Personal care services include (a) personal care services
and (b) ancillary services prescribed in accordance with a plan of
treatment.
(a) Personal care services
include:
(1) Assisting with ambulation,
including walking or moving around (i.e., wheelchair) inside the home, changing
locations in a room, moving from room to room to gain access for the purpose of
engaging in other activities. Ambulation does not include movement solely for
the purpose of exercise.
(2)
Bathing and grooming including the cleaning the body using a tub, shower or
sponge bath, including getting a basin of water, managing faucets, getting in
and out of tub, or shower, reaching head and body parts for soaping, rising,
and drying. Grooming includes hair combing and brushing, shampooing, oral
hygiene, shaving and fingernail and toenail care.
(3) Dressing includes putting on and taking
off, fastening and unfastening garments and undergarments, and special devices
such as back or leg braces, corsets, elastic stockings/garments and artificial
limbs or splints.
(4) Bowel,
bladder and menstrual care including assisting the person on and off toilet or
commode and emptying commode, managing clothing and wiping and cleaning body
after toileting, assistance with using and emptying bedpans, ostomy and/or
catheter receptacles and urinals, application of diapers and disposable barrier
pads.
(5) Repositioning, transfer
skin care, and range of motion exercises.
(A)
Includes moving from one sitting or lying position to another sitting or lying
position; e.g., from bed to or from a wheelchair, chair, sofa, and the like,
coming to a standing position and/or rubbing skin and repositing to promote
circulation and prevent skin breakdown. However, if decubiti have developed,
the need for skin and wound care is a paramedical service.
(B) Such exercises shall include the carrying
out of maintenance programs, i.e., the performance of the repetitive exercises
required to maintain function, improve gait, maintain strength, or endurance;
passive exercises to maintain range of motion in paralyzed extremities; and
assistive walking.
(6)
Feeding, hydration assistance including reaching for, picking up, grasping
utensil and cup; getting food on utensil, bringing food, utensil, cup to mouth,
manipulating food on plate. Cleaning face and hands as necessary following
meal.
(7) Assistance with self
administration of medications. Assistance with self-administration of
medications consists of reminding the beneficiary to take prescribed and/or
over-the-counter medications when they are to be taken and setting up
Medi-sets.
(8) Respiration limited
to nonmedical services such as assistance with self-administration of oxygen,
assistance in the use of a nebulizer, and cleaning oxygen equipment.
(9) Paramedical services are defined in
Welfare and Institutions Code Section
12300.1
as follows:
(A) Paramedical services include
the administration of medications, puncturing the skin or inserting a medical
device into a body orifice, activities requiring sterile procedures, or other
activities requiring judgment based on training given by a licensed health care
professional.
(B) Paramedical
services are activities which persons could perform for themselves but for
their functional limitations.
(C)
Paramedical services are activities which, due to the beneficiary's physical or
mental condition, are necessary to maintain the beneficiary's
health.
(b)
Ancillary services are subject to time per task guidelines when established in
Sections
30-758 and
30-763.235(b) and 30-763.24 of the
Department of Social Services' Manual of Policies and Procedures and are
limited to the following:
(1) Domestic
services are limited to the following:
(A)
Sweeping, vacuuming, washing and waxing of floor surfaces.
(B) Washing kitchen counters and
sinks.
(C) Storing food and
supplies.
(D) Taking out the
garbage.
(E) Dusting and picking
up.
(F) Cleaning oven and
stove.
(G) Cleaning and defrosting
refrigerator.
(H) Bringing in fuel
for heating or cooking purposes from a fuel bin in the yard.
(I) Changing bed linen.
(J) Miscellaneous domestic services (e.g.,
changing light bulbs and wheelchair cleaning, and changing and recharging
wheelchair batteries) when the service is identified and documented by the case
worker as necessary for the beneficiary to remain safely in his/her
home.
(2) Laundry
services include washing and drying laundry, and is limited to sorting,
manipulating soap containers, reaching into machines, handling wet laundry,
operating machine controls, hanging laundry to dry if dryer is not routinely
used, mending, or ironing, folding, and storing clothing on shelves, in closets
or in drawers.
(3) Reasonable food
shopping and errands limited to the nearest available stores or other
facilities consistent with the beneficiary's economy and needs; compiling a
list, bending, reaching, and lifting, managing cart or basket, identifying
items needed, putting items away, phoning in and picking up prescriptions, and
buying clothing.
(4) Meal
preparation and cleanup including planning menus; e.g., washing, peeling and
slicing vegetables; opening packages, cans and bags, mixing ingredients;
lifting pots and pans; reheating food, cooking, and safely operating stove,
setting the table and serving the meals; cutting the food into bite-size
pieces; washing and drying dishes, and putting them away.
(5) Assistance by the provider is available
for accompaniment when the beneficiary's presence is required at the
destination and such assistance is necessary to accomplish the travel limited
to:
(A) Accompaniment to and from appointments
with physicians, dentists and other health practitioners. This accompaniment
shall be authorized only after staff of the designated county department has
determined that no other Medi-Cal service will provide transportation in the
specific case.
(B) Accompaniment to
the site where alternative resources provide in-home supportive services to the
beneficiary in lieu of IHSS. This accompaniment shall be authorized only after
staff of the designated county department have determined that neither
accompaniment nor transportation is available by the
program.
(6) Heavy
Cleaning which involves thorough cleaning of the home to remove hazardous
debris or dirt.
(7) Yard hazard
abatement which is light work in the yard which may be authorized for:
(A) removal of high grass or weeds and
rubbish when this constitutes a fire hazard
(B) removal of ice, snow or other hazardous
substances from entrances and essential walkways when access to the home is
hazardous.
(c)
Ancillary services may not be provided separately from personal care services
listed in section (a) above.