Definitions of Services

Below is a description of services offered through programs provided directly or subcontracted through the Area Agency on Aging. These programs include the Alzheimer’s Disease Initiative (ADI), Community Care for the Elderly (CCE), Home Care for the Elderly (HCE), Older Americans Act (OAA) which is followed by the number/letter of the OAA Title (IIIB, IIIE, etc), Assisted Living for the Elderly Medicaid Waiver (ALE), and Aged/Disabled Adult Medicaid Waiver (A/DA). Not included in these definitions are delivery standards, special conditions, provider qualifications, and record keeping requirements which are also part of the service definitions as determined by the Department of Elder Affairs.

Adult Day Care
Program Funding Source(s): CCE, HCE, OAAIIIB, OAAIIIE
Description: A program of therapeutic social and health activities and services provided to adults who have functional impairments, in a protective environment that provides as noninstitutional an environment as possible.

Adult Day Health Care
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB, OAAIIIE
Description: Adult Day Health Care Services are furnished four (4) or more hours per day on a regularly scheduled basis, for one or more days per week, in an outpatient setting, encompassing both health and social services needed to ensure the optimal functioning of the individual.

Basic Subsidy
Program Funding Source(s): HCE
Description: A fixed sum cash payment made to an eligible caregiver each month to reimburse some of their expenses of caring for the client. A basic subsidy is provided for support and maintenance of the care recipient, including medical costs not covered by Medicaid, Medicare, or any other insurance.

Caregiver Training/Support
Program Funding Source(s): A/DA, ADI, CCE, HCE, OAAIIIB, OAAIIIE, OAAVII
Description: Caregiver training and support is defined as the training of caregivers, individually or in group settings to: reduce stress, increase coping skills, provide strategies for effective management of caregiving tasks, and enable them to provide high quality care to recipients within the home. Caregiver training and support may be provided through forums which include community workshops, seminars, and other organized local, regional, or statewide events.

Case Aide
Program Funding Source(s): A/DA, ADI, CCE, HCE, OAAIIIB
Description: Case Aide services are adjunctive and supplemental to case management services and are provided by paraprofessionals under the direction of case managers or designated supervisory staff. These services include:

  • Assistance with implementing plans of care;
  • Assistance with accessing medical and other appointments;
  • Oversight and supervision of provider activities;
  • Delivery of supplies and equipment;
  • Assistance with paying bills;
  • Assistance with eligibility determination;
  • Facilitating linkages of providers with recipients via telephone contacts and visits;
  • Scheduling and documentation of activities;
  • Arrangement, scheduling, and maintenance of scheduled services; and,
  • Reconciliation and voucher activities.

Case Management
Program Funding Source(s): A/DA, ADI, ALE, CCE, HCE, OAAIIIB
Description: Case management is a client centered service that assists individuals in identifying physical and emotional needs and problems through an interview and assessment process; discussing and developing a plan for services which addresses these needs; arranging and coordinating agreed upon services; and monitoring the quality and effectiveness of the services. Case Management is a service for actively enrolled clients that provides continuing support and addresses the changing needs of clients.
Child Day Care
Program Funding Source(s): OAAIIIE
Description: Day care services are services provided to a minor child, not more than 18 years old, residing with an age 60+ grandparent or other age 60+ related caregiver.
Chore
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB, OAAIIIE
Description: Chore is defined as the performance of routine house or yard tasks including such jobs as seasonal cleaning; yard work; lifting and moving furniture, appliances, or heavy objects; household repairs which do not require a permit or specialist; and household maintenance. Pest control may be included when not performed as a distinct activity.

Chore (Enhanced)
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB, OAAIIIE
Description: Performance of any house or yard task necessary to provide a clean, sanitary, and safe living environment. This service is beyond the scope of chore due to the level of service needed. The service includes a more intensified, thorough cleaning to address more demanding circumstances. Pest control may be included when not performed as a distinct activity.

Companionship
Program Funding Source(s): A/DA, CCE, OAAIIIB
Description: Companionship is visiting a client who is socially and/or geographically isolated, for the purpose of relieving loneliness and providing continuing social contact with the community by casual conversation, providing assistance with reading, writing letters, entertaining games, escorting a client to a doctor’s appointment, and diversional activities such as going to the movies, the mall, the library, or grocery shopping.

Congregate Meals
Program Funding Source(s): OAAIIIC1
Description: This service is the provision of a meal at a congregate meal site which complies with the Dietary Guidelines for Americans and provides 1/3 daily RDA for individuals 51 years or older as established by Food and Nutrition Board of National Academy of Sciences.

Counseling (Gerontological)
Program Funding Source(s): A/DA, ADI, CCE, HCE, OAAIIIB, OAAIIID, OAAIIIE
Description: Counseling uses the casework mode of relating to a client (via interview, discussion or lending a sympathetic ear) to advise and enable the older person and/or their family to resolve problems (concrete or emotional) or to relieve temporary stresses encountered by them. Through counseling, persons are helped to maximize the use of available resources to assure physical and emotional well-being. Counselors may also act as advocates. This may be done on a one-to-one or a group basis.

Gerontological Counseling provides emotional support, information, and guidance through a variety of modalities including mutual support groups for older adults who are having mental, emotional, or social adjustment problems that have arisen as a result of the process of aging.

Counseling (Mental Health Counseling/Screening)
Program Funding Source(s): A/DA, ADI, CCE, HCE, OAAIIIB, OAAIIID, OAAIIIE
Description: Mental health counseling services focus on the unique treatment of psychiatric disorders and rehabilitation for impairments for persons suffering from a mental illness, including depression and anxiety. These services include specialized individual, group, and family therapy provided to individuals using techniques appropriate to this population.

Specialized mental health services include information gathering and assessment, diagnosis, and development of a treatment plan in coordination with the individual’s care plan. This specialized treatment will integrate the mental health interventions with the overall service and supports to enhance emotional and behavioral functions. This may be done on a one-to-one basis or a group basis.

Disease Information
Program Funding Source(s): OAAIIID
Description: Disease Information is providing information to individuals, families, caregivers, and the general public about chronic conditions and diseases; prevention measures and services, treatment, rehabilitation, and coping strategies for those factors which cannot change. This can be done on a one-on-one or group basis.

Education/Training
Program Funding Source(s): ADI, OAAIIIB, OAAIIIE
Description: Education/Training is defined as:

  • Speaking to groups or distributing materials to individuals at public gatherings about services and opportunities available to them within their communities;
  • Providing formal or informal opportunities for individuals or groups to acquire knowledge, experience or skills; to increase awareness in such areas as crime or accident prevention; promoting personal enrichment; and to increase or gain skills in a specific craft, trade, job or occupation. Training individuals or groups in guardianship proceedings of older individuals if other adequate representation is unavailable can also be done; and,
  • Training conducted by Alzheimer’s Disease Initiative Memory Disorder Clinics is designed to increase understanding of the disease and facilitate management of persons with Alzheimer’s disease by their caregivers and health professionals.

Emergency Alert Response
Program Funding Source(s): A/DA, CCE, OAAIIIB
Description: Emergency alert/response service is defined as a community based electronic surveillance service which monitors the frail homebound elder by means of an electronic communication link with a response center. The service consists of:

  • 24 hours, seven days a week surveillance, from a remote location, of client actuated wireless signal, waterproof portable button;
  • Response to the client actuated emergency signal by the surveillance/response center; and,
  • An emergency telephone communication from the response center to a local emergency team such as 911, police, fire department, ambulance, friends and/or neighbors directing emergency services to the home of the client.

Escort
Program Funding Source(s): A/DA, CCE, OAAIIIB
Description: Escort is personal accompaniment and assistance to a person who has difficulties (physical or cognitive) using regular vehicular transportation. The accompaniment and assistance is provided to individuals to or from service providers, medical appointments, or other destinations needed by the client. Escort is essential during travel to provide safety, security, and support.

Financial Risk Reduction (Assessment)
Program Funding Source(s): A/DA, CCE, OAAIIIE
Description: Financial Risk Reduction services provide assessment of problem area(s) or coaching and guidance for managing income, assets, liabilities, and expenditures. The service may include the establishment of checking accounts and direct deposits which reduce the risk of financial exploitation of the recipient

Financial Risk Reduction (Maintenance)
Program Funding Source(s): A/DA, CCE, OAAIIIE
Description: Financial Risk Reduction services provide ongoing assessment of problem area(s) or coaching and guidance for managing income, assets, liabilities, and expenditures.

Health Promotion
Program Funding Source(s): OAAIIID
Description: Health Promotion services offer individual and/or group sessions that assist participants to understand how lifestyle impacts physical and mental health and to develop personal practices that enhance total well-being. Services are provided at multipurpose senior centers, congregate meal sites and other appropriate places that target elders that are low income, minorities, or medically under-served. Services related to health promotion include, health risk assessments, routine health screenings, home injury control services, mental health screenings for prevention and diagnosis, medication management screening and education, gerontological counseling, and the distribution of information concerning diagnosis, prevention, treatment, rehabilitation of aged related diseases and chronic disabling conditions such as osteoporosis and cardiovascular diseases.

Health Risk Assessment
Program Funding Source(s): OAAIIID
Description: Health Risk Assessment is defined as an assessment utilizing one or a combination of tools to test older persons for certain risk factors that are known to be associated with a disease or condition. Many factors are modifiable, including diet, risk-taking behaviors, coping styles, and lifestyle choices (such as smoking and overeating), and can be measured or identified through risk appraisal questionnaires. The Health Risk Assessment helps the individual to determine the addictive nature of many factors in an individual’s life. This can be done on a one-on-one or group basis.

Health Risk Screening
Program Funding Source(s): OAAIIID
Description: Health Risk Screening services utilize diagnostic tools to screen large groups of people or individuals for the presence of a particular disease or condition. This service is designed for early intervention and detection. Referral is required when screening results indicate professional services are needed or a request is made by the individual being served. Health Risk Screening procedures screen for disease and ailments such as hypertension, glaucoma, cholesterol, cancer, vision, hearing, diabetes, and nutrition deficiencies.

Health Support
Program Funding Source(s): A/DA, CCE, OAAIIIB
Description: Health Support activities assist persons to secure and utilize necessary medical treatment as well as preventive, emergency and health maintenance services. Examples of health support activities are:

  • Physical activities, including regular exercise programs, weight control emphasis, and activities to reduce mental fatigue, stress, and boredom;
  • Special programs, such as Hospice or Alzheimer’s Disease support groups, which focus on caring rather than curing, for the impaired and terminally ill and their families; and,
  • Prevention and assistance activities such as obtaining appointments for treatment, locating health and medical facilities, obtaining therapy;
  • Obtaining clinic cards for clients; and,
  • Arranging hospice service for non-Medicaid or Medicare clients when all other resources have been exhausted.

Home Delivered Meals
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIC2
Description: Provision of a home delivered meal which complies with the Dietary Guidelines for Americans and provide 1/3 daily RDA for individuals 51 years or older as established by Food and Nutrition Board of National Academy of Sciences.

Home Health Aide Service
Program Funding Source(s): CCE, HCE, OAAIIIB
Description: Home Health Aide service is the provision of hands on personal care services, the performance of simple procedures as an extension of therapy or nursing services, assistance in ambulation or exercises, and assistance with self-administered medication as defined by Chapter 400.488, Florida Statutes, and Chapter 59A-8.020, Florida Administrative Code. Services are performed by a trained home health aide or certified nursing assistant to an individual in the home as assigned by and under the supervision of a registered nurse or licensed therapist. Types of assistance provided with activities of daily living include: bathing, dressing, eating, personal hygiene, toileting, assistance with physical transfer, and other responsibilities as outlined in Chapter 59A-8, Florida Administrative Code.

Home Injury Control
Program Funding Source(s): OAAIIID
Description: Home injury control is defined as services aimed at preventing or reducing physical harm due to falls or other preventable injuries of elders in their homes. This can be done on a one-on-one or group basis.

Homemaker
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB
Description: Homemaker service is defined as the accomplishment of specific home management duties including housekeeping, laundry, cleaning refrigerators, clothing repair, minor home repairs, assistance with budgeting and paying bills, client transportation, meal planning and preparation, shopping assistance, and routine house-hold activities by a trained homemaker.

Housing Improvement
Program Funding Source(s): CCE, HCE, OAAIIIB, OAAIIIE
Description: Housing Improvement is defined as providing home repairs, environmental modifications, adaptive alterations, or installing security devices.

Information
Program Funding Source(s): OAAIIIB, OAAIIIE
Description: Information is an “access” service and is defined as responding to an inquiry from a person, or on behalf of a person, regarding public and private resources and available services.

Intake
Program Funding Source(s): ADI, CCE, HCE, OAAIIIB, OAAIIIC2, OAAIIIE
Description: Administering standard intake and screening instruments for the purpose of gathering information about an applicant for services. It also encompasses the follow-up of individuals waiting for services to review any changes in their situation and ensure prioritization for services. This service may also include assistance to clients with applications for the Emergency Home Energy Assistance for the Elderly Program.

Legal Assistance
Program Funding Source(s): CCE, OAAIIIB, OAAIIIE
Description: Legal Assistance is defined as legal advice and representation by an attorney (including, to the extent feasible, counseling or other appropriate assistance by a paralegal or law student under the supervision of an attorney), and includes counseling or representation by a non-lawyer when permitted by law, to older individuals with economic or social needs. Legal Assistance protects against the loss of basic civil rights and ensures the autonomy and independence of older persons.

Material Aid
Program Funding Source(s): CCE, HCE, OAAIIIB, OAAIIIE
Description: Material Aid is defined as:

  • Aid in the form of goods or food such as the direct distribution of commodities, surplus food, clothing, smoke detectors, eyeglasses, hearing aids, security devices, etc.;
  • Food item(s) necessary for the health, safety, or welfare. This may include condiments or paper products necessary for food consumption and delivery charges. Alcohol, drug, and tobacco products are excluded;
  • The repair, purchase, delivery, and installation of any household appliance necessary to maintain a home or assist with household tasks necessary for the health, safety, or welfare of the person;
  • The purchase of materials necessary to perform the services Chore or Enhanced Chore (refer to Chore and Enhanced Chore services); and,
  • The purchase of construction materials necessary to perform housing improvements, alterations, and repairs (refer to Housing Improvement service).

Medication Management
Program Funding Source(s): CCE, OAAIIID
Description: Medication Management screening and education is defined as identification and counseling regarding the medication regime that individuals are using, including prescription and over the counter medications, vitamins and home remedies. These services also help to identify any dietary factors that may interact with the medication regime. The combination of alcohol or tobacco with various medications and diets, along with the effects on specific conditions would ideally be included in this service. This can be done on a one-on-one or group basis.

Nutrition Counseling
Program Funding Source(s): CCE, OAAC1, OAAC2, OAAIIID
Description: Nutrition Counseling provides individualized advice and guidance to persons, who are at nutritional risk because of their poor health, nutritional history, current dietary intake, medications use or chronic illnesses. Nutritional Counseling includes options and methods for improving an individual’s nutritional status. The service may be provided individually or in small groups.

Individuals to receive counseling may be identified through a screening/intake process, self-referred, or referred by a caregiver or other concerned party. A licensed dietitian/nutritionist (LD/N) or a Registered Diet Technician (RDT) under the supervision of a LD/N evaluates the participant’s nutritional needs, conducts a comprehensive nutrition assessment, and develops a nutrition care plan in accordance with Chapter 64B8-43, Florida Administrative Code. Based on the individual’s needs and with appropriate contact with the individual’s physician and caregiver, the LD/N develops and implements or supervises the development and implementation of the nutrition care plan.

Nutrition Education
Program Funding Source(s): OAAIIIC1, OAAIIIC2
Description: Nutrition Education is an activity designed to promote better health by providing accurate, scientifically sound, practical and culturally sensitive nutrition information and instruction to participants and caregivers in a group or individual setting consistent with their needs and food resources. Nutrition education is the process by which individuals gain the understanding, skills and motivation necessary to promote and protect their nutritional well-being through their food choices and food preparation methods.

Occupational Therapy
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB
Description: Occupational therapy services are services prescribed by a physician that are necessary to produce specific functional outcomes in self-help, adaptive, and sensory motor skill areas, and assist the individual to control and maneuver within the environment. The services may also include an occupational therapy assessment that does not require a physician’s prescription. In addition, this service may include training direct care staff and caregivers and monitoring those individuals to ensure they are carrying out therapy goals correctly.

Outreach
Program Funding Source(s): OAAIIIB, OAAIIIC1, OAAIIIC2, OAAIIIE
Description: Outreach is an access service and is a required service or function in Title IIIB or Title IIIC. Outreach is defined as making active efforts to reach target individuals face to face, either in a community setting or in their home, neighborhood with large numbers of low income minority elderly, making one-to-one contact, identifying their service need, and encouraging their use of available resources.

Personal Care
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB
Description: Personal Care is assistance with eating, dressing, personal hygiene, and other activities of daily living. This service may include assistance with meal preparation, housekeeping chores such as bed making, dusting, and vacuuming incidental to the care furnished or essential to the health and welfare of the individual.

Personal care can include accompanying the client to clinics, physician office visits, or trips for the purpose of health care provided that the client does not require special medical transportation. Personal care can also include shopping assistance to purchase food, clothing, and other items needed for the client’s personal care needs.

Pest Control (Enhanced Initiation)
Program Funding Source(s): CCE
Description: Helps rid the environment of insects, and other potential carriers of disease and enhances the safety, sanitation, and cleanliness for recipients. Initiation covers start up costs. This service is beyond the scope of pest control initiation due to the greater effort required.

Pest Control (Initiation)
Program Funding Source(s): A/DA, CCE
Description: Helps rid the environment of insects, and other potential carriers of disease and enhances the safety, sanitation, and cleanliness for recipients. Initiation covers start up costs.

Pest Control (Maintenance)
Program Funding Source(s): A/DA, CCE
Description: Helps rid the environment of insects and other potential carriers of disease and enhances the safety, sanitation, and cleanliness for recipients.

Pest Control (Rodent Control)
Program Funding Source(s): CCE
Description: Helps rid the environment of rodents, and other potential carriers of disease and enhances the safety, sanitation, and cleanliness for recipients. Rodent service consists of trapping, baiting, or other treatments or applications that result in the elimination of rodent(s).

Physical Fitness
Program Funding Source(s): OAAIIID
Description: Physical Fitness services are defined as activities for elders to improve their strength, flexibility, endurance, muscle tone, range of motion, reflexes, cardiovascular health, and/or other aspects of physical functioning.

Physical Therapy
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB
Description: Physical therapy is a service prescribed by a physician that is necessary to produce specific functional outcomes in ambulation, muscle control, and postural development, and prevent or reduce further physical disability. The service may also include a physical therapy assessment, which does not require a physician’s prescription. In addition, this service may include training direct care staff and caregivers and monitoring those individuals to ensure they are carrying out therapy goals correctly.

Referral/Assistance
Program Funding Source(s): OAAIIIB, OAAIIIE
Description: Referral is an activity provided via telephone or one on one in person. Information is obtained about a person’s needs, needs are assessed, and persons are directed to the appropriate resources most capable of meeting the need. Contact with the resource is made for the person as needed. Follow-up is a mandatory part of Referral/Assistance and is conducted with the referred person and/or the resource to determine the outcome of the Referral/Assistance.

In Referral/Assistance, more in-depth interviewing and assessment may be required than in information-giving to assist an individual in either determining his or her need; or, linking him or her with an appropriate resource.

Respite (Facility Based)
Program Funding Source(s): A/DA, ADI, CCE, HCE, OAAIIIB, OAAIIIE
Description: Respite Care is defined as relief or rest for a primary caregiver from the constant/continued supervision, companionship, therapeutic and/or personal care, of a functionally impaired older person for a specified period of time.

Respite (In-Home)
Program Funding Source(s): A/DA, ADI, CCE, HCE, OAAIIIB, OAAIIIE,
Description: Respite Care is defined as relief or rest for a primary caregiver from the constant/continued supervision, companionship, therapeutic and/or personal care, of a functionally impaired older person for a specified period of time.

Screening/Assessment
Program Funding Source(s): OAAIIIB, OAAIIIC2, OAAIIIE
Description: Screening/Assessment is defined as administering standard assessment instruments for the purpose of gathering information about and prioritizing clients at the time of active enrollment or to reassess currently active clients to determine need and eligibility for services.

Shopping Assistance
Program Funding Source(s): CCE, OAAIIIB
Description: Shopping Assistance is defined as assisting a client in getting to and from stores or shopping on behalf of a client; and includes the proper selection of items to purchase. The service also includes storing purchased items upon return to the client’s home. An individual Shopping Aide may assist more than one client during a shopping trip.

Sitter
Program Funding Source(s): OAAIIIE
Description: Sitter services are provided to a minor child, not more than 18 years old, residing with an age 60+ grandparent or other age 60+ related caregiver. Sitter services may be carried out in the home or in a facility during the day, at night or on weekends and are arranged by the caregiver for a specified period of time.

Skilled Nursing Services
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB
Description: Skilled Nursing Service is part-time or intermittent nursing care administered to an individual by a licensed practical nurse, registered nurse, or advanced registered nurse practitioner, in the client’s place of residence, pursuant to a plan of care approved by a licensed physician.

Specialized Medical Equipment, Services, and Supplies
Program Funding Source(s): A/DA, ADI, CCE, HCE, OAAIIIB, OAAIIIE
Description: Specialized Medical Equipment, Services, and Supplies include:

  • Adaptive devices, controls, appliances or services which enable individuals to increase their ability to perform activities of daily living. This service also includes repair of such items as well as replacement parts;
  • Dentures, walkers, reachers, bedside commodes, telephone amplifiers, touch lamps, adaptive eating equipment, glasses, hearing aids, and other mechanical or nonmechanical, electronic, and non-electronic adaptive devices;
  • Supplies may include such things as adult briefs, bed pads, oxygen or nutritional supplements;
  • Medical services pay for doctor visits or dental visits; and,
  • Pharmaceutical services pay for needed prescriptions.

Speech Therapy
Program Funding Source(s): A/DA, CCE, HCE, OAAIIIB
Description: Speech Therapy is a service prescribed by a physician that is necessary to produce specific functional outcomes in the communication skills of an individual with a speech, hearing or language disability. The service may also include a speech therapy assessment, which does not require a physician’s prescription. In addition, this service may include training direct care staff and caregivers and monitoring those individuals to ensure they are carrying out therapy goals correctly.

Telephone Reassurance
Program Funding Source(s): OAAIIIB
Description: Telephone Reassurance is defined as communicating with designated clients by telephone on a mutually agreed schedule to determine their safety and to provide psychological reassurance, or to implement special or emergency assistance

Transportation
Program Funding Source(s): CCE, HCE, OAAIIIB, OAAIIIE
Description: Transportation is defined as travel to or from community services and resources, health and medical care, shopping, social activities, or other life sustaining activities.