Appendix D:

Long-Term Care Services Personal Assistance Services

Available Topics:

What Are Personal Assistance Services?

Who Provides Personal Assistance Services?

How Are Personal Assistance Services Paid For?

Who should I Contact for Additional Information?

What Are Personal Assistance Services?

Personal assistance services provide routine, ongoing care or services to individuals in a residence or independent living environment. Personal assistance services provide individuals with help and supervision in completing activities of daily living such as bathing, dressing, grooming, eating, walking, taking medication, toileting, and other personal care activities. This type of personal care may be provided by unlicensed personnel without nursing supervision and does not require a physician's order. Services may also include some limited activities related to a person's health needs, such as changing bed linens and meal preparation. Personal assistance services are not for the treatment of medical needs and do not include nursing care. Personal assistance services may also be referred to as attendant care services, personal care services, and supportive home care services.

Example: Javier is 82 years old and lives with his wife, Rose, who is 76 years old. Javier had a stroke two years ago and as a result, he needs assistance with his personal care. Rose is able to provide some of that care but it is becoming increasingly difficult due to her arthritis. Javier and Rose are otherwise in good health. A personal assistant comes by daily to assist Javier with his bathing, grooming, and dressing.

Who Provides Personal Assistance Services?

Many elderly do not receive formal, paid home and community-based long-term care services, but rely instead on informal, unpaid support given by family and friends. In fact, this informal care accounts for about 75 percent of the home and community-based long-term care services provided. Where home care in the form of unpaid, informal support is unavailable or inadequate, community care programs may authorize personal assistance services.

In Texas, these services may be administered by state and local units or by private nonprofit or even for-profit agencies. Services may be paid for directly by the authorizing program or by the client through a subsidy or voucher. However, services must be provided by a home and community support service agency licensed by the Texas Department of Health.

How Are Personal Assistance Services Paid For?

The Texas Department of Human Services pays for personal assistance services for those persons meeting financial, medical, and functional criteria through a variety of programs. Some programs serve a limited number of clients and waiting lists for their services may exist. Area Agencies on Aging fund services through Texas Department on Aging funds.

Most private insurance policies do not cover personal assistance services but check your health care plan for specific coverage information.

Who to Contact for Additional Information:

Texas Department on Aging

1949 IH-35 South

Austin, Texas 78741

(800) 252-9240 (you should be automatically connected to the Agency on Aging nearest you).

Texas Department of Human Services

P.O. Box 149030

Austin, Texas 78714-9030

(800) 252-9240 (to find out your local contact agency)

Texas Association of Homes and Services for the Aging

2205 Hancock Drive

Austin, Texas 78756

(512) 467-2242

Texas Association for Home Care, Inc.

3737 Executive Center, Suite #151

Austin, Texas

(800) 880-8893

Tips:

1. Personal assistance services can be an important factor in allowing a person to remain in their own home and can prevent the need for institutionalization.
2. Personal assistance services are not only for elderly persons living alone but may be provided to elderly persons living with another caregiver. This service can reduce the burden of the caregiver while allowing the elderly person to remain in the home.
3. Personal assistance services not only provide help with certain care needs but can reduce the isolation for many elderly people living alone in their own homes.
4. Many home modifications or adaptive aides can make daily activities easier to perform. These devices and products can lead to increased independence and/or reduce the need for some personal assistance services. There are many "aides for daily living" available through pharmacies and medical equipment dealers.
5. Personal emergency response systems consist of a small device worn around the neck or on the wrist and allow the wearer to signal for help by pressing a button. They transmit a signal to an emergency monitoring center where staff attempt to determine the nature of the emergency and respond accordingly. These devices can increase a person's independence, security, and peace of mind.
6. Ask the provider for any written statements that describe its services, fees, patient rights, confidentiality, complaint procedures, hours of service, and emergency arrangements.
7. Ask the provider how they select their employees. Do they perform background checks on their employees?
8. If you have a problem or complaint about a provider, you may contact the Texas Department of Health - Health Facility Licensure Home Health Hotline at 1-800-228-1570.

References

The Equitable Foundation and Children of Aging Parents. 1995. Aging Parents and Common Sense: A Practical Guide for You and Your Parents. New York, NY. December.

National Association for Home Care. http://www.nahc.org

Texas Association for Home Care. http://www.tahc.org

Texas Health and Human Services Commission, Health and Human Services in Texas: A Reference Guide, May, 1993.

Texas Health and Human Services Commission, State Medicaid Office, Texas Medicaid in Perspective, Austin, Texas. May, 1994.