ADRL Companionship Services 650-25-90

(Revised 12/01/2023 ML 3780)

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Purpose

Reduces social isolation in older adults and individuals with physical disabilities living in the community who are not eligible for the home and community-based services (HCBS) waiver and are experiencing negative effects of social isolation. Companionship services reduce social isolation which can have a negative impact to physical and mental health that can lead to institutional placement.

 

Service Description

Non-medical care, supervision, and socialization provided to an eligible recipient who is experiencing negative effects of social isolation (e.g. anxiety or depression). The provision of companion services does not entail hands-on nursing care or medication administration. Providers may only perform light housekeeping tasks that are directly related to the companionship activity (example: if the caregiver completes an art project, the caregiver may assist with the cleanup from this companionship activity). This service must be provided in accordance with a therapeutic goal in the care plan and/or service authorization.

 

Socialization that is therapeutic is directly tied to the individual's goal(s) in the person-centered plan and/or service authorization. An example of therapeutic activity could be a game or activity that enhances fine motor skills to help the participant recover from a stroke.

 

Activities that support therapeutic socialization could also be associated with a goal to reduce social isolation, decrease depression, anxiety or help the individual maintain the most inclusive community life.

 

Service Eligibility, Criteria for

The individual receiving companionship services will meet the following criteria:

  1. Must be eligible and receiving:
  1. Older Americans Act (OAA) Services for example, home delivered or congregate meals, vulnerable adult protective services.
  2. Service Payments to the Elderly and Disabled (SPED).
  3. Expanded service Payments to the elderly and disabled (Ex-SPED).
  4. Medicaid State Plan Personal Care – Community.
  5. ADRL Grant - community transition services.
  6. Options Counseling
  1. Is experiencing negative effects of social isolation (e.g. anxiety or depression); and
  2. Be at least age 60.
  3. Priority for Companionship services must be given to older individuals:
    1. Residing in rural areas.
    2. With the greatest economic need (with particular attention to low-income older individuals including minorities with limited English proficiency).
    3. With the greatest social need (with particular attention to low-income older individuals including minorities with limited English proficiency).
    4. With severe disabilities.
    5. With limited English proficiency.
    6. With Alzheimer’s disease and related disorders with neurological and organic brain dysfunction and the caretakers of such individuals.
    7. At risk for institutional placement.

The care needs of the client must fall within the scope of companionship services as described in this service chapter.

 

Service Tasks/Activities

Allowable companionship tasks include but are not limited to supervision which means having the knowledge of, and account for, the activity and whereabouts of the recipient at all times to allow immediate provider intervention as necessary to safeguard the individual from harm.

 

During the time that the provider is providing companionship services to the recipient and is not actively providing services under SPED, Ex-SPED, Medicaid State Plan (MSP) personal care or homemaker tasks etc., they may play games, visit, read, go for walks, and participate in activities with the client. If the client is physically able, they may also participate in activities within the local community or trade area that supports an identified goal on the person-centered plan and/or service authorization.

 

Companionship services include assisting eligible individuals who are only requesting help with accessing shopping, provided it is to meet a therapeutic goal (example: the individual is requesting to go to the grocery store for socialization and community integration).

 

The following tasks are not considered allowable tasks under this service unless they are incidental to the companionship activity:

Bathing, dressing/undressing, feeding/eating, incontinence, mobility, toileting, transferring/turning/ positioning.

Communication, housework, laundry, meal preparation money management, and medication assistance.

 

Companionship services provided outside of the client's home

Payment can be made for time performing authorized companionship tasks outside of the client's home/grounds. The amount of hours authorized includes any time spent traveling to engage in activities in the community, shopping etc. Mileage is not reimbursed separately but is included in the rate.

 

Service Activity Limits

  1. Companionship services do not include hands-on nursing care or medication administration but may include verbal instruction or cueing;

  2. Companionship services do not include activity fees (e.g. movie or event fees);

  3. Companionship cannot be combined with adult foster care, adult residential care, transitional living, residential habilitation, community support services, and recipients of the senior companion program under the Cooperation for National and Community Service;

  4. Companionship services cannot be provided by an individual who is identified as the recipients relative within the definition of family home care under subsection 4 of N.D.C.C. 50-06.2-02;

  5. Companionship services cannot be provided to residents of a basic care facility, assisted living facility, memory care facility, skilled nursing facility or traumatic brain injury facility.

  6. Companionship services are based on the amount of funds available at the time of the request.

  7. The task of “visiting” is considered a companionship activity; however, a QSP may only bill for a maximum of 2 hours per week for this task, or 8 hours in one month.

For unusual or unique circumstances, approval from an Aging Services Program Administrator must be obtained.

 

Authorizing Service

  1. The service tasks/activities within the scope of this service chapter must be identified on the Authorization to Provide Service SFN 739.
  2. The amount of units allocated for companionship services cannot exceed 15 hours of service per month (60 units).
  3. The companionship provider may also be the personal care, homemaker provider etc. However, the services cannot be provided at the same time.
  4. Request for services will only be accepted from the OAA provider, VAPS investigator, Community Services Coordinator (CSC), HCBS Case Manager, ADRL Transition Coordinator.
  5. Aging Services will not accept requests for services directly from individuals i.e. caregivers, family, individuals needing services.
  6. Request for service approval must be submitted via email at carechoice@nd.gov.
  7. Request for services may not exceed six (6) months. Additional requests for services may be made after the initial six (6) month period.
  8. Aging Services may deny a request for additional services for consumers have been previously authorized services but have not used the services in the past.
  9. A new Authorization to Provide Services, SFN 739, must be completed yearly with a face-to-face visit along with new signatures to continue services.
  10. If the participant is authorized services under Options Counseling, the CSC is not required to complete a face-to-face visit to initiate services but will be required annually thereafter.

  11. Companionship will not be authorized if an individual is already receiving a service to address social isolation.

 

Standards for Providers

  1. Individuals enrolled as a QSP who meet the standards to provide adult companion services except for individuals who are identified as a relative of the recipient within the definition of family home care under subsection 4 of N.D.C.C. 50-06.2-02.

  2. Agencies enrolled as a QSP that meet the standards for adult companion services.
  1. Employees of agencies enrolled to provide this service cannot use an employee who is identified as a relative of the recipient within the definition of family home care under subsection 4 of N.D.C.C. 50-06.2-02.
  1. Organizations enrolled as a QSP that provide companion service under the Corporation for National and Community Service Senior Companion Programs.
  1. Employees of organizations enrolled to provide this service cannot use an employee who is identified as a relative of the recipient within the definition of family home care under subsection 4 of N.D.C.C. 50-06.2-02.
  2. Organization providers must meet all the standards established by the Corporation for National and Community Service National and Community Service Senior Companion program grantees.
  1. Verification of organization credentials is done by the national corporation.

  2. Individual or Agencies enrolled to provide respite care under the ND Family Caregiver Support Program. These providers can only serve individuals who are receiving companionship services through the ADRL grant or via OAA Tittle IIIB funds.
  3. The QSP must maintain service records for seven (7) years per the QSP documentation standards for OAA providers. Records must be kept even if the entity stopped being a provider or was closed or terminated by the Department.

All records must include:

  1. Name and ID of the participant/member

  2. Name and ID of the provider

  3. Date of the service

  4. Start time and end time (including a.m. and p.m.) in the participant’s home

  5. Units of service, by procedure code

  6. Tasks performed (use tasks name as listed on the authorization)

  1. The Companionship Billing Worksheet, SFN 740, must be used for monthly billing of the services provided. The SFN 740 must include:

    1. The billable units and authorized companionship task being provided for each date of service;

    2. The total number of units and total amount being requested.

    3. The companionship tasks being provided must match the service tasks authorized.

    4. Companionship billing must be filed within 60 days of services being rendered, or the claim may be denied.

  1. All individual companionship providers and the employees of agency providers must also have the global endorsement for cognitive/supervision. Organization employees/ volunteers do not need this endorsement.