activities

  1. Housework
  2. Meal Preparation
  3. Laundry
  4. Shopping
  1. Transportation or escorting of the client are unallowable
  1. Communication
  2. Managing Money

 

Services Activities, Authorized and Limits

  1. The service tasks/activities within the scope of this service chapter are defined on page 2 of the Authorization to Provide Services for SPED/ExSPED, SFN 1699 and page 2 of the Authorization to Provide Medicaid Waiver Services, SFN 410.
  2. When a client receives assistance with laundry, shopping, housekeeping, under Medicaid State Plan Personal Care (MSP-PC) in excess of the funding cap allowed for homemaker services under SPED, EXSPED, or HCBS Wavier, additional tasks of Meal Prep, Communication or Managing Money may not be authorized under Homemaker Services.
  3. If a client is receiving MSP-Personal Care assistance for meal prep, communication, and money management, these tasks are not allowable homemaker tasks unless approval is obtained from a HCBS Program Administrator.
  4. If a client is receiving MSP-Personal Cares, the tasks of laundry, shopping, and housekeeping cannot exceed 30% of the entire care plan. When MSP-PC units are authorized, homemaker tasks must be authorized under this funding source (MSP-PC) unless:
    1. MSP-PC Level C is authorized; or
    2. The total cost of the maximum number of units that are able to be moved from SPED/Ex-SPED and authorized under MSP-PC is less than $150. (When calculating whether this cost is under $150, first determine how many homemaker units you are able to move to MSP-PC. Then, take that number of units and multiply it by the current homemaker rate. If that total is less than $150, you do not need to move the units from SPED/Ex-SPED over to MSP-PC.)
      1. If a rural differential (RD) rate is authorized, the RD rate must be used to calculate the laundry, shopping, housekeeping total cost.

    3. Homemaker is authorized under Medicaid Waiver then all HMK tasks may be authorized under MSP-PC Levels A and B or Medicaid Waiver since both (MSP-PC and Medicaid Waiver) are Medicaid-funded programs.