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Home Health Aide

Page posted: 10/01/03

Page reviewed:

Page updated: 8/4/11

Legal Authority

42 C.F.R. 440.70, 42 C.F.R. 484.36, Minn. Stat. §256B.0625 and Minn. Stat. §256B.0651

Definition

Home health aide: Provides medically oriented task(s) to maintain health or to facilitate treatment of an illness or injury provided in a person’s place of residence.

Place of Residence

The following are considered a place of residence:

  • • Home rented, owned, or shared by person
  • • Rule 5 residential programs for children with severe emotional disturbances
  • • Rule 8 group homes
  • • Rule 35 chemical dependency rehabilitation programs
  • • Rule 36 residential facilities for adults with mental illness
  • • Residential programs and services for persons with developmental disabilities excluding ICFs/DD
  • • Non-certified boarding care homes eligible for Group Residential Housing room and board payments
  • The following are not considered a place of residence:

  • • Hospital
  • • Intermediate care facility
  • • Nursing facility
  • Covered Services

    Home health aide visits to:

  • • Assist in administering medications that are ordinarily self-administered
  • • Assist in ambulating or exercises
  • • Assist with instrumental activities of daily living
  • • Perform simple procedures as an extension of therapy or nursing services
  • • Provide hands-on personal care
  • A HHA follows a care plan developed by the agency registered nurse and is supervised. HHA supervision is completed by:

  • • A registered nurse or
  • • An appropriate therapist (physical, occupational, speech-language pathology) when receiving one of the named skilled services
  • Medical Assistance pays for home health aide visits when other funding resources are exhausted.

    Non-Covered Services

    HHA visits for the sole purpose to provide:

  • • Companionship or socialization
  • • Education
  • • Household tasks
  • • Transportation
  • Services not prescribed by a physician are not reimbursed by MA.

    Provider Standards and Qualifications

    Medicare-certified home health agency that employs:

  • • Registered nurse(s) with current Minnesota registration
  • • Home health aide(s) with current certification from the Minnesota Department of Health
  • Process and Procedures

    MA State Plan Service
    CAC, CADI, BI Waivers

    DD Waiver

    Rates - See Continuing Care and other provider rate changes page

    Process/Procedure: HHA - MA State Plan Service

    Access

    Anyone may make a referral directly to a Medicare-certified home health agency.

    Medicare-certified agencies with MDH

    Assessment

    Registered nurse of the Medicare-certified home health agency completes an assessment to determine need for service. An assessment:

  • • Identifies the needs of the person
  • • Determines outcome for visit(s)
  • • Is documented in the record of the person
  • • Includes an individualized plan of care or service plan
  • Authorization

    Medicare-certified home health agency submits the following to DHS:

  • • Home health certification and plan of care
  • • Physician orders
  • • Service Agreement DHS-3070 (PDF) – submit via ITS software or mail paper form
  • DHS reviews material submitted for completeness of information, need for service and number of visits needed.

    If approved, DHS provides:

  • • Temporary authorization (a one-time authorization for up to 45 days maximum)
  • • Long-term service authorization (authorization for up to one year, depending on the needs of the person)
  • Limitations

    Once approved, one visit per day per person is permitted.

    Process/Procedure: HHA - CAC, CADI, BI Waivers

    Access

    A waiver case manager/service coordinator makes a referral to an approved Medicare-certified agency with MDH.

    Assessment

    The long-term care consultation process is used for determination of need for service. The registered nurse of the Medicare-certified home health agency:

  • • Completes assessment to determine need and develops care plan
  • • Uses agency forms with retention of documents in the person’s file
  • • Obtains physician orders
  • Authorization

    County case manager/service coordinator completes authorization for HHA with entry into the MMIS service agreement.

    First authorized visit/day is billed as MA State Plan service. All subsequent visits for the day are billed to the appropriate waiver.

    Length of authorization is based on a person’s need and/or length of current service agreement.

    Limitations

    Once approved:

  • • One visit per day is authorized through MA State Plan service
  • • Extended HHA is authorized through Waiver
  • All visits need prior authorization from the case manager/ service coordinator.

    Process/Procedure: HHA - DD Waiver

    Access

    A waiver case manager/service coordinator makes a referral to an approved Medicare-certified agency with MDH.

    Assessment

    The developmental disability screening process is used for assessment of service need. The registered nurse of the Medicare-certified home health agency:

  • • Completes agency assessment to determine need and develops care plan
  • • Obtains physician orders
  • • Uses agency forms with retention of documents in the person’s file
  • Authorization

    The county service coordinator completes authorization for a HHA visit(s) with entry into the MMIS service agreement.

    Length of authorization is based on a person’s medical need and/or length of current service agreement.

    Limitations

    Once approved:

  • • One visit per day per person is permitted
  • • Extended HHA is not available
  • All visits need prior authorization from the case manager/service coordinator.

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    Updated: 8/15/14 3:56 PM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 8/15/14 3:56 PM