Homemaker Service 525-05-30-35

(Revised 04/01/23 ML #3723)

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Purpose

The purpose of Homemaker Service is to complete intermittent or occasional environmental tasks that an eligible 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. For live-in providers: the tasks of laundry, shopping, housekeeping, meal preparation, money management, and communication are allowed only when the service activity benefits the individual.

The department may pay a provider for homemaker tasks that would otherwise be considered the individual’s share of the responsibility to complete the task. An example of this would be authorizing housekeeping for the individual’s personal private space OR their shared responsibility of cleaning the common living space.

  1. For an individual who lives with an able-bodied adult, the department may pay a provider for homemaker activities involving the inidividual’s personal private space and if the individual is living with an adult, the individual’s share of the common living space.
  1. The need for environmental tasks/activities is intermittent or occasional.
  2. 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 individual (e.g. cooking, cleaning).
  3. The funding cap applies to a household and may not be exceeded regardless of the number of eligible individuals residing in the home.

EXAMPLE: If a husband and wife both qualify for homemaker services, the max funding cap must be shared by both individuals. 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 individual are unallowable
  1. Communication
  2. Managing Money

 

Service Location

Services will be administered in the most integrated setting consistent with the Person Centered Plan of Care, including (checked if allowable):

ü The individual's home

□ Workplace

□ Other community service settings

 

Services Activities, Authorized and Limits

  1. The service tasks/activities within the scope of this service chapter are defined on the Authorization to Provide Services.
  2. When an individual 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 an individual 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 an individual 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. In that case, 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.

Providers

Homemaker Service may be provided by the following individual QSP's or employees of a QSP agency (checked if allowable):

□ Guardian

ü Legally Responsible Person - Legal spouse or parent of a minor child.

üRelative (who does not live with the individual) within the definition of Family Home Care under subsection 4 of N.D.C.C. 50-06.2.02.