FUNCTIONAL ASSESSMENT SCORING

A. The need for skilled personal care shall not be included in the scoring of the need for paid care. B. In order to be eligible for the Home Care Allowance program, each client shall score a minimum of twenty one (21) points when assessed for the ability to complete the ADL using the following functional impairment scale: 1. Independent: score zero (0) if the client is physically able to perform all essential components of the ADL, with or without an assistive device. 2. Low: score one (1) if the client requires occasional or intermittent supervision or stand-by assistance in a limited number of the components of the activity such as he or she is able to perform all essential components of the function, but impairment of function exists even with an assistive device. a. Occasional or intermittent means the client does not need assistance daily, but may need assistance a few times a month or up to two (2) times per week. b. Supervision means verbal prompting, cueing, and reminders to help the client if he or she needs assistance up to two (2) times per week. c. Stand-by assistance means assistance or monitoring to help the client if he or she needs physical assistance up to two (2) times per week. 3. Moderate: score two (2) if the client is unable to perform the majority of the essential components of the function even with an assistive device, and the client requires hands-on and frequent assistance to accomplish the activity. a. Frequent means the client needs assistance at least three (3) times per week and up to daily. b. Hands-on assistance means the care provider must physically assist the client in completing the task. 4. Severe: score three (3) if the client is totally unable to perform the function and requires someone to perform the task, or the client requires constant supervision for the task. C. The need for paid care score shall be based on the frequency of the client's unmet need for paid care and shall be modified by the following factors: 1. Need for paid care shall be scored as zero (0) when those services are provided through another program, agency, or individual. 2. For clients living with others, the need for paid care shall be scored only on the client's needs that are greater than and differentiated from typical household routine and the typical expectation of assistance by family members living in the home. D. For children age five (5) through eighteen (18) years, functional capacity and need for paid care shall be scored according to age appropriate criteria. Children under the age of 5 shall not be scored and are not eligible to receive Home Care Allowance. E. The need for paid care scale is as follows: Score Frequency Definition Of Frequency 0 None Client's needs are met. No need for paid care. 1 Weekly Client needs paid care up to and including once a week. 2 Daily Client needs paid care more than once a week and up to once a day, seven days a week. 3 Twice Client needs paid care two or more times per Daily day at least five days per week. F. The functional assessment shall be scored on the State Department prescribed form, which shall list each activity of daily living, the functional capacity score and the need for paid care score for each ADL.