FREQUENTLY ASKED QUESTIONS (FAQ)
We have collected a few of the most frequent questions here for your information. If you do not see something, and want to know more, we are here to assist in any way possible. Please click here to leave us a message.
What is "Home Care?"
Homemaker Chore Services include cleaning, cooking, dusting, taking out the trash, washing and laundry conducted for a participant who needs the home based assistance and is unable to obtain it through family.
How do I become a caregiver?
Whether you wish to become a caregiver for your loved one or for a senior or a disabled participant, we encourage you to contact us with an application. For your convenience, an application is provided online, (Employment Inquiry Form) but may be brought in or dropped off in person, An interview may then be scheduled and your references, criminal check as well other required screenings will be completed at that time. We are able to provide full, part and PRN employment for willing caregivers.
How does the Consumer Directed Services (CDS) program work?
Under the Consumer Directed Services, a consumer is able to direct their own care and may hire up to four individuals to attend to his /her activities of daily living. Usually, the consumer identifies someone they trust (a family member, a friend, a neighbor or a caregiver who may have worked with the consumer in the past). Under the state regulations, the consumer must be responsible for ensuring that their caregiver follows directions and does not commit fraud. The agency, hired as a vendor of CDS services provides payroll support, oversight and background checks as well as regular visits to the CDS care recipient via phone and in person.
What is 'Personal Care'?
Personal Care Assistance is assistance with participant’s personal needs, including bathing & grooming, feeding, toileting, transfer and mobility and other functions of daily living. Advanced Personal Care assists with activities of daily living when devices and procedures related to altered body functions are required.
Is a participant expected to pay for the services?
If a participant is a MoHealthNet recipient and is approved for services by Missouri Department of Health and Senior Services, there are no fees to the participant. ‘Private pay’ fee-based services are available to seniors who may not qualify for state insurance coverage or may not meet full criteria of nursing home level of care. We do not accept Medicare as payment as home care services are not covered by Medicare.
How is a care plan made and can it ever be changed?
Care plans are made between the authorizing party and the participant. Care plans are built on information gathered by an in-person assessment of participant’s unique healthcare needs. These plans are generally revisited annually, but all participants are encouraged to contact our team or the Department of Health and Senior Services if their needs have changed and when care plan is no longer effectively addressing them.
ADDITIONAL INFORMATION – GLOSSARY
What are the 'Activities of Daily Living?
Also referred to as ADL, these are defined as the 6 key activities which together represent the ability of an individual to care for themselves and be independent. They include: 1) Dressing 2) Toileting 3) Continence 4) Bathing 5) Feeding oneself 6) Transferring (i.e. ability to move oneself from bed to chair or in and out of a bathtub)
I heard that an assessment must be completed to qualify for home based services. What is this 'assessment?
In order to qualify for Medicaid coverage of either Home & Personal Care or Consumer Directed Services , an assessment must be conducted by a state of Missouri certified assessor. This comprehensive assessment evaluates factors that determine whether a senior meets the nursing home level of care: • physical state and abilities – hearing, vision, walking, falls, balance, movement, activity level, sleep, fatigue, continence; • mental state and abilities – memory, thinking, cognitive skills, decision making skills, social interactions and relationships, behavior, any changes; and • capacity, i.e. ability to act independently in relation to meal prep, housework, finances, shopping, meds etc. The results will determine if the state believes care is warranted, and what types and duration of tasks are appropriate. The (annual) assessment also determines whether or not a participant is able to direct their own care. If you would like to learn if you qualify for a pre-screening and referral, call our office at 314-645-7600.
What exactly is a 'care plan?
A service plan (AKA care plan) is the customized written document that specifies the services and supports that are to be furnished to meet the preferences, choices, abilities and needs of the individual, and that assist the individual to direct those services and supports and remain in the community. We are frequently asked why one’s individual care plan prepared by the Department of Health and Senior Services does not allow for more than a specific amount of a certain task. These tasks are based on the minimally required assistance to enhance one’s ability to live independently and – due to the fact that MoHealthNet pays for the services to assist participants in maintaining community living – enhanced services may be cost prohibitive to the state. Therefore, care plans are not always able to meet every need of a qualified senior, but meet these needs minimally to avoid long term care placement.
What is the difference between Medicaid and MoHealthNet?
Medicaid is a joint federal and state program that helps low-income individuals or families pay for the costs associated with long-term medical and custodial care, provided they qualify. Although largely funded by the federal government, Medicaid is run by the state where coverage may vary. Missouri’s Medicaid Program called MO HealthNet provides health care access to low income individuals that are elderly, disabled, members of families with dependent children, low-income children, uninsured children, pregnant women, refugees, or children in state custody. Adults in ME (Medical Eligibility) categories that pertain to persons who are in the Aid to the Blind or pregnant women receive a full comprehensive benefit package including primary, acute and preventive care, hospital care, dental, prescriptions, and vision. Adults other than those in the Aid to the Blind and pregnant women receive a limited benefit package of services depending on their ME category. Services are received through a fee-for-service (FFS) or managed care delivery system For more information, see: http://dss.mo.gov/mhd/providers/pdf/puzzledterm.pdf
I heard 'caregiver' referred to as a 'home health aide'. What is a home health aide?
Home Health Aide is professional who provides daily personal care, such as bathing, grooming or meal preparation, light housekeeping, help with chores, and some errands. This is not someone with nursing training or skills. Home Care is often referred to as “caregiving” or non-medical in-home services in which help is provided for activities of daily living. Medical aspects of daily living are met through nursing services or advanced personal care services.
QUESTIONS ABOUT PARTICIPANT RIGHTS & RESPONSIBILITIES
What is "Home Care?"
Participants are expected to: * explain any specific information about tasks authorized on the care plan * provide supplies needed for tasks in the care plan *allow the caregiver to use participant’s landline telephone, or otherwise permit to use EVV (electronic visit verification) *ensure that reported services adequately reflect tasks that were completed as governed by the care plan * notify us if a participant plans to be absent from home * notify us of any problems with care delivery * accept or select an aide without regard to race, color, age, or religion
I heard participants may be disallowed services. What are some reasons?
According to MoHealth Net and DHSS guidelines, participants are not allowed to require services to their family or pets. Participants may not threaten, physically, verbally or sexually abuse or allow any members or guests of the household to abuse the aide. Unless private pay arrangement is made, participants may expect that the aide will complete assigned tasks only in participant quarters, in participant’s presence, even if the residence a larger home where other family members reside. Participant may not take any part in fraudulent activity, including but not limited to sharing of funds, falsification of time records, or misrepresentation of medical need for nursing home level of care. Engagement in fraudulent activity will be immediately reported and may result in loss of services or loss of insurance benefit.
What are some guidelines to ensure participant safety?
While CDS allows consumers to select and hire up to four personal aides, only registered and screened by Missouri Family Care Safety caregivers are accepted. Our responsibility is not only to ensure consumers’ ability to direct their care, but also conduct regular screenings to verify their safety and caregiver’s trustworthiness. Participant of home care services are advised not to leave valuables, cash or checkbook in plain sight, not to be asked for a car ride, not to pay cash to the designated aide and not to engage in an unprofessional relationship.
If I am a CDS consumer and my caregiver and I go on vacation, can my caregiver continue to assist me with my daily needs?
MoHealthNet only covers services offered to the participant in their own home, or listed place of residence. We will ask you to provide details re your stay, while away and we will remind you that only personal care services may be allowed, if you are staying at a hotel and eating out. Please, note that caregiver may not bill and / or collect for services she / he provides while you are hospitalized.