Serving 18 Counties in Northwest Kansas

Northwest Kansas 
Area Agency on Aging

Home     Counties Served     News & Events   Calendar    Volunteer

Free Test For Diabetes 

Services & Information

CARE (Client Assessment & Referral Evaluation)

Senior Health Insurance/ Prescription Drug Program

Nutrition Program

In-Home Services

Legal Services

Caregiver Program

Disease Prevention/ Health Promotion

Free Publications

Links

Contact Us

Site Index
Last Modified 07/22/04

CARE Connection

Winter 2010

Planning for Update Training Beginning

When you go on vacation picking out the destination is half the fun!  Why should choosing services to make your life more enjoyable be any different?

There are numerous options available to help us stay in our homes both now and in the future.  In-home services may delay the need for Assisted Living; Assisted Living may delay or prevent the need for Nursing Facility care.  All of us want to live in the least restrictive environment we can - and as CARE assessors we have the opportunity to ensure this happens for our clients.

Planning for the 2010 updates is beginning.  Please email/call/fax to let us know what format interests you most - see...that choice thing again!  We will try to use the format you like best.

• Traditional classroom presentation with a couple of invited speakers
• Small group discussions with the CARE coordinator presenting discussion topics
• Health fair setting - attend several presentations based on your interests
• Other:________________________________
• Suggested Speakers, Topics or Other Requests:_____________________________________

There are numerous choices to make when planning for long term care - are we sharing all of the choices with our clients?

New Assessor Training Coming Soon!

Thursday April 22, 2010

Kansas Highway Patrol Building

1821 Frontier Road in Hays

8:30 am - 4:30 pm

Call Tammy G for more information at 1-800-432-7422 or (785) 625-2037.

CARE Assessment Reminders

All of our CARE assessors in Northwest Kansas do an excellent job on their assessments!

We have discussed several areas of the assessment at recent meetings with KDOA that are frequently skipped or missed, so here's a gentle reminder.

Fax the Release of Information, regardless of if it is signed or not.  If there is a reason it's not signed please document it.  This shows you tried to get it signed - you just had an uncooperative patient or patient who was unable to sign it.

Although the Social Security Number is labeled as optional on the CARE assessment, it is really helpful for Lorna when the customer applies for Medicaid.  When it's possible, please try to include it.  We do not share the number with outside entities.

Independent assessors are encouraged to call the nursing facility before going to complete the assessment.  It is helpful to have someone from the nursing facility staff introduce you to the client.  Be sure to leave a copy of the CARE certificate for the facility.

Please remember that you must complete the entire CARE assessment you begin.  If an exception to this rule is needed, please contact the Area Agency on Aging.  Only in very rare circumstances will this be allowed.

Continue coding the referral section!  This is a great data set to present to the Kansas Legislature to indicate the widespread use of in-home services and the need for funding of additional services.

Additional Resources

We are working with other agencies to provide informational articles for you on the NWKAAA website.  This is a way for you to learn a little about other agencies and to provide a bit of information for your client and their family.  If you know of an agency - or are a member of an agency - we need more information about, please email us a request or article for the webpage.

If possible, contact the individual and a family member or other representative to be present for the assessment.   Call or notify the individual to verify a good time to complete the assessment.

Why do we do CARE?

At one time or another all of us have had a client ask us "Why do we have to do this CARE assessment?"  Sometimes family will intervene and say, "Mom/Dad, It's just part of the paperwork that has to be done before you can go to the nursing home."  Other times we are the ones giving the response.

So...the big question is...why do we have to do a CARE assessment?  The true purpose of the CARE assessment is to divert individuals from institutionalization by introducing in-home services that will help the client live at home safely for a longer period of time.  (Lorna's informal poll at training found that nearly all of us wanted to remain in our homes as long as possible.  Most of our clients do too.  Hmmm.)  We are able to provide resources for staying in the community safely.

As CARE assessors we must remember to present the numerous choices a client and their family have regarding long term care.  Many times its easier for us to encourage our "frequent fliers" to enter a nursing facility  so they stop coming into our hospitals so often.  Is that always the best solution?  For our convenience, maybe...for our clients and their wishes, probably  not.

Safety First:  Personal Safety in the Workplace

K4A presented a workshop entitled "Safety First - Personal Safety in the Workplace" on September 10, 2009.

Kansas Highway Patrol Master Trooper Bill Poland explained the signs and symptoms of drug abuse and the 7 categories of drugs - according to the law enforcement definition - and the characteristics of people who use these groups of drugs.

The 7 categories include:

• CNS Depressants (alcohol)
• CNS Stimulants (cocaine)
• Hallucinogens (Peyote cactus)
• Dissociative Anesthetics (PCP, DXM)
• Narcotic Analgesics (vicodin)
• Inhalants
• Cannabis

Officer Brian Dawson of the Hays Police Department described personal protection and safety.  The biggest piece of advice he gave was:  Leave if you feel uncomfortable!

There are many laws relating to personal safety and self-defense.  However, prevention, not laws, is the key to remaining safe.  Maintaining awareness of surroundings and situation, eye contact with others, remembering to breathe, and using your mind to help you out of dangerous situations may keep you from getting hurt.  The psychological will to survive may be even more important than physical self-defense tactics.  Weapons, such as guns, knives, and pepper spray may be used against you and require training.

Have a plan before you go on each home visit.  Park your vehicle in a location that allows for quick egress.  Let the client lead you to the door - and leave a gap between you.  Sit near the door whenever possible.  Follow your gut reaction.

Your co-workers can help you too.  Make sure they know your schedule.  Keep your cell phone charged and with you at all times.  Have a code word to let them know you're in trouble if you call them. If you wear an ID badge make sure it's on a breakaway device.  Don't wear movement-restrictive clothing.  Take defense classes / de-escalation classes.  Complete a public records search on new clients.

The presentation ended with a powerful quote:  "Whatever you fear most has no power - it is your fear that has the power." - unknown author

The CARE Assessment is:

• IS An opportunity for the CARE assessor to review community-based service options with the client and family.
• IS An evaluation of some of the client's health care needs.
• IS A document that is used to collect data on community services that are available and those that are not available.  This information is submitted to the legislature each year as an effort to expand community-based service options needed to maintain Kansans in their own homes.

The CARE Assessment is NOT:

• IS NOT Used to determine whether a client may or may not enter a nursing facility.
• IS NOT A guarantee of Medicaid eligibility.  To determine Medicaid eligibility, SRS considers the client's financial resources and determines the level of care the client needs by evaluating the information on the CARE assessment.
• IS NOT Used as an application for Medicaid.  If the client wants to apply for Medicaid, the CLIENT must contact the local SRS office to begin the paperwork.

The Medicaid application can be found online at http://www.srskansas.org/onlineapp/  You can also call your local SRS office to obtain an application.

Webinar Coming Soon

Does your facility have a trained CARE assessor?  Do they handle all aspects of the admission related to CARE?

There is usually someone who is not a trained CARE assessor who is significantly involved in the CARE process.  Would it be helpful if this person knew just a little more about the program and why things are the way they are - laws, regulations, etc.?

Soon we are planning to present a webinar targeted at people who would benefit from a little extra CARE knowledge, but will NOT be considered CARE assessors (although CARE assessors are invited to view this presentation, too!).

Watch your email for a notice of the date and time of this informational webinar.

Emergency Admits to Nursing Facilities

Please remember:  CARE paperwork must be on file for ALL ADMISSIONS, regardless of payment source PRIOR TO ADMISSION.  It's the law!

Clients are considered to be "emergencies" if they fit one of the following, very specific, criteria.

• An admission is requested by Social and Rehabilitation Services (SRS) Adult Protective Services (APS);
• A natural disaster occurs;
• The primary caregiver becomes unavailable, due to a situation beyond the caregiver's control (e.g., caregiver becomes ill or an accident involving the caregiver occurs);
• An admission from an out-of-state community to a nursing facility that is beyond the individual's control, i.e., an individual being admitted from their place of residence in another state on a weekend when an AAA CARE assessor is not available; or
• A physician ordered immediate admission due to the individual's condition.  (condition/situation should be noted in comments).

If you have any questions about emergency admissions, please contact the NWKAAA at 1-800-432-7422.

Please consider sending someone to the training in the spring if your facility doesn't have a trained CARE assessor.  The Director of Nursing is only supposed to complete PASRR for the facility until they can get to a CARE training, which are held in the spring and fall.

Does your facility have difficulty remembering to check for the CARE certificate or other paperwork?  Consider creating a checklist.

ADL/IADL Coding Clarifications

Our clients rarely fit neatly into one of the 4 codes for ADLs / IADLs.  Hopefully some of these clarifications will make it easier!

1 - Independent - Customer can do the task SAFELY alone - with no help or reminders from anyone.  Customer can be independent if they use assistive equipment correctly.

2 - Supervision Needed - Customer can do the task if someone reminds them or provides "set-up" assistance.  This is "hands-off" help.  May apply for customers with cognitive deficits.

3 - Physical Assistance - Customer can tell someone how they want the task done, but cannot safely do it themselves.  ALWAYS code "3" for UNSTEADINESS.  This is "hands-on" help.  Many people who receive 3s can start a task, but cannot adequately finish it.

4 - Unable to Perform - Customer cannot perform a task even if reminded and cannot tell anyone how to do it for them.  This is usually a result of late Alzheimer's, Stroke, Paralyzation, or Late Lou Gehrig's disease.  This is NOT for someone who is UNWILLING to complete the task.

Since many of you see clients in the Nursing Facility or Hospital, ask how they would perform the tasks at home.  If possible, observe transfers, walking, etc.