Library: Policy

340:105-10-50.1. Title III services taxonomy

Revised 9-15-2022

(a) Rule. Parts B, C, D, and E of Title III of the Older Americans Act (OAA) of 1965, as amended, authorize the development of a variety of services to meet the needs of qualified older participant. A comprehensive list of services that may be funded, service definitions, and service units are included in (1) through (18) of this subsection.

(1) Personal care - one hour; provides personal assistance, stand-by assistance, supervision, or cues.

(2) Homemaker - one hour, or partial hours may be reported to two decimal places, for example 0.25 hours; provides light housekeeping tasks in a qualified older participant’s home and possibly other community settings. Tasks may also include preparing meals, shopping for personal items, or using the phone.

(3) Chore - one hour, or partial hours may be reported to two decimal places, for example 0.25 hours; provides heavy housework tasks in a qualified older participant’s home and possibly other community settings. Tasks may also include, yard work, or sidewalk maintenance.

(4) Home delivered meal - one meal provided to a participant by a qualified nutrition project provider at his or her residence, served by a program administered by the State Unit on Aging or Area Agency on Aging (AAA), and meeting all OAA and legal requirements. Each meal:

(A) complies with the most recent Dietary Guidelines for Americans published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture;

(B) provides, when one meal is served, a minimum of 33 and 1/3 percent of the current dietary reference intakes (DRI) as established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences;

(D) provides, when three meals are served together, 100 percent of the DRI allowances.

(5) Adult day care or adult day health - one hour; provides personal care for dependent adults in a supervised, protective, and congregate setting during some portion of a day. Services offered in conjunction with adult day care or adult day health typically include social and recreational activities, training, counseling, and services, such as rehabilitation, medication assistance, and home health aide services for adult day health.

(6) Case management - one hour; provides assistance either in the form of access or care coordination in circumstances where the participant is experiencing diminished functioning capacities, personal conditions, or other characteristics requiring service provision from formal providers or family caregivers. Case management activities include:

(A) assessing needs;

(B) developing care plans;

(D) providing follow-up and reassessment, as required.

(7) Congregate meal - one meal provided to a participant by a qualified nutrition project provider in a congregate or group setting, served by a program administered by the State Unit on Aging or Area Agency on Aging (AAA), and meeting all OAA and legal requirements. Each meal:

(A) complies with the most recent Dietary Guidelines for Americans, published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture;

(B) provides, when one meal is served, a minimum of 33 and 1/3 percent of the DRI as established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences;

(D) provides, when three meals are served together, 100 percent of the DRI allowances.

(8) Nutrition counseling - one hour, or partial hours may be reported to two decimal places, for example 0.25 hours; provides individualized guidance as defined by the Academy of Nutrition and Dietetics (AND) to a participant, or to his or her caregiver, when the qualified person is at nutritional risk because of health or nutrition history, dietary intake, medication use, or chronic illnesses. A registered dietician provides one-on-one counseling and addresses the options and methods for improving nutrition status with a measurable goal.

(9) Assisted transportation - one one-way trip; provides services or activities that provide or arrange for travel, including travel costs for individuals from one location to another. This service includes escort or other appropriate assistance for a qualified older participant who has difficulties, physical or cognitive, using regular vehicular transportation.

(10) Transportation - one one-way trip; provides participants with services or activities that provide or arrange for travel, including travel costs, from one location to another and does not include any other activity.

(11) Legal assistance - one hour, or partial hours may be reported to two decimal places, for example 0.25 hours; an attorney provides legal advice and representation to qualified older participants with economic or social needs. Includes, to the extent feasible, counseling or other appropriate assistance by a paralegal or law student under a lawyer's direct supervision, and a non-lawyer's representation or counseling where permitted by law.

(12) Nutrition education - one session per participant; a dietician or an individual with comparable experience oversees a targeted program that promotes better health by providing accurate and culturally sensitive nutrition, physical fitness, or health information consistent with the current Dietary Guidelines for Americans, and provides instruction to participants, caregivers, or both in a group setting. This service:

(A) is approved by a registered dietician who answers participant questions related to nutrition education;

(B) occurs at least once per month;

(D) is documented on the Dietary Consultant's Report.

(13) Information and assistance - one contact; a one-on-one contact between a service provider and participant, caregiver or person on behalf of participant or caregiver. Activities involving contact with multiple current or potential participants or caregivers, such as publications, publicity campaigns, and other mass media activities are not counted as a unit of service. Internet website hits are counted only when information is requested and supplied. This service for older Oklahomans:

(A) provides current information on opportunities and services available within their communities, including information relating to assistive technology;

(B) assesses the participant's problems and capacities;

(D) ensures, to the maximum extent practicable, qualified older participants receive the services they need, and are aware of the opportunities available to them, by establishing adequate follow-up procedures; and

(E) serves the entire community of older individuals, particularly those

(i) with greatest social need;

(ii) with greatest economic need; and

(iii) at risk for institutional placement.

(14) Outreach - one contact; provides participant with intervention initiated by an agency or organization for the purpose of identifying potential qualified older participants or their caregivers and encouraging their use of existing services and benefits. Outreach is a one-on-one contact between a service provider and a participant or caregiver. Activities involving contact with multiple current or potential participants or caregivers, such as publications, publicity campaigns, and other mass media activities, are not counted as a unit of service.

(15) Health promotion - Evidence Based - one event; Title III-D programs or services are Community Living, Aging and Protective Services (CAP) approved prior to implementation. Title III-D Evidence Based programs and activities meet highest-level criteria and include activities related to:

(A) preventing and mitigating the effects of chronic disease, including:

(i) osteoporosis;

(ii) hypertension;

(iii) obesity;

(iv) diabetes, and

(v) cardiovascular disease; and

(B) alcohol and substance abuse reduction;

(D) weight loss and control;

(E) stress management;

(F) falls prevention;

(G) physical activity; and

(H) improved nutrition.

(16) Health promotion – non-evidence based – one event; activities related to heath promotion and disease prevention that do not meet the Administration on Aging or Administration for Community Living definition for an evidence based program. Activities may include:

(A) health risk assessments;

(B) routine health screening;

(D) programs regarding physical fitness and therapy;

(E) home injury control services;

(F) screening for mental and behavioral health issue prevention;

(G) educational programs on preventive health services;

(H) medication management screening and education;

(I) information concerning age-related diseases and chronic disabling conditions;

(J) gerontological counseling; and

(K) counseling.

(17) National Family Caregiver Support Program service categories are listed in (A) through (H) of this paragraph:

(A) Assistance: case management – one hour, or partial hours may be reported to two decimal places, for example 0.25 hours; a service provided to a caregiver, and at his or her direction. Service is provided by a qualified case manager who delivers and coordinates the services. Caregiver case management includes:

(i) a comprehensive assessment of the caregiver's physical, psychological, and social needs;

(ii) the development and implementation of a service plan to mobilize and monitor the caregiver's formal and informal resources and services to meet the caregiver's identified needs. Caregiver case managers:

(I) coordinate caregiver resources and services with any other plans existing for various formal services;

(II) coordinate caregiver resources and services with the information and assistance services provided under the OAA;

(III) periodically reassess the caregiver's status and revises his or her plan; and

(V) advocates on the caregiver's behalf, according to his or her wishes, for needed services or resources.

(B) Assistance: information and assistance – one contact – this service:

(i) provides the individuals with current information about opportunities and services available to the individuals within their communities, including information relating to assistive technology;

(ii) assesses the problems and capacities of the individuals;

(iii) links the individuals to the available opportunities and services;

(iv) ensures, to the maximum extent practicable, individuals receive needed services and are aware of available opportunities by establishing adequate follow-up procedures; and

(v) serves the entire community of older individuals.

(vi) refers to individual, one-on-one contacts between a caregiver provider and an older client or caregiver. An activity that involves a contact with several current or potential clients or caregivers is not counted as a unit of information and assistance. Internet website hits are counted only when information is requested and supplied.

(C) Counseling – one hour, or partial hours may be reported to two decimal places, for example 0.25 hours; a service designed to support caregivers and assist them in their decision-making and problem solving. Counselors are service providers with degrees or credentials as required by state policy. Counselors are trained to work with older adults and families understanding and addressing complex physical, behavioral, and emotional problems related to caregiver roles. Counseling is a separate function apart from support group activities or training and includes counseling in individual or group sessions.

(D) Information services – per activity – a public and media activity that conveys information to caregivers about available services and can include in-person interactive presentations to the public; a booth or exhibit at a fair, conference, or other public event; and radio, TV, or website events. Information services are activities directed to large audiences of current or potential caregivers, such as disseminating publications, conducting media campaigns, and other similar activities.

(E) Respite care – one hour, or partial hours may be reported to two decimal places, for example 0.25 hours; this service provides temporary, substitute supports or living arrangements for qualified older participants to provide a brief period of caregiver relief or rest. When the specific service units purchased via a direct payment, such as cash or voucher can be tracked or estimated, the service unit is reported by hour or partial hour. Types of respite care include:

(i) in-home respite service provided in the caregiver's or care receiver’s home and allows the caregiver time away to do other activities;

(ii) out of home respite service provided in settings other than the caregiver's or care receiver’s home, such as in adult day care, a senior center or in other non-residential settings where an overnight stay does not occur; and

(iii) out of home overnight respite service provided in facilities such as nursing homes, assisted living facilities, and adult foster homes;

(F) Supplemental services – units and service in this category are determined by CAP and provides goods and services on a limited basis to complement the care provided by caregivers. The AAA contacts CAP prior to this category's use.

(G) Support groups – per session – a service that is led by a trained individual, moderator, or professional, as required by state policy, to facilitate caregivers to discuss their common experiences and concerns and to develop a mutual support system. Support groups are typically held on a regularly scheduled basis and may be conducted in person, over the telephone, or online.

(H) Training – one hour , or partial hours may be reported to two decimal places, for example 0.25 hours – a service that provides family caregivers with instruction to improve knowledge and performance of specific skills relating to their caregiving roles and responsibilities. Skills may include activities related to health, nutrition, and financial management; providing personal care; and communicating with health care providers and other family members. Training may include using evidence-based programs and is conducted in-person or online in individual or group settings.

(18) Funded "Other" category - unit varies per service – a service provided using OAA funds under Title III-B in whole or in part, that do not fall into previously defined service categories and may include assistive technology, durable equipment, emergency response, consumable supplies, home modifications or repairs, elder abuse prevention, elder rights, health, outreach, public education, socialization, access not reported elsewhere, and others.

(A) Advocacy or representation - one hour; provides action taken on behalf of a participant to secure the person's rights or benefits. Advocacy or representation includes receiving, investigating, and working to resolve disputes or complaints. It does not include services provided by an attorney or person under the supervision of an attorney.

(B) Education or training - one session; provides formal and informal opportunities for participants to acquire knowledge, experience, or skills individually or in group events designed to increase awareness.

(C). Wellness checks – one contact; individualized contact between two people via phone, text, email, webinar, video chat, or other means to provide a well-being check, reassurance, or socialization to a qualified older participant or family caregiver. The provider successfully converses with the older adult is spoken to in order for the contact to be counted, regardless of the length of contact.

(D) Home repair - one job; provides minor repairs, modifications, or maintenance on a home owned and occupied by an eligible participant, up to $250 annually, per participant.

(E) Coordination of services - unit to be determined by CAP; provides for the administration or delivery of a service not directly funded by Title III. The AAA contacts CAP regarding use of this category.

(b) Authority. The authority for this Section is the Older Americans Act.

(1) incorporates rule provisions into AAA policies and procedures manual;

(2) provides technical assistance to prospective service project applicants regarding the rule in the development of services; and

(3) utilizes the rule as an indicator in the service project proposal evaluation.

(d) Cross references. Refer to Oklahoma Administrative Code 340:105-10-40 and 340:105-10-51.