INSTRUCTIONS TO STAFF
1. LTC nurse responsibilities in the provision of Medicaid Personal Care Services.
Determines and documents an individual's competency to meet the needs of each client prior to the initiation of Personal Care Services.
Provides and documents ongoing training to the PCA based upon the needs of the PCA and/or the needs of the client.
Utilizes the plan of care to determine the training needs of the PCA for each client assigned and implements the plan of care that meets the needs of each client.
Reports any PCA suspected of abuse, neglect or exploitation to the DHS Adult Protective Services staff, the Attorney General's Medicaid Unit and the Oklahoma Department of Health Nurse Aide Registry.
Prior to service delivery assignment of the PCA, contacts the Oklahoma State Department of Health Nurse Aide Registry for any pending notation related to the abuse, neglect and/or exploitation of a client by a PCA.
Prior to service delivery assignment of the PCA, contacts the Department of Human Services Community Services Worker Registry created pursuant to Section 1025.3 of Title 56 of the Oklahoma Statutes.
An Oklahoma State Bureau of Investigation (OSBI) background check will be initiated prior to the PCA beginning work.
2. The LTC nurse, with input from the DHS social worker, submits a written request for an exception to the rule for the client receiving Personal Care while living in the PCA's home. Documentation included with the exception request shall include the name and case number of the client, the name and address of the potential PCA, the client's diagnosis, physical condition and care needs and the reason for the request.
3. The LTC nurse or Administrative Agent (AA) nurse submits a written request to the area nurse for an exception to the rule restricting provision of Personal Care to the home setting. Documentation included with the exception request shall include the name and case number of the client, the client's vocational goal(s) and goal justification, the name of the potential PCA, the client's diagnosis and care needs in the vocational setting, the number of hours of care requested per week in the vocational setting and the vocational setting name and address.
4. An Oklahoma State Bureau of Investigation (OSBI) background check will be initiated prior to the PCA beginning work. The LTC nurse must complete the DHS form ADM-130, Request for Background Check, and submit it to the DHS-DCFS Fingerprint Processing Section. The original copy will be returned to the LTC nurse who will file it in the Personal Care Assistant's file. If the results indicate that the individual PCA may have had a felony charge filed against them, the LTC nurse checks with the county court house indicated for the deposition of the case and notes it on the original copy. If the PCA was convicted, pled guilty, or pled no contest, he/she cannot serve as a PCA.
5. When the client selects the individual to be considered as the Personal Care Assistant, the client notifies the county or the LTC nurse. The LTC nurse makes an appointment for the individual to come to the DHS county office for orientation and determination that the individual meets the minimum qualifications to be a Personal Care Assistant. The PCA may begin work after a contract is executed by the OHCA and a determination of competency to carry out the plan of care is made by the LTC nurse. The LTC nurse notifies the social worker of the service effective date and documents it in the client's case record. The county forwards the original contract to the OHCA, who will be responsible for annual renewal. Once the client selects the PCA, the social worker updates the authorization file.
6. Initial interaction between the LTC nurse and the PCA includes, at a minimum:
(A) a determination that the PCA has met the qualifying criteria for Personal Care Service provision and has the knowledge and skill to carry out the assigned task on the plan of care as documented on DHS form AG-24, Documentation of Qualifications to Provide Personal Care Service;
(B) discussion of the role and responsibilities of the PCA;
(C) discussion of the needs of the client and the tasks included on the plan of care, DHS form AG-4, Personal Care Plan;
(D) discussion of the employer/employee relationship between the client and PCA;
(E) assistance in completing OHCA form OHCA-0026, Personal Care Program Individual Contract;
(F) discussion of the method of filing claim for payment and record maintenance;
(G) discussion of the date service is to begin, the number of hours, and the days per week;
(H) discussion of the use of DHS form AG-5, Personal Care Planning Schedule, and DHS form AG-6, Personal Care Service Plan;
(I) FICA information;
(J) when and how to contact the LTC nurse and DHS social worker; and
(K) how to complete the Individual Personal Care Provider Services Record, DHS form AG-PC-8).
7. A follow-up letter is sent to the PCA stating the reason for counseling and the expected change in performance. Notice is also given that continued problems will result in a recommendation for termination. The LTC nurse sends a copy of the PCA letter to the client and files a copy in the county's PCA file and the client's case record maintained by the nurse.