service definitions and unit measurements direct purchase of service (dps)

Service Definitions and Unit Measurements

Direct Purchase of Service (DPS)

Presentation ObjectivesPresentation Objectives

Review Importance of Accurate Review Importance of Accurate Performance ReportingPerformance Reporting

Review NM’s Taxonomy of Service Review NM’s Taxonomy of Service Definitions Definitions

Review Unit of Service MeasurementsReview Unit of Service Measurements

WHY is this “stuff” important?WHY is this “stuff” important?

Each state is required to report both the Each state is required to report both the demographic and service data to the demographic and service data to the federal government Administration on federal government Administration on Aging (AoA) using the State Program Aging (AoA) using the State Program Report (SPR).Report (SPR).

The reporting requirements are approved by The reporting requirements are approved by the Office of Management and Budget the Office of Management and Budget (OMB) and was most recently published (OMB) and was most recently published on May 25, 2010.on May 25, 2010.

WHY is this “stuff” important?WHY is this “stuff” important?

Federal and state funding for aging Federal and state funding for aging programs is based on the data that is programs is based on the data that is compiled and reported.compiled and reported.

Statistics reported indicate whether or not Statistics reported indicate whether or not services are being provided to those most services are being provided to those most in need. (Elderly age 60+ who: live in rural in need. (Elderly age 60+ who: live in rural areas; have minimal support; who are areas; have minimal support; who are disabled, etc.)disabled, etc.)

Okay . . . let’s take a CLOSER LOOK

Adult Day CareAdult Day Care

A supervised, protective, congregate setting A supervised, protective, congregate setting in which social services, recreational in which social services, recreational activities, meals, personal care, activities, meals, personal care, rehabilitative therapies and/or nursing care rehabilitative therapies and/or nursing care are provided to dependent adults. Facility are provided to dependent adults. Facility must be licensed by the State of New must be licensed by the State of New Mexico.Mexico.

Unit of Service: 1 HourUnit of Service: 1 Hour

Case ManagementCase Management Assistance either in the form of access or care Assistance either in the form of access or care

coordination in circumstances where the coordination in circumstances where the older person is experiencing diminished older person is experiencing diminished functioning capacities, personal conditions or functioning capacities, personal conditions or other characteristics which require the other characteristics which require the provision of services by formal service provision of services by formal service providers or family caregivers. Activities of providers or family caregivers. Activities of case management include such practices as case management include such practices as assessing needs, developing care plans, assessing needs, developing care plans, authorizing and coordinating services among authorizing and coordinating services among providers, and providing follow-up and providers, and providing follow-up and reassessment, as required. reassessment, as required.

Note: This is an ongoing process including Note: This is an ongoing process including assessing needs of a client and effectively assessing needs of a client and effectively planning, arranging, coordinating and planning, arranging, coordinating and following-up services which most following-up services which most appropriately meet the identified needs as appropriately meet the identified needs as mutually defined by the client, staff, and mutually defined by the client, staff, and where appropriate, a family member(s) or where appropriate, a family member(s) or other caregiver(s).other caregiver(s).


Case Management Cont’dCase Management Cont’d

ChoreChore

Assistance with heavy housework, yard Assistance with heavy housework, yard work or sidewalk maintenance at a work or sidewalk maintenance at a person’s place of residence.person’s place of residence.


Homemaker/HousekeepingHomemaker/Housekeeping

Assistance with meal preparation, shopping, Assistance with meal preparation, shopping, managing money, making telephone calls, managing money, making telephone calls, light housework, doing errands and/or light housework, doing errands and/or providing occasional transportation. providing occasional transportation.


Transportation ServicesTransportation Services

Services designed to transport older Services designed to transport older persons to and from medical and health persons to and from medical and health care services, social services, meal care services, social services, meal programs, senior centers, shopping and programs, senior centers, shopping and recreational activities; so that such recreational activities; so that such services will be accessible to eligible services will be accessible to eligible individuals who have no other means of individuals who have no other means of transportation or are unable to use existing transportation or are unable to use existing transportation. transportation.

There are two methods of transportation services: There are two methods of transportation services: Demand/ResponseDemand/Response-transportation designed to -transportation designed to

carry older individuals from specific origin to carry older individuals from specific origin to specific destination upon request. Older specific destination upon request. Older individuals request the transportation service in individuals request the transportation service in advance of their need. advance of their need.

Fixed RouteFixed Route-transportation service that -transportation service that operates along a prescribed route according to a operates along a prescribed route according to a fixed schedule. The fixed-route does not vary fixed schedule. The fixed-route does not vary and the provider strives to reach each transit and the provider strives to reach each transit stop at the scheduled time. The older individual stop at the scheduled time. The older individual does not reserve a ride as in a demand-does not reserve a ride as in a demand-response system; the individual simply goes to response system; the individual simply goes to the designated location and at the designated the designated location and at the designated time to gain access to the transit system.time to gain access to the transit system.

Assisted TransportationAssisted Transportation

Providing assistance and transportation, including Providing assistance and transportation, including escortescort, to an older individual who has difficulties , to an older individual who has difficulties (physical or cognitive) using regular vehicular (physical or cognitive) using regular vehicular transportation. The “trip” includes the following: transportation. The “trip” includes the following: assisting the older individual from preparation for assisting the older individual from preparation for the trip, to assisting the older individual from the trip, to assisting the older individual from their place of residence into the vehicle their place of residence into the vehicle providing transportation, assisting the older providing transportation, assisting the older individual from the transporting vehicle to the individual from the transporting vehicle to the destination, such as the doctor’s office staying destination, such as the doctor’s office staying with the older individual at the point of with the older individual at the point of destination; and the reverse for a return trip.destination; and the reverse for a return trip.

Unit of Service: 1, One-Way TripUnit of Service: 1, One-Way Trip

TransportationTransportation

Taking an older person from one location to Taking an older person from one location to another. This does not include any other another. This does not include any other activity. activity.

Unit of Service: 1, One-Way TripUnit of Service: 1, One-Way Trip

Nutrition ServicesNutrition Services PURPOSE: Nutrition services assist older

Americans to live independently by promoting better health through improved nutrition and reduced isolation through a program coordinated with other supportive services. As outlined in the Older Americans Act, the intent of this service is to:

1. Reduce hunger and food insecurity; 2. Promote socialization of older individuals; and 3. Promote the health and well-being of older

individuals to gain access to nutrition and other disease prevention and health promotion services to delay the onset of adverse health conditions resulting from poor nutritional health or sedentary behavior.

There are two types of meals:There are two types of meals:Standard meal – A regular meal from the Standard meal – A regular meal from the

standard menu that is served to the standard menu that is served to the majority of the participants.majority of the participants.

Therapeutic meal or liquid supplement – A Therapeutic meal or liquid supplement – A special meal or liquid supplement that has special meal or liquid supplement that has been prescribed by a physician and is been prescribed by a physician and is planned specifically for the participant by a planned specifically for the participant by a dietician (e.g., diabetic diet, renal diet, dietician (e.g., diabetic diet, renal diet, tube feeding).tube feeding).

Congregate MealsCongregate Meals

A hot or other appropriate meal served to an A hot or other appropriate meal served to an eligible person which meets one-third (1/3) of eligible person which meets one-third (1/3) of the dietary reference intakes (DRI) as the dietary reference intakes (DRI) as established by the Food and Nutrition Board of established by the Food and Nutrition Board of the Institute of Medicine of the National the Institute of Medicine of the National Academy of Sciences and complies with the Academy of Sciences and complies with the most recent Dietary Guidelines for Americans, most recent Dietary Guidelines for Americans, published by the Secretary and the Secretary of published by the Secretary and the Secretary of Agriculture, and which is served in a congregate Agriculture, and which is served in a congregate setting five or more days per week.setting five or more days per week.

Unit of Service: 1 MealUnit of Service: 1 Meal

Home Delivered MealsHome Delivered Meals

Hot, cold, frozen, dried, canned or supplemental Hot, cold, frozen, dried, canned or supplemental food (with a satisfactory storage life) which food (with a satisfactory storage life) which provides a minimum of one-third (1/3) of the provides a minimum of one-third (1/3) of the dietary reference intakes (DRI) as established by dietary reference intakes (DRI) as established by the Food and Nutrition Board of the Institute of the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences Medicine of the National Academy of Sciences and complies with the Dietary Guidelines for and complies with the Dietary Guidelines for Americans, published by the Secretary and the Americans, published by the Secretary and the Secretary of Agriculture, and is delivered to an Secretary of Agriculture, and is delivered to an eligible person in the place of residence. eligible person in the place of residence.

The objective is to assist the recipient in The objective is to assist the recipient in sustaining independent living with access sustaining independent living with access to nutritional meals, five or more days per to nutritional meals, five or more days per week, in a safe and healthful environment. week, in a safe and healthful environment. Home delivered meals may be served as Home delivered meals may be served as breakfast, lunch, dinner or weekend breakfast, lunch, dinner or weekend meals.meals.

Unit of Service: 1 MealUnit of Service: 1 Meal

Home Delivered Meals Cont’dHome Delivered Meals Cont’d

Nutrition CounselingNutrition Counseling

Individualized guidance, including Individualized guidance, including recommendations for improving nutritional recommendations for improving nutritional status, provided one-on-one by a status, provided one-on-one by a registered registered dieticiandietician to persons who are at nutritional risk, or to persons who are at nutritional risk, or their caregivers. Nutritional risk may be due to their caregivers. Nutritional risk may be due to health history, dietary intake/habits, chronic health history, dietary intake/habits, chronic illness or medication use.illness or medication use.

Unit of Service: 1 Session per ParticipantUnit of Service: 1 Session per Participant

Nutrition EducationNutrition Education

Accurate and culturally sensitive nutrition Accurate and culturally sensitive nutrition and health related information and and health related information and instruction provided in a group or instruction provided in a group or individual setting overseen by a dietician individual setting overseen by a dietician or individual with comparable expertise.or individual with comparable expertise.

Unit of Service: 1 Session per Unit of Service: 1 Session per ParticipantParticipant

Health Promotion ActivitiesHealth Promotion Activities

This includes health fairs, physical fitness activities This includes health fairs, physical fitness activities conducted by an exercise professional, (i.e. conducted by an exercise professional, (i.e. Aerobics’ Instructor), evidence-based health Aerobics’ Instructor), evidence-based health promotion programs, medication management promotion programs, medication management that is inclusive of monitoring, screening and that is inclusive of monitoring, screening and education to prevent incorrect medication usage education to prevent incorrect medication usage and adverse drug reaction. Home and adverse drug reaction. Home safety/accident prevention that involves a home safety/accident prevention that involves a home assessment, assistive devices, accident assessment, assistive devices, accident prevention training, assistance with home prevention training, assistance with home modifications to prevent accidents/facilitate modifications to prevent accidents/facilitate mobility, and/or follow-up services to determine mobility, and/or follow-up services to determine effectiveness of modifications/assistive devices.effectiveness of modifications/assistive devices.

Education/TrainingEducation/Training

Formal or informal opportunities for Formal or informal opportunities for individuals to acquire knowledge or individuals to acquire knowledge or experience, increase awareness, promote experience, increase awareness, promote personal or community enrichment and/or personal or community enrichment and/or increase or gain skills.increase or gain skills.


Health ScreeningHealth Screening

Pre-nursing home admission screening Pre-nursing home admission screening and/or routine health screening.and/or routine health screening.


Home Safety ServicesHome Safety Services

Home assessment, assistive devices, Home assessment, assistive devices, accident prevention training, assistance accident prevention training, assistance with modifications to prevent with modifications to prevent accidents/facilitate mobility, and/or follow-accidents/facilitate mobility, and/or follow-up services to determine effectiveness of up services to determine effectiveness of modifications/assistive devices.modifications/assistive devices.


Medication ManagementMedication Management

Monitoring, screening and education to Monitoring, screening and education to prevent incorrect medication usage and prevent incorrect medication usage and adverse drug reactions.adverse drug reactions.

Unit of Service: 1 ContactUnit of Service: 1 Contact

Physical Fitness/ExercisePhysical Fitness/Exercise

Individual or group exercise activities (with Individual or group exercise activities (with or without equipment), such as walking, or without equipment), such as walking, running, swimming, sports and/or Senior running, swimming, sports and/or Senior Olympics physical conditioning/training.Olympics physical conditioning/training.


National Family National Family Caregiver (CG) ServicesCaregiver (CG) Services

PURPOSE: To provide for a multifaceted PURPOSE: To provide for a multifaceted system of support services for (1) family system of support services for (1) family caregiver; and (2) for grandparents or caregiver; and (2) for grandparents or older individuals that are relative older individuals that are relative caregivers. The intent of the program is to caregivers. The intent of the program is to provide information, support and provide information, support and assistance to family caregivers. assistance to family caregivers.

CG Access AssistanceCG Access Assistance

A service that assists caregivers in obtaining A service that assists caregivers in obtaining access to the services and resources that access to the services and resources that are available within their communities. To are available within their communities. To the maximum extent practicable, it the maximum extent practicable, it ensures that the individuals receive the ensures that the individuals receive the services needed by establishing adequate services needed by establishing adequate follow-up procedures. follow-up procedures.

Note: Information and assistance to caregivers is Note: Information and assistance to caregivers is an access service, i.e., a service that: (A) an access service, i.e., a service that: (A) provides individuals with information on services provides individuals with information on services available within the communities; (B) links available within the communities; (B) links individuals to the services and opportunities that individuals to the services and opportunities that are available within the communities; (C) to the are available within the communities; (C) to the maximum extent practicable, establishes maximum extent practicable, establishes adequate follow-up procedures. Internet web adequate follow-up procedures. Internet web site “hits” are to be counted only if information is site “hits” are to be counted only if information is requested and supplied.requested and supplied.

Unit of Service: 1 ContactUnit of Service: 1 Contact

CG Access Assistance Cont’dCG Access Assistance Cont’d

CG CounselingCG Counseling

Counseling to caregivers to assist them in Counseling to caregivers to assist them in making decisions and solving problems making decisions and solving problems relating to their caregiver roles. This relating to their caregiver roles. This includes counseling to individuals, support includes counseling to individuals, support groups, and caregiver training (of groups, and caregiver training (of individual caregivers and families).individual caregivers and families).


CG Information ServicesCG Information Services

A service for caregivers that provides the public A service for caregivers that provides the public and individuals with information on resources and individuals with information on resources and services available to the individuals within and services available to the individuals within their communities. [Note: service units for their communities. [Note: service units for information services are for activities directed to information services are for activities directed to large audiences of current or potential large audiences of current or potential caregivers such as disseminating publications, caregivers such as disseminating publications, conducting media campaigns, and other similar conducting media campaigns, and other similar activities.]activities.]

Unit of Service: 1 ActivityUnit of Service: 1 Activity

CG Respite CareCG Respite Care

Services which offer temporary, substitute Services which offer temporary, substitute supports or living arrangements for care of supports or living arrangements for care of recipients in order to provide a brief period of recipients in order to provide a brief period of relief or rest for caregivers. Respite Care relief or rest for caregivers. Respite Care includes: (1) In-home respite (personal care, includes: (1) In-home respite (personal care, homemaker, and other in-home respite); (2) homemaker, and other in-home respite); (2) respite provided by attendance of the care respite provided by attendance of the care recipient at a senior center or other recipient at a senior center or other nonresidential program; and/or 3) institutional nonresidential program; and/or 3) institutional respite provided by placing the care recipient in respite provided by placing the care recipient in an institutional setting such as a nursing home an institutional setting such as a nursing home for a short period of time as a respite service to for a short period of time as a respite service to the caregiver; andthe caregiver; and

for grandparents caring for children such for grandparents caring for children such as summer camps. If the specific service as summer camps. If the specific service units purchased via a direct payment units purchased via a direct payment (cash or voucher) can be tracked or (cash or voucher) can be tracked or estimated, report those service unit hours. estimated, report those service unit hours. If not, a unit of service in a direct payment If not, a unit of service in a direct payment is one payment.is one payment.


CG Respite Care Cont’d CG Respite Care Cont’d

CG Supplemental ServicesCG Supplemental Services

Services provided on a limited basis to Services provided on a limited basis to complement the care provided by complement the care provided by caregivers. Examples of supplemental caregivers. Examples of supplemental services include, but are not limited to, services include, but are not limited to, home modifications, assistive home modifications, assistive technologies, emergency response technologies, emergency response systems, and incontinence supplies.systems, and incontinence supplies.

Unit of Service: 1 Distribution EventUnit of Service: 1 Distribution Event

It all begins here!It all begins here! Running an effective and efficient senior service Running an effective and efficient senior service

program begins with clearly understanding:program begins with clearly understanding:• the definition and intention of the services the definition and intention of the services

that are being provided; that are being provided; • what the service requirements and what the service requirements and

limitations are; limitations are; • how the service is performed; and how the service is performed; and • how to properly document, count and report how to properly document, count and report

each service unit that is being provided.each service unit that is being provided.

service definitions and unit measurements direct purchase of service (dps)

Documents

hour unit of service

hour slide

service data

social services

formal service providers

health care services

provision of services

closer look slide