Of Employment of Direct Service Workers in Maine ...

1: DRAFT date: Nov. 5, 2009, Revised from first draft presented to IMT April 23, 2009 To Print on Letter-Size paper: Select "Letter" in the print dialogue box in the "Zoom,/ Scale to Paper Size" option in lower right corner

Profile of Employment of Direct Service Workers in Maine Department of Health and Human Services Programs

Explanation of this table: A search of the Maine Department of Health and Human Services (DHHS) benefits policy and rule-making manuals was conducted to identify programs that list personal care-type services, such as Activities of Daily Living, as a covered service and/or reference the employment of personal care/support worker/unlicensed assistive personnel. These selected programs were scanned to identify the entry-level (no college-level credential required) personal care/support job titles, their responsibilities/job functions, and when noted, their qualification requirements. Notation: Job titles requiring college-level credentials are not listed. The programs are grouped as MaineCare, Medicare, Office of Elder Services, and Mental Health and Mental Retardation, Office of Substance Abuse, and Department of Education, Psychiatric Institutions/Hospitals. A glossary of abbreviations is listed at the end of the document. This table was last updated in November 2009.

Maine DHHS Service Programs

Direct Service Worker Titles Employed

1. MaineCare: Section 2, Adult Family Care Services

This benefit provides coverage for members in the ? CNA

Assisted Housing Programs: Level III and IV Residential Care Facilities.

? CNA-M ? Unlicensed Health Care Assistive Personnel

? Unlicensed Assistive Personnel/Medications and Treatment

Worker Responsibilities/ Job Functions

Worker Qualifications (see Glossary for defined requirements)

? Personal Care Services ? ADLs ? IADLs ? Personal supervision ? Protection from environmental hazards ? Diversional and motivational activities ? Dietary services and care management ? Medication assistance (CNA-M) ? Other Responsibilities, with consumers:

- ensure and promote health & safety

- Provide prompts for activities of daily living or for important appointments

- assisting with adjusting to facility residence - arranging transportation and appointments - reporting deviations of consumers' normal

appearance, behavior or state of health - arranging or providing motivational and

diversionary activities (individual or group) that focus on social interaction to reduce isolation or withdrawal and to enhance communication and social skills)

? CNA: standard training

? CNA-M: standard training

? Unlicensed Health Care Assistive Personnel: standard training

? Unlicensed Assistive Personnel/Medications and Treatment: standard training; treatment duties are client-specific; medical needs may require training that is unique, and is provided by the employer

1: University of Southern Maine, Muskie School of Public Service

1

(DRAFT ? Do not reproduce, Note- Current draft Nov. 2009 following (updated from first draft presented to Department IMT April 2009)

2: DRAFT date: Nov. 5, 2009, Revised from first draft presented to IMT April 23, 2009 To Print on Letter-Size paper: Select "Letter" in the print dialogue box in the "Zoom,/ Scale to Paper Size" option in lower right corner

Maine DHHS Service Program

Direct Service Worker Titles

2. MaineCare: Section 6, Assisted Living Services

This benefit provides coverage for clients residing ?

in private apartments in buildings that include a

?

common dining area, either provided directly by the provider or indirectly through contracts with

?

persons, entities, or agencies.

?

?

CRMA PCA PSS RCS (see revised title in glossary, below) Untitled other staff

3. MaineCare: Section 12, Consumer-Directed Attendant Services

This benefit provides coverage for members

? Attendant

wishing to self-direct services. "Self-Direct" means

the member trains his/her attendant(s) and directs

the provision of attendant services. The member's

ability to self-direct must be documented on the

Medical Eligibility Determination Form as defined

in this Section.

Worker Responsibilities/ Job Functions

Worker Qualifications (see Glossary for defined requirements)

? Personal Care Services

? CRMA: standard training

? ADLs

? PCA: standard training

? IADLs

? PSS: standard training

? Other (medication administration and nursing ? RCS: standard training

services within an assisted living facility)

? Other staff: demonstrating evidence of

? supervision of, or assistance with, obtaining,

training/education/experience on file that they

storing and administering prescribed

are qualified to perform assigned tasks, such as

medication (CRMA)

assistance with laundry, household chores, and

? Personal supervision, meaning general

meal preparation

awareness of a member's whereabouts,

giving general consideration to the nature of

the living arrangement, and observation and

assessment of the member's functioning or

behavior to enhance his or her health or

safety or the health or safety of others

? Diversional or motivational activities that respond to member's interests and which stimulate social interaction, reduce isolation or withdrawal and enhance communication and social skills

? Personal Care Services ? ADLs ? IADLs

? Attendant: standard requirements, plus completion of consumer instruction and performance evaluation

2: University of Southern Maine, Muskie School of Public Service

2

(DRAFT ? Do not reproduce, Note- Current draft Nov. 2009 following (updated from first draft presented to Department IMT April 2009)

3: DRAFT date: Nov. 5, 2009, Revised from first draft presented to IMT April 23, 2009 To Print on Letter-Size paper: Select "Letter" in the print dialogue box in the "Zoom,/ Scale to Paper Size" option in lower right corner

Maine DHHS Service Programs

Direct Service Worker Titles Employed

Worker Responsibilities/ Job Functions

Worker Qualifications (see Glossary for defined requirements)

4. MaineCare: Section 17, Community Support Services

This benefit provides coverage for members with cognitive disorders, neurological conditions and substance abuse or dependence, or anti-social personality disorders, who are18 or over in home and community settings.

? CRMA ? CIPSS ? Employment Specialist ? MHRT-1 ? MHRT/C

? Daily Living Support Services ? Medication assistance (CRMA) ? Community Support Services ? Skills Development Services

? CRMA: standard training ? CIPSS: standard training ? Employment Specialist:

standard training ? MHRT-1: standard training ? MHRT/C: standard training

5. MaineCare: Section 19, Home and Community-Based Benefits for the Elderly and for Adults with Disabilities (Waiver)

The Home and Community-Based Waiver for Elders ? PSS

and Adults with Disabilities covers two home and community benefits (HCB) populations: elderly members and members who are adults with

? HHA ? CNA

disabilities in their own residence.

? Personal Care Services ? Homemaker Services ? IADLs

6. MaineCare: Section 21, Home and Community Benefits for Members with Mental Retardation or Autistic Disorder (Waiver)

This benefit is offered in a community-based setting as an alternative for members who qualify to live in an Intermediate Care Facility for Persons with Mental Retardation (ICF/MR).

? CNA-M ? DSP ? DSP/CRMA ? Employment Specialist ? MHRT/C

? Direct Support Services ? Home Support ? Work Support ? Community Support ? Crisis Intervention ? Medication assistance (CNA-M, CRMA)

? PSS: standard training ? HHA: standard training ? CNA: standard training

? CNA-M: standard training ? DSP: standard training ? DSP/CRMA: standard training ? Employment Specialist:

standard training ? MHRT?C: standard training

7. MaineCare: Section 22, Home and Community Benefits for the Physically Disabled (Waiver)

This benefit is offered in home and community-

? PCA

based settings to MaineCare members who are

? Attendant

physically disabled and age eighteen (18) and over.

? Personal Care Services ? IADSs ? ADLs

? PCA: standard training

? Attendant: standard requirements, plus completion of consumer and/or agency instruction and performance evaluation

3: University of Southern Maine, Muskie School of Public Service

3

(DRAFT ? Do not reproduce, Note- Current draft Nov. 2009 following (updated from first draft presented to Department IMT April 2009)

4: DRAFT date: Nov. 5, 2009, Revised from first draft presented to IMT April 23, 2009 To Print on Letter-Size paper: Select "Letter" in the print dialogue box in the "Zoom,/ Scale to Paper Size" option in lower right corner

Maine DHHS Service Programs

Direct Service Worker Titles Employed

Worker Responsibilities/ Job Functions

Worker Qualifications (see Glossary for defined requirements)

8. MaineCare: Section 26, Day Health Services

Day health services are those services provided

? CNA

? Personal Care Services

outside the member's residence at a site licensed ? Other service aides and assistants who provide

by the Bureau of Elder and Adult Services, on a

day health services appropriate to their level

regularly scheduled basis. The ongoing service may

of training under the supervision of a licensed

include, based on individual needs: monitoring of

professional

health care, supervision, assistance with activities

of daily living, nursing, rehabilitation, health

promotion activities, exercise groups, counseling,

Noon meals and snacks are provided as a part of

day health services.

9. MaineCare: Section 29, Community Support Benefits for Members with Mental Retardation and Autistic Disorder

The Community Support Benefit is for members

? CNA-M

with Mental Retardation and Autistic Disorder who ? DSP

continue to live either with their families or on their own. The Community Support Benefit is also ? DSP/CRMA

designed to support members in the workplace.

? Employment Specialist

? HHA

? Personal Care Services ? Home Support ? Work Support ? Community Support ? Medication assistance (CNA-M, CRMA)

10. MaineCare: Section 40, Home Health Services

This benefit provides home health services.

? HHA

11. MaineCare: Section 41, Day Treatment Services

This benefit provides day treatment services to children as part of an integrated educational program.

? OQMHP-Day Treatment

? Personal Care Services ? ADLs

? Daily living services ? Community integration services ? Interpersonal functioning services

? CNA: standard training

? CNA-M: standard training ? DSP: standard training ? DSP/CRMA: standard training ? Employment Specialist:

standard training ? HHA: standard training

? HHA: standard training

? A Relevant Bachelor's Degree, and current training in First Aid, CPR, and non-aggressive techniques of intervention, OR,

? OQMHP-Day Treatment: Standard Training ? Certification as an Ed Tech

4: University of Southern Maine, Muskie School of Public Service

4

(DRAFT ? Do not reproduce, Note- Current draft Nov. 2009 following (updated from first draft presented to Department IMT April 2009)

5: DRAFT date: Nov. 5, 2009, Revised from first draft presented to IMT April 23, 2009 To Print on Letter-Size paper: Select "Letter" in the print dialogue box in the "Zoom,/ Scale to Paper Size" option in lower right corner

Maine DHHS Service Programs

Direct Service Worker Titles Employed

Worker Responsibilities/ Job Functions

Worker Qualifications (see Glossary for defined requirements)

12. MaineCare: Section 43, Hospice Services

This benefit provides hospice services to the terminally ill and to that person's family.

? HHA ? CNA

? Personal Care Services ? Homemaker Services

? HHA: standard training ? CNA: standard training

13. MaineCare: Section 67, Nursing Facility Services

Nursing Facility Services means services that are ? CNA primarily professional nursing care or rehabilitative ? CNA-M services for injured, disabled, or sick persons; needed on a daily basis and as a practical matter can only be provided in a nursing facility; ordered by and provided under the direction of a physician; and less intensive than hospital inpatient services

? ADLs ? General care of nursing home residents under

supervision for personal care, mobility, nutrition, quality of environment

? Medication assistance (CNA-M)

? CNA: standard training

? CNA-M: standard training

? Alzheimer's/ Dementia care providers must also document 6 hours of classroom training on Alzheimer's and other dementia for all licensed staff, CNA, social work, activities and housekeeping staff. In addition, 4 of the 12 contact hours required for CNA certification in- service must be in the area of managing residents with cognitive impairments. Training shall be provided by individuals qualified by education or experience.

14. MaineCare: Section 96, Private Duty Nursing and Personal Care Services

These benefits are provided to individuals under age 21 and are eligible for Level IV and individuals of any age eligible for all other Levels of care.

? PCA ? HHA ? CNA ? CNA-M ? Family Services Provider

? Homemaker Services ? Personal Care Services ? ADLs ? IADLs ? Medical assistance ? Medical services as authorized ? Family Provider Services

? PCA: standard training, plus 1) option to hire untrained staff with requirement for immediate 8-hour orientation; 2) completion of approved training and examination within 6 months of hire date; and/or 3) specialized training as needed by clientele

? HHA: standard training

? CNA: standard training

? CNA-M: standard training

? Family Provider: no training defined

5: University of Southern Maine, Muskie School of Public Service

5

(DRAFT ? Do not reproduce, Note- Current draft Nov. 2009 following (updated from first draft presented to Department IMT April 2009)

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