(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. § 222.44 Services to meet 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. 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 Homemaker services. By April 1, 1974, State plans must provide for homemaker services which must: (a) Include home management, home maintenance, and personal care services 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 who are former applicants for or recipients of financial assistance who request services or on whose behalf services are requested. See § 222.86 (b) for Federal financial participation. (2) Aged, blind, or disabled persons who request services, or on whose behalf services are requested, and who are likely to become applicants for or recipients of financial assistance, i.e., those who: (i) Are not money payment recipients but are eligible for medical assistance under the State's Title XIX plan. (ii) Are likely, within 5 years, to become recipients of financial assistance. (iii) Are at or near dependency level, including those in low income neighborhoods and among other groups that might be expected to include more aged, blind, or disabled assistance cases than other low-income groups, where the services are provided on a group basis. (b) All aged, blind, or disabled persons in the above groups or a selected reasonable classification of such persons with common problems or common service needs may be included. § 222.56 Range of optional services. A State may elect to include in its State plan under title I, X, XIV, or XVI of the Social Security Act provision for optional services as provided for in §§ 222.57222.61 in the costs of which 75 percent Federal financial participation is available, provided that the State plan also meets all of the requirements contained in Subparts A and B of this part. § 222.57 Services to individuals to improve their living arrangements and enhance activities of daily living. Services may include any or all of the following individual service items: Housing improvement and assistance services; services to adults in foster care; day care; chore services; home delivered meals; companionship services; education services related to consumer protection and money management; and homemaker services. and organizations; provision of social group services in agency or other settings, e.g., neighborhood centers, multipurpose senior centers. § 222.59 Services to individuals to meet special needs. Services may include any or all of the following individual service items: Legal services for persons desiring the help of lawyers with their legal problems (see separate policies governing the provision of such services); family planning; services for such groups as alcoholics, drug addicts, and mentally retarded individuals; special services to the blind, deaf, and other disabled individuals. $ 222.60 Other services. A State may submit other optional services for consideration and approval by the Department of Health, Education, and Welfare. § 222.61 Consultant services. A State may use those services which consist of advice and consultation provided by persons who are expert in such matters as medical (including psychiatric), social, legal, educational, psychological, nutritional, and employment problems of individuals, for the purposes of assisting agency staff, as necessary, in diagnosing and developing service plans to meet individual applicant or recipient needs and in the development and evaluation of agency service programs. anticipated service needs of all aged, blind, or disabled applicants and recipients. Staff activities include work with other agencies, organizations and interested citizens' groups, including State and local commissions on aging and the blind, in stimulating community support and action on behalf of all the aged, blind, or disabled so that in developing and extending community services to the total group, applicants and recipients will also benefit. § 222.68 Day care services. Day care services means services provided during the day to eligible persons in a protective setting approved by the State agency for purposes of personal care and to promote their social, health, and emotional well-being through opportunities for companionship, self-education and other satisfying leisure time activities. § 222.70 Home delivered meals. Home delivered meals means service which consists of preparing and delivering one or more hot meals daily to the homes of eligible persons who are unable to obtain or prepare nourishing meals. § 222.71 Homemaker services. Homemaker services means home management and maintenance services, and personal care services, provided to maintain, strengthen and safeguard the functioning of eligible persons in their own homes where no responsible person is available for this purpose. § 222.72 Housing improvement and assistance services. Housing improvement and assistance services means services, in cooperation with the applicant or recipient, landlord, and others to assist in the upgrading of substandard rental housing in which the applicant or recipient resides; to obtain repairs to his own home if substandard or unsuitable; or to find other housing in the community suitable and adequate to his needs at prices which he can afford to pay; and to help to increase the sup § 222.74 Services to adults in foster care. Services to adults in foster care mean services to eligible persons to assure placement in settings approved by the appropriate State and/or local authority and suitable to the needs of each individual; assure that the person receives proper care in such placement; and to determine continued appropriateness of and need for placement through periodic reviews, at least annually. § 222.75 Services to meet health needs. Services to meet health needs mean services provided for the purpose of assisting eligible persons to attain and retain as favorable a condition of health as possible by helping them to identify and understand their health needs and to secure and utilize necessary medical treatment as well as preventive and health maintenance services including services in medical emergencies. § 222.76 Social group services. Social group services mean use of group methods to provide eligible persons with opportunities for group experiences. Such experiences can help individuals to cope with personal problems, develop capacities for more adequate social and personal functioning, relieve social isolation, develop friendships and mutual aid, and increase understanding between the group and the agency. § 222.77 Special services for the blind. Special services for the blind means services related to age, presence of other disabilities and amount of residual vision. 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 E-Federal Financial § 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. (a) 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 remedial 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 aged, blind, or disabled persons. Federal financial participation is available for services provided in behalf of aged, blind, or disabled persons, e.g., community planning; assuring accessibility to resources to which the person is entitled; and studies of service needs and results. § 222.89 Kinds of expenses for which Federal financial participation is available. (a) Salary and travel costs of service workers (including travel and expenses of volunteers) and their supervisors giving full-time to services and for staff entirely engaged (either at State or local level) in developing, planning, and evaluating services. (b) Salary costs of service-related staff such as, supervisors, clerks, secretaries, and stenographers, which represent that portion of the time spent in supporting full-time service staff. (c) Related expenses of staff performing service or service-related work under paragraphs (a) and (b) of this section in proportion to their time spent on services, such as communication, equipment, supplies, and office space. (d) Definitions: Applicable to staff performing service functions. (1) Full-time service work. (i) Persons performing full-time on functions related to the provision of services means persons assigned exclusively to such functions and does not relate to the number of hours of employment. Services to families and children may also be carried. (ii) It is not necessary to maintain daily time records for this purpose but it is expected that States will check periodically to assure that persons assigned on a full-time basis are performing substantially on this basis. (iii) A full-time worker can be expected to receive questions from recipients (and former and potential) related to eligibility and the amount of payment or medical benefits and to make this information available to staff responsible for eligibility and related functions, Such workers may not carry the responsibility for securing information or taking the actions in respect to determining initial and continuing eligibility for financial or medical assistance or to change the amount of financial assistance being provided. (2) Meaning and illustrations of service work. Service work means activity of staff in providing the services and carrying out the related responsibilities specified in Subparts A, B, and C of this part. This includes activities of such staff as caseworkers, homemakers, and community planning staff. (3) Meaning and illustrations of service-related work. Service-related work means activity of staff other than service workers which is necessary to administer a service program fully. This includes secretaries, stenographers, and clerks serving service staff; supervisors of service workers and their supervisors, staff responsible for developing and evaluating service policies, and staff collecting and summarizing financial and statistical data on services either at State or local level. (4) Staff. Staff individually or in groups performing service or servicerelated work includes professional, subprofessional (e.g., recipients and other workers of low income), and volunteer staff. (e) Other expenses related to the provision of service in support of full-time service staff, including a portion of the salary costs of any agency person (except the service worker who must be on a fulltime basis) who is working part-time on service functions (either at the State or local agency level). Such expenses include the portion of salary costs of supervisors related to supervision of service work, a portion of fiscal costs related to services, a portion of research costs related to services, a portion of salary costs of field staff, etc. (f) Costs of services purchased when purchased in accordance with applicable policies (see Part 226 of this chapter). (g) Travel and related costs for eligible aged, blind, or disabled persons to community facilities and resources. (h) Costs of State and local advisory committees, including expenses of attending meetings, supportive staff and other technical assistance. (See § 222.2 (a) (3) and (4)). (i) Costs of administrative and supervisory staff attending public or voluntary agency meetings pertinent to the development or implementation of Federal or State service policies and programs. (j) Costs of operation of agency facilities used solely for the provision of services. Costs may include expenditures for staff; space, including minor renovating, heat, utilities, and cleaning furnishings; program supplies, equipment and materials; food and food prepara |