Application for a §1915 (c) hcbs waiver Submitted by

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Service Specification

Service Title:

Consumer Directed Attendant Care Unskilled

Complete this part for a renewal application or a new waiver that replaces an existing waiver. Select one:


Service is included in current waiver. There is no change in service specifications.

Service is included in current waiver. The service specifications have been modified.

Service is not included in the current waiver.

Service Definition (Scope):

Consumer-directed attendant care services are service activities performed by a person to help a consumer with self-care tasks which the consumer would typically do independently if the consumer were otherwise able. The service activities may include helping the consumer with any of the following non skilled

service activities:

(1) Dressing.

(2) Bath, shampoo, hygiene, and grooming.

(3) Access to and from bed or a wheelchair, transferring, ambulation, and mobility in general. It is

recommended that the provider receive certification of training and return demonstration for transferring.

Certification for this is available through the area community colleges.

(4) Toilet assistance, including bowel, bladder, and catheter assistance. It is recommended that the

provider receive certification of training and return demonstration for catheter assistance. Certification

for this is available through the area community colleges.

(5) Meal preparation, cooking, eating and feeding but not the cost of meals themselves.

(6) Housekeeping services which are essential to the consumer’s health care at home.

(7) Medications ordinarily self-administered including those ordered by a physician or other qualified

health care provider. It is recommended the provider successfully complete a medication aide

course administered by an area community college.

(8) Wound care.

(9) Assistance needed to go to or return from a place of employment and assistance with job related

tasks while the consumer is on the job site. The cost of transportation for the consumer and

assistance with understanding or performing the essential job functions are not included in consumer directed

attendant care services.

(10) Cognitive assistance with tasks such as handling money and scheduling.

(11) Fostering communication through interpreting and reading services as well as assistive devices

for communication.

(12) Assisting or accompanying a consumer in using transportation essential to the health and welfare

of the consumer. The cost of the transportation is not included.

Specify applicable (if any) limits on the amount, frequency, or duration of this service:

A unit of service is one hour or one eight to 24 hour day. Consumer Directed Attendant Care services may be provided to a recipient of in-home health related care services, but not at the same time. There is an upper limit per hour for an agency provider and an individual provide and there it can not exceed an upper daily rate. These limits are subject to change each year. The individuals’ plan of care will address how the consumer health care needs are being met. The Case Manager will monitor the plan.

Provider Specifications

Provider Category(s)

(check one or both):


Individual. List types:


Agency. List the types of agencies:

Any individual who contracts with the consumer to provide attendant care services

Home Care providers

Home Heath providers

Chore providers

Community Action agencies

Certified Supported Community Living Providers

Assisted Living Providers

Adult Day Care Providers

Specify whether the service may be provided by (check each that applies):

Legally Responsible Person


Relative/Legal Guardian

Provider Qualifications (provide the following information for each type of provider):

Provider Type:

License (specify)

Certificate (specify)

Other Standard (specify)


At least 18 years of age, and qualified or trained to carry out the consumer’s plan of care pursuant to the department approved plan

Home Care

Certificate from the Iowa Department of Public Health

Home Health

Certified to participate in the Medicare program


Letter of approval from the area on aging that they are qualified to provided services

Community Action Agencies

Supported Community Living

Certified by the Iowa Department of Human Services or CARF

Assisted Living

As certified by the Department of Inspections and Appeals

Adult Day Care

The Department of Inspections and Appeals

As certified by CARF

Verification of Provider Qualifications

Provider Type:

Entity Responsible for Verification:

Frequency of Verification

Home Care Providers

Iowa Department of Human Services Iowa Medicaid Enterprise

Verified based on the length of the certification or license

Home Health Agencies

Same as above

Same as above

Chore providers

Same as above

Same as above

Community Action Providers

Same as above

Same as above

Supported Community Living Agencies

Same as above

Same as above

Assisted living programs

Same as above

Same as above

Adult Day

Same as above

Same as above

Service Delivery Method

Service Delivery Method (check each that applies):


Participant-directed as specified in Appendix E

Provider managed

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