These rules take effect immediately upon filing with the secretary of state unless adopted under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA 306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become effective 7 days after filing with the secretary of state.
(By authority
conferred on the department of health and human social services
by sections 6 and 10 of Act No. 280 of the Public Acts of the
social welfare act, 1939 PA 280, as amended, being SS MCL
400.6 and 400.10 of the Michigan Compiled
Laws)
R 400.1101, R 400.1102, R 400.1103, R 400.1104, R 400.1105, R 400.1106, and R 400.1107 of the Michigan Administrative Code are rescinded, as follows:
R 400.1101 Definitions.
Rescinded.
Rule 1. As used in these rules:
(a) "Co-payment of services cost" means the
amount set by the department which the client must pay directly to the adult
home help provider toward the total cost of adult home help services.
(b) "Department" means the department of
social services.
(c) "Excluded services" means activities for
which adult home help services payments are not to be made because a normally
able individual would not usually perform them for himself. These activities
include professional medical services, professional contracting or repair
services, and other activities that require licensure or special certification.
(d) "Functional limitations" means deficits in
personal and social functioning necessary to meet basic needs, such as
limitations resulting from handicaps or the process of aging.
(e) "Home-based care" means services provided
in a home setting to compensate for functional limitations. Home settings
include residential settings other than licensed homes for the aged, adult
foster care facilities, nursing homes, hospitals, infirmaries, medical
care facilities, and state institutions.
(f) "Home help providers" means individuals or
public or private agency providers who perform light work, household tasks, or
other unskilled activities of daily living.
(g) "Home help services payments" means
payments issued by the department to eligible individuals to pay for the
assistance of home help providers with necessary unskilled daily activities,
including both the personal and nonpersonal activities of daily living that the
individuals cannot perform by themselves.
(h) "Nonpersonal activities of daily living"
means activities required for the maintenance of an individual's living
quarters and immediate environment. Activities may include meal preparation
and planning, laundry, light and heavy housecleaning, home maintenance and
minor repairs, yard work, and shopping and other necessary errands.
(i) "Personal activities of daily living"
means activities required for an individual's physical maintenance or care of
self. Activities may include tasks associated with eating, toileting,
bathing, grooming, dressing, locomotion, stair climbing, and communication.
Activities may also include the maintenance of a guide dog for the blind.
(j) "Supplemental security income" and
"SSI" means the program of assistance to the aged and disabled authorized under title XVI of
the social security act, 42
U.S.C. S1381 et seq.
R 400.1102 Payments generally. Rescinded.
Rule 2. The department shall provide adult home help
services payments for the home-based care of eligible adults who experience
functional limitations.
R 400.1103 Department responsibilities. Rescinded.
Rule 3. The department shall discharge the following
responsibilities in administering adult home help services payments:
(a) Determine each individual's eligibility for services
payments in accordance with R 400.1105 based upon a written
application and information furnished by the individual or an authorized representative.
(b) Determine, in conjunction with the individual, and
document the need for services and the probable duration of that need, in
accordance with R 400.1106.
(c) Assist the client, as needed and requested, with all
of the following:
(i) Locating needed providers.
(ii) Negotiating an agreement with providers concerning
services to be performed and reimbursement to be made.
(iii) Carrying out that
agreement.
(iv) Authorize payments in accordance with R
400.1107 based upon information obtained from interviews with both the client
and the provider.
(v) Redetermine continuing eligibility and need for
services in accordance with title XX of the social security act, 42 U.S.C.
S1397 et seq., 45 C.F.R. S228, and other standards set by the department,
both periodically and when otherwise necessary as indicated by department
evaluation or other information.
R 400.1104 Client responsibilities. Rescinded.
Rule 4. A client or an authorized representative, or
both, shall assume the following responsibilities as a condition of receiving
an adult home help services payment:
(a) Employ and discharge the providers, negotiate the
services to be performed and the rate of reimbursement, set the hours and
the conditions of employment, monitor the providers' performance, and pay them
for work performed.
(b) Contribute co-payment of services cost as assessed
by the department by direct payment
of this amount to a provider or providers.
(c) Notify the department of any change in circumstances
that affect the authorization of home help services payments, including changes
in providers, numbers of hours
worked, and the client's own abilities to perform the necessary activities.
R 400.1105 Eligibility.
Rescinded.
Rule 5. To be eligible to receive adult home help
services payments, an individual shall be either of the following:
(a) A recipient of supplemental security income (SSI).
(b) An individual who meets SSI eligibility criteria for
age, blindness, or disability, and for resource limitations. Such individual
shall also be within income limits and shall be subject to co-payment of
services cost, as set by the department.
R 400.1106 Determination of need. Rescinded.
Rule 6. To be determined in need of adult home help
services payments, a client shall meet all of the following conditions:
(a) Require assistance with necessary personal or
nonpersonal activities of daily living.
(b) Documentation of need is based upon the client's
statements and direct observations by the social services worker supplemented,
as appropriate, by other verifications, such as that of medical or mental
health professionals and collateral contacts with providers and others.
(c) Determination of need includes the evaluation of all
of the following:
(d) Client's physical strengths and limitations.
(e) Client's psychological strengths and limitations.
(f) Client's physical
environment.
(g) Client's accessibility and proximity to needed resources.
(h) Client's available assistance from relatives,
friends, neighbors, and community resources.
(i) Needed assistance is not available without cost from
any other source.
R 400.1107 Payment authorization; criteria.
Rescinded.
Rule 7. Adult home help payments shall be authorized by
the department in accordance with the following criteria:
(a) Payments shall be authorized to all eligible
individuals who request assistance and whose need for services can be documented.
(b) The total amounts of the authorized payments to an
individual for all providers, plus any co-payment of services cost from the
individual, shall not exceed a monthly maximum set by the department.
(c) The department may set variable payment levels,
within the monthly maximum, by geographic location based on prevailing wage rates.
(d) Payment shall not be authorized for excluded services.
(e) Payment shall be authorized for assistance to an
individual in nonpersonal activities of daily living only to the extent that
the individual is responsible for the performance of those activities within
the household setting.