PHC

Primary Home Care

WHAT IS THE PHC PROGRAM?

The goal of the Primary Home Care (PHC) program is to prevent or delay the institutionalization of clients by providing necessary supportive care in the client’s home. The PHC program is able to provide basic care and is not meant to meet all of the client’s needs. PHC services are considered to be non-medical, non-nursing, non-technical, non-emergency care that is meant to encourage the client to do as much as he can for himself. PHC assists the client to accomplish basic personal care and minimal household tasks. PHC only provides tasks allowable in the program. These services will be provided at the client’s primary residence unless special permission is obtained to provide them elsewhere. PHC is not nursing care nor is it a maid service.

COVERED SERVICES

• Escort: Accompanying the consumer on trips to obtain medical diagnosis or treatment or both. Additional time may not be allocated for escort services for other purposes. This service does not include the direct transportation of the consumer by the attendant.
• Home Management: Assistance with housekeeping activities that support the consumer’s health and safety, including the following:
  • housekeeping
  • laundry
  • shopping
  • other household tasks
• Personal Care: Assistance with activities related to the care of the consumer’s physical health, including the following:
  • bathing
  • dressing
  • grooming
  • routine hair and skin care
  • preparing meals
  • feeding
  • exercising
  • helping with self-administered medication
  • toileting
  • transferring/ambulating

HOW DOES A CLIENT OBTAIN PHC?

Persons interested in PHC should contact the Department of Aging and Disability Services Long Term Care Program for the Elderly or Disabled hotline at 1-888-902-9990 to make a referral. Once contacted, a Department of Aging and Disability Services (DADS) caseworker will make a home visit and complete a socio-economic assessment. The results of this assessment are entered into a scoring system, which in turn results in a detailed service plan that is individualized for that specific client. This service plan designates which tasks the client needs help with and how much time has been allowed to carry out the plan.

The DADS caseworker mails the service plan to the PHC agency. The agency is chosen by client preference or by agency rotation if the client has no preference. When the agency RN obtains the service plan fr om DADS, she has 14 days in which to complete the packet and request a signed physicians statement. The packet to be completed consists of the forms fr om the RN’s physical assessment of the client, a physicians statement that the RN must send to the physician to be signed, and the RN’s assessment of the needed services. Once the signed physician statement is received, services can begin. The PHC agency then has to hire, train, and place the attendant in the client’s home. The hiring and training process consists of a Criminal History affidavit, a Criminal History check by the Texas Department of Safety in Austin, checking the Misconduct and Nurse Aide Registries and references, Pre-employment drug testing, a general orientation/training session, and TB testing and possibly Hepatitis B vaccination.

HOW DOES THE SERVICE PLAN WORK?

The service plan designates exactly what tasks are to be done for the individual client, exactly how many hours per week will be allowed, the approximate time of day in which the tasks are to be done, and any other information that the caseworker deems necessary. The services will be provided at the client’s home unless an alternative location is approved by the DADS caseworker. The agency attendant is ONLY authorized to do the tasks listed on the service plan, and ONLY during the days/hours specified unless different arrangements are made. The attendant is ONLY authorized to provide services for the client only... not the client’s family or any other person. If changes need to be made to the service plan, please notify the PHC agency. Service plans are usually issued to an agency for a period of 1 year, with an annual review recertification process performed by the DADS caseworker.

CONSUMER ELIGIBILITY

• Age: Must be 21 or older.
• Income: Medicaid eligible.
• Resources: $2,000 or less for an individual or $3,000 or less for a couple
• Functional Assessment Score:
  • Minimum score of 24
  • Functional limitation with at least one personal care task based on medical condition
  • Practitioner’s statement of medical need
• Unmet Need: For home management and personal care task(s)

Service Maximum

Consumers can receive:

• 50 hours per week; or
• 42 hours per week if receive Priority Status.

FAMILY CARE

Family care is a Medicaid program administered by the Texas Department of Aging and Disability Services (DADS) which provides non-technical attendant services to Medicaid eligible consumers who reside at home. Under the Family Care Program, the attendant or provider could be a family member, a friend or a neighbor. Participation in the family care program does not require a doctor’s order. However, like in Primary Home Care a consumer must have a functional limitation and need assistance with activities of daily living.

To make a referral, call this toll free hotline # 1-888-902-9990.

If possible, you will need to have as much of the following information available when you call:

• What does the person need help with?
• What are that persons physical and mental limitations? Does this person live alone?
• Who helps this person now?
• What are their medical problems? Are they able to walk? Do they use a cane or a walker?
• Social Security Number, Date of birth, Street & Mailing Addresses, phone number, contact person.
• Monthly income if you know this information.

Referrals can be made even if you do not have all of the above information.

If you have any questions, you may call us at Veritas Home Health at 972-519-0308.