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(c) Provision of services to assist individuals to move from situations which are, or are likely to become, hazardous to their health and well-being.

(d) Cooperating and planning with the courts as necessary on behalf of individuals with serious mental impairments. § 222.43

Services to enable persons to remain in or to return to their homes

or communities. Services must include, but are not limited to:

(a) Assistance in locating suitable independent living arrangements or arrangements for placement in foster family or protected care settings.

(b) Enlisting the help of interested relatives, friends, and other resources to assist the person to remain in or to return to the community and to maintain himself in the selected environment.

(c) Assisting the individual to carry out necessary medical, health, and health maintenance plans.

(d) Assistance in securing any additional special arrangements or supportive services that will contribute to a satisfactory and adequate social adjustment of the individual. $ 222.4.4 Services to ineet health needs.

Services must include, but are not limited to:

(a) Assistance in securing necessary diagnostic, preventive, remedial, ameliorative, and other health services (including prosthetic, orthotic, and assistive aids) available under Medicare, Medicaid (or other agency health services program) and from other agencies or providers of health services.

(b) Assistance in making arrangements for transportation to and from health resources.

(c) Planning with the individual relatives, or other appropriate persons, to assist the individual in carrying out medical recommendations.

(d) Maintaining necessary liaison with the physician, nurse, institution, or other provider of health services to assure the provision of social services necessary to carry out medical recommendations.

(e) In medical emergencies, obtaining services of a physician; arranging care of dependents and other social services required as a result of the individual's medical emergency.

(f) Providing, as necessary, the services of escorts and bilingual interpreters, who, whenever possible, shall be subprofessional staff who are residents of neighborhoods in which the persons reside. $ 222.45 Self-support services for the

handicapped. Such services must include, but are not limited to:

(a) Exploring interests and potentials for self-support in whole or in part.

(b) Individual counseling, necessary to deal with family barriers which prevent or limit individuals in their use of training and employment opportunities.

(c) Providing for referral to and use of public and voluntary agencies in the fields of vocational rehabilitation, health, education, and employment, including special attention to the capabilities of rehabilitation centers and sheltered workshops, community action agencies, neighborhood centers, and similar organizations. § 222.46 Homernaker services.

By April 1, 1974, State plans must provide for homemaker services which must:

(a) Include home management, home maintenance, and personal care ervices for adults who are determined by the agency to need this service.

(b) Be in accord with the recommended standards of related national standard setting organizations such as the National Council for Homemaker Service. § 222.47 Special services for the blind.

By April 1, 1974, State plans must provide for special services for the blind. § 222.50 Community planning.

(a) There must be provision for community planning by the staff of the agency at the State and local levels, with authority and responsibility assigned to assure development and utilization of community services and resources to meet the needs of low-income groups. Subpart C-Optional Provisions and

Services § 222.55 Coverage of optional groups

for services. (a) The agency may elect to provide services to all or to reasonably classified subgroups of the following:

(1) Aged, blind, or disabled persons and organizations; provision of social who are former applicants for or recipi- group services in agency or other setents of financial assistance who request tings, e.g., neighborhood centers, multiservices or on whose behalf services are purpose senior centers. requested. See $ 222.86(b) for Federal

§ 222.59 Services to individuals to meet financial participation.

special needs. (2) Aged, blind, or disabled persons who request services, or on whose behalf Services may include any or all of services are requested, and who are likely

the following individual service items: to become applicants for or recipients of

Legal services for persons desiring the financial assistance, i.e., those who: help of lawyers with their legal problems (i) Are not money payment recipients

(see separate policies governing the probut are eligible for medical assistance

vision of such services); family planunder the State's Title XIX plan.

ning; services for such groups as (ii) Are likely, within 5 years, to

alcoholics, drug addicts, and mentally become recipients of financial assistance.

retarded individuals; special services to (iii) Are at or near dependency level,

the blind, deaf, and other disabled inincluding those in low income neighbor

dividuals. hoods and among other groups that $ 222.60 Other services. might be expected to include more aged, blind, or disabled assistance cases than

A State may submit other optional other low-income groups, where the

services for consideration and approval services are provided on a group basis.

by the Department of Health, Education, (b) All aged, blind, or disabled per

and Welfare.
sons in the above groups or a selected S 222.61 Consultant services.
reasonable classification of such persons

A
State may

use those services with common problems or common

which consist of advice and consulservice needs may be included.

tation provided by persons who are § 222.56 Range of optional services. expert in such matters as medical (inA State may elect to include in its State

cluding psychiatric), social, legal, educaplan under title I, X, XIV, or XVI of the

tional, psychological, nutritional, and Social Security Act provision for optional

employment problems of individuals, for services as provided for in $ $ 222.57

the purposes of assisting agency staff, as 222.61 in the costs of which 75 percent

necessary, in diagnosing and developing Federal financial participation is avail

service plans to meet individual appliable, provided that the State plan also

cant or recipient needs and in the develmeets all of the requirements contained

opment and evaluation of agency service

programs. in Subparts A and B of this part. § 222.57 Services to individuals to im

Subpart D--Definitions prove their living arrangements and

§ 222.65 Chore services. enhance activities of daily living.

Chore services means services in perServices may include any or all of the

forming light work, or household tasks, following individual service items: Hous

which eligible persons are unable to do ing improvement and assistance services;

for themselves because of frailty or other services to adults in foster care; day care; conditions and which do not require the chore services; home delivered meals;

services of a trained homemaker or other companionship services; education serv

specialist. Chore services may include ices related to consumer protection and such activities as: Help in shopping, money management; and homemaker lawn care, simple household repairs, runservices,

ning errands, etc. § 222.58 Services to individuals and § 222.66 Community planning.

groups to improve opportunities for social and community participation.

Community planning means activities

of the staff of the agency, at the State Services may include any or all of the and local levels, in providing leadership following individual service items: As- in the planning, development, extension, sistance in obtaining recreational and and improvement of the broad range of educational services; opportunities to services, facilities, and opportunities reparticipate in volunteer and paid service quired to prevent dependency for low inroles with various community agencies come adults and to meet the current and

consumer

anticipated service needs of all aged, ply and availability of safe and suitable blind, or disabled applicants and recipi- housing for applicants or recipients who ents. Staff activities include work with have housing problems through cooperaother agencies, organizations and inter- tive community planning activities with ested citizens' groups, including State appropriate individuals and groups in and local commissions on aging and the the community. blind, in stimulating community support

§ 222.73 Protective services. and action on behalf of all the aged, blind, or disabled so that in developing Protective services means a system of and extending community services to the services (including medical and legal total group, applicants and recipients services which are incidental to the serywill also benefit.

ice plan) which are utilized to assist

seriously impaired eligible individuals § 222.68 Day care services.

who, because of mental or physical Day care services means services pro- dysfunction, are unable to manage their vided during the day to eligible persons own resources, carry out the activities of in a protective setting approved by the

daily living, or protect themselves from State agency for purposes of personal neglect or hazardous situations without care and to promote their social, health,

assistance from others and have no one and emotional well-being through oppor- available who is willing and able to assist tunities for companionship, self-educa- them responsibly. tion and other satisfying leisure time activities.

$ 222.74 Services to adults in foster care.

Services to adults in foster care mean $ 222.69 Education services related to

services to eligible persons to assure protection and

money management.

placement in settings approved by the

appropriate State and/or local authority Education services related to consumer

and suitable to the needs of each individprotection and money management mean

ual; assure that the person receives services that help eligible persons learn

proper care in such placement; and to how to manage household budgets ef

determine continued appropriateness of fectively and to use sound consumer

and need for placement through periodic practices.

reviews, at least annually. $ 222.70 Home delivered meals.

§ 222.75 Services to meet health needs. Home delivered meals means service

Services to meet health needs mean which consists of preparing and deliver

services provided for the purpose of asing one or more hot meals daily to the

sisting eligible persons to attain and rehomes of eligible persons who are unable

tain as favorable a condition of health as to obtain or prepare nourishing meals.

possible by helping them to identify and § 222.71 Homemaker services.

understand their health needs and to Homemaker services

secure and utilize necessary medical means home

treatment as well as preventive and management and maintenance services, and personal care services, pro

health maintenance services including vided to maintain, strengthen and safe

services in medical emergencies. guard the functioning of eligible persons § 222.76 Social group services. in their own homes where no responsible Social group services mean

use of person is available for Shis purpose. group methods to provide eligible persons § 222.72 Housing improvement and as

with opportunities for group experiences. sistance services.

Such experiences can help individuals to

cope with personal problems, develop Housing improvement and assistance services means services, in cooperation

capacities for more adequate social and with the applicant or recipient, landlord,

personal functioning, relieve social isoand others to assist in the upgrading of

lation, develop friendships and mutual substandard rental housing in which the

aid, and increase understanding between

the group and the agency. applicant or recipient resides; to obtain repairs to his own home if substandard § 222.77 Special services for the blind. or unsuitable; or to find other housing Special services for the blind means in the community suitable and adequate services related to age, presence of other to his needs at prices which he can afford disabilities and amount of residual vito pay; and to help to increase the sup- sion. Such services may include assistance

in securing mobility training, personal care, home management and communication skills; also arrangements for talking book machines and obtaining special aids and appliances to solve or reduce problems arising from blindness as well as help in securing safety items, particularly those necessary to assure safe housing and prevent accidents. Arrangements for educational counseling to assure appropriate classroom placement and when timely, guidance from a school and/or rehabilitation program to prepare for a vocation are essential for the young blind to reach their full potential. Additionally, services may include referral of parents of blind children to agencies with special counseling competence in this field. Subpart Federal Financial

Participation § 222.85 General.

Federal financial participation is available in expenditures as found necessary by the Secretary:

(a) For the proper and efficient administration of the plan,

(b) For the costs of providing the services for the groups of aged, blind, or disabled,

(c) For carrying out the activities described in Subparts A, B, and C of this part that are included in the approved State plan. Such participation will be at the rates prescribed in this subpart. § 222.86 Persons eligible for services.

Federal financial participation is available under this subpart only for services provided to:

(a) An aged, blind, or disabled person applying for or receiving assistance under the plan.

(b) The groups defined in § 222.55: Former and potential applicants or recipients who request services or on whose behalf services are requested, and other individuals requesting information and referral service only. In respect to any aged, blind, or disabled person who has formerly been an applicant for or recipient of assistance, counseling and casework services may be provided. Other services may be provided only to those aged, blind, or disabled persons who have received assistance within the previous 2 years or who qualify under the definition of potential applicants or recipients (see § 222.55(a) (2)).

$ 222.87 Sources for furnishing services.

Federal financial participation is available for services furnished:

(a) By State or local agency staff, i.e., full- or part-time employed staff; and volunteers, or

(b) By purchase, contract, or other cooperative arrangements with public or private agencies or individuals, provided that such services are not available without cost from such sources. 222.88 Provisions governing costs of

certain services. ia) Medical and assistance costs. Federal financial participation will not be available under this subpart in expenditures for subsistence and other assistance items or for medical or remedial care or services, except:

(1) For subsistence and medical care when they are provided as essential components of a comprehensive service program a facility and their costs are not separately identifiable, such as, in a rehabilitation center, day care facility, or neighborhood service center;

(2) For medical and reniedial care and services as part of family planning services;

(3) For medical diagnosis and consultation when necessary to carry out service responsibilities, e.g., for recipients under consideration for referral to training and employment programs.

(b) Vocational rehabilitation services. Federal financial participation is not available in the costs of providing vocational rehabilitation services for handicapped individuals as defined in the Vocational Rehabilitation Act except pursuant to an agreement with the State agency administering the rehabilitation program. This applies to provision of services by staff of the agency and purchase.

(c) Services related to adult foster care. Federal financial participation is available in the costs of staff in providing services related to adult foster care, i.e., recruitment, study, and approval of foster family homes (except staff primarily engaged in the issuances of licenses or in the enforcement of standards); services to adults in foster care, and work with foster families and staff of institutions caring for adults, such as homes for the aged. Payments for the foster care itself are assistance payments and are, therefore, not subject to the service rate of Federal financial participation.

(d) Services provided in behalf of staff in providing the services and carryaged, blind, or disabled persons. Federal ing out the related responsibilities specifinancial participation is available for fied in Subparts A, B, and C of this part. services provided in behalf of aged, blind, This includes activities of such staff as or disabled persons, e.g., community caseworkers, homemakers, and commuplanning; assuring accessibility to re- nity planning staff. sources to which the person is entitled; (3) Meaning and illustrations of servand studies of service needs and results. ice-related work. Service-related work

means activity of staff other than service § 222.89 Kinds of expenses for which

workers which is necessary to administer Federal financial participation is available.

a service program fully. This includes

secretaries, stenographers, and clerks (a) Salary and travel costs of service

serving service staff ; supervisors of seryworkers (including travel and expenses ice workers and their supervisors, staff of volunteers) and their supervisors giv

responsible for developing and evaluating full-time to services and for staff en

ing service policies, and staff collecting tirely engaged (either at State or local

and summarizing financial and statislevel) in developing, planning, and

tical data on services either at State or evaluating services.

local level. (b) Salary costs of service-related

(4) Staff. Staff individually or in staff such as, supervisors, clerks, secre

groups performing service or servicetaries, and stenographers, which repre

related work includes professional, subsent that portion of the time spent in

professional (e.g., recipients and other supporting full-time service staff.

workers of low income), and volunteer (c) Related expenses of staff perform- staff. ing service or service-related work under (e) Other expenses related to the proparagraphs (a) and (b) of this section vision of service in support of full-time in proportion to their time spent on service staff, including a portion of the services, such as communication, equip- salary costs of any agency person (except ment, supplies, and office space.

the service worker who must be on a full(d) Definitions: Applicable to staff time basis) who is working part-time on performing service functions.

service functions (either at the State or (1) Full-time service work. (i) Per- local agency level). Such expenses insons performing full-time on functions clude the portion of salary costs of superrelated to the provision of services means visors related to supervision of service persons assigned exclusively to such work, a portion of fiscal costs related to functions and does not relate to the num- services, a portion of research costs reber of hours of employment. Services to lated to services, a portion of salary costs families and children may also be of field staff, etc. carried.

(f) Costs of services purchased when (ii) It is not necessary to maintain purchased in accordance with applicable daily time records for this purpose but it

policies (see Part 226 of this chapter). is expected that States will check peri- (g) Travel and related costs for eligiodically to assure that persons assigned

ble aged, blind, or disabled persons to on a full-time basis are performing sub

community facilities and resources. stantially on this basis.

(h) Costs of State and local advisory (iii) A full-time worker can be ex

committees, including expenses of atpected to receive questions from recip- tending meetings, supportive staff and ients (and former and potential) related

other technical assistance. (See § 222.2 to eligibility and the amount of payment

(a) (3) and (4)). or medical benefits and to inake this in- (i) Costs of administrative and superformation available to staff responsible visory staff attending public or voluntary for eligibility and related functions, agency meetings pertinent to the deSuch workers may not carry the respon- velopment or implementation of Federal sibility for securing information or tak- or State service policies and programs. ing the actions in respect to determining (j) Costs of operation of agency faciliinitial and continuing eligibility for fi- ties used solely for the provision of nancial or medical assistance or to services. Costs may include expenditures change the amount of financial assist- for staff; space, including minor renoance being provided.

vating, heat, utilities, and cleaning fur(2) Meaning and illustrations of serv- nishings; program supplies, equipment ice work. Service work means activity of and materials; food and food prepara

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