Home Health Care
Service Standard
Home Health Care Service Standard print version
Texas Department of State Health Services, HIV Care Services Group – HIV/STD Program | Texas DSHS
Subcategories | Service Units |
---|---|
Home Health Care | Per visit |
Home Health Specialized Care | Per visit |
Health Resources and Services Administration (HRSA) Description
Home Health Care is the provision of services in the home that are appropriate to an eligible client’s needs and are performed by licensed professionals. Activities provided under Home Health Care must relate to the client’s HIV disease and may include:
- Administration of prescribed therapeutics (e.g., intravenous and aerosolized treatment, and parenteral feeding)
- Preventive and specialty care
- Wound care
- Routine diagnostic testing administered in the home
- Other medical therapies
Program Guidance
The provision of Home Health Care is limited to clients that are homebound. Agencies may fund non-licensed personal care services with the Home and Community-based Health Services service category.
Limitations
Providers cannot conduct Home Health Care in nursing facilities or inpatient mental health or substance abuse treatment facilities. Personal care and non-licensed in-home care providers are not allowable services.
Services
A licensed and certified home health agency provides Home Health Care Services in a home or community-based setting in accordance with a written, individualized plan of care established by a licensed primary medical care provider. Home Health Care Services may include the following:
- Part-time or intermittent skilled nursing care
- Physical therapy
- Occupational therapy
- Speech-language pathology services
- Durable medical equipment
- Medical supplies for use at home
Universal Standards
Services providers for Home Health Care must follow HRSA and DSHS Universal Standards 1-52 and 84-85.
Service Standards and Measures
The following standards and measures are guides to improving healthcare outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.
Standard | Measure |
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Initiation of Care Orders: The home health agency must receive written orders from the client’s primary HIV medical provider before initiation of care by the home health agency from a licensed practitioner to include the following:
Note: Section 3708 of the CARES Act allows a nurse practitioner, clinical nurse specialist, or physician assistant who is working in accordance with State law to order or refer home health services. This applies on or after March 1, 2020.. Homebound Status: The ordering provider must certify the client is homebound or confined to home as applicable. To receive Home Health Services, the client must meet one or more of the following criteria:
Note: If the client does leave the home, the client may still meet the definition of homebound if the absences from the home are infrequent or for periods of relatively short duration or are attributable to the need to receive health care treatment. |
1. Percentage of clients with documentation of signed orders for home health care services by a qualified licensed practitioner before initiation of care by the home health agency. 2. Percentage of clients with documentation of certification of client homebound status by a licensed health care practitioner. (Pilot Measure) |
Timely Initiation of Care: Staff must contact the client within 1 business day of the referral, and must initiate services at the time specified by the primary medical care provider or within 2 business days, whichever is earlier. |
3. Percentage of clients with documentation of initiation of care within one of the following criteria: a. Within 1 business day of receipt of referral or order for services b. On the date specified by referring or ordering provider c. Within 2 days of the date specified by the provider |
Initial Assessment: Agencies must complete a comprehensive assessment of the client’s psychosocial, functional, past medical history, current health status, to include:
|
4. Percentage of clients with documentation of a completed comprehensive assessment on initiation of care. |
Implementation of Care Plan: Staff will complete a care based on the primary medical care provider's order that includes:
Care providers will update the care plan at least every 60 calendar days. |
5. Percentage of clients with documentation of care plans completed in accordance with the primary medical care provider’s order(s). 6. Percentage of clients with documentation of care plan reviewed or updated as necessary based on changes in the client’s situation at least every 60 calendar days. |
Provision of Services: Professional staff will:
The agency will maintain ongoing communication with the primary medical care provider. |
7. Percentage of clients with documentation of completed progress notes within 14 working days of the service rendered in the client’s primary record. 8. Percentage of clients with documentation of ongoing communication and care coordination with the primary medical care provider. |
Transfer/Discharge: Transfer and discharge of clients from home health care services should result from a planned and progressive process that considers the needs and desires of the client and the caregiver(s), family, and support network. Agencies must develop a transfer plan when one or more of the following criteria are met:
|
9. Percentage of clients with documentation of a transfer plan developed in coordination with the client, caregiver(s), and multidisciplinary team with a referral to an appropriate service provider agency, as applicable. 10. Percentage of clients with documentation of a discharge plan developed with client, caregiver(s), and multidisciplinary team, as applicable. (Pilot Measure) |
Notification of Transfer/Discharge: When a client is transferred or discharged from services, agencies must:
|
11. Percentage of clients with documentation of notification of transfer or discharge within 5 days before the date of transfer or discharge as applicable to the following parties: (Pilot Measure) a. The client or legal representative b. The client’s attending practitioner, as applicable. |
References
Division of Metropolitan HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part A Recipients. Health Resources and Services Administration, June 2022.
Division of State HIV/AIDS Programs, HIV/AIDS Bureau (HAB). Ryan White HIV/AIDS Program (RWHAP) National Monitoring Standards for RWHAP Part B Recipients. Health Resources and Services Administration, June 2022.
Ryan White HIV/AIDS Program. Policy Notice 16-02: Eligible Individuals & Allowable Uses of Funds. Health Resources and Services Administration, 22 October 2018.
Texas Administrative Code, Title 1 Administration, Part 15 Texas Health and Human Services Commission, Chapter 354 Medicaid Health Services, Subchapter A Purchased Health Services, Division 3 Medicaid Home Health Services, Rule §354.1039 Home Health Services Benefits and Limitations, https://texreg.sos.state.tx.us/public/readtac$ext.TacPage?sl=R&app=9&p_dir=&p_rloc=&p_tloc=&p_ploc=&pg=1&p_tac=&ti=1&pt=15&ch=354&rl=1039