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123456789101112Task /
ActivityNeeds Intensity Score 1
Needs and Minute RangesMinutes Assigned within Range Needs Intensity Score 2
Needs and Minute RangesMinutes Assigned within RangeNeeds Intensity Score 3 Needs and Minute RangesMinutes Assigned within RangeFrequencyTotal Minutes per week Minutes of Assistance with Task Per Week from Another Source Total Minutes/ Hours Per Week Net of Assistance from Another SourceTotal Net Hours per MonthBathing Laying out supplies
Drawing water
Standby assistance for safety
Minimal assistance in/out of tub or shower
Reminding, monitoring
Minute range: 5-10Tub/shower bathing
Sponge bathing
Bed bathing
Drying
Extensive assistance in/out of tub or shower
Minute range: 15-30Total assistance with bathing
Minute range: 35-45DressingLaying out clothing
May require occasional help with zippers, buttons, putting on socks or shoes
Reminding or monitoring
Minute range: 5-10
Always requires assistance with zippers, buttons, socks, or shoes
Requires assistance getting into and out of garments
Minute range: 15-20
Total assistance with dressing
Minute range: 25-30Feeding Verbal reminders & encouragement
Standby assistance
Applying adaptive devices
Note: feeding is calculated by # of meals per week, not # of days
Minute range: 5-10
Spoon feeding
Bottle feeding
Minute range: 15-20Total assistance with feeding
Minute range: 25-30
Grooming/Routine hair and skin care Laying out supplies
Verbal reminders
Combing/brushing hair
Applying non-prescription lotion to skin
Minute range: 10-20
Shaving
Brushing teeth
Shaving legs, underarms
Caring for nails
Washing hair
Drying hair
Setting/rolling/braiding hair
Washing hands and face
Applying makeup
Minute range: 30-50Total assistance with grooming and routine hair and skin care
Minute range: 60-75
ToiletingPreparing toileting supplies / equipment
Assisting with clothing during toileting
Occasional help with Cleaning self
Occasional help with catheter or colostomy care
Standby assistance
Minute range: 5-10
Assisting on/off bedpan
Assisting with the use of urinal
Assisting with toileting hygiene
Assisting with feminine hygiene needs
Changing diapers Changing external catheter
Emptying catheter bag
Changing colostomy bag
Minute range: 15-20Total assistance with toileting
Minute range: 25-30
Transferring Helping with positioning (adjusting/changing position)
Minimal assistance in rising
Standby assistance
Minute range: 5-10
Non-ambulatory movement from one stationary position to another
Hands-on assistance with rising from a sitting to a standing position
Extensive assistance with positioning or turning
Minute range: 15-20Total assistance with positioning or transferring from bed to chair
Minute range: 25-30
Walking Standby assistance with walking
Assistance with putting on and removing leg braces
Minute range: 5-10
Steadying in walking/using steps
Assistance with wheelchair ambulation
Minute range: 15-20Total assistance with wheelchair ambulation
Minute range: 25-30
CleaningMinimal assistance with cleaning
Make bed
Straightening areas
Minute range: 60-90
Cleaning up after personal care tasks
Cleaning floors of living area used by individual
Dusting
Cleaning bathroom
Changing bed linens
Cleaning stove top, counters, washing dishes
Cleaning refrigerator and stove
Emptying and cleaning bedside commode
Carrying out trash, setting out garbage for pickup
Minute range: 95-235Total assistance with cleaning
Minute range: 240-300LaundryIndividual requires at least minimal assistance but has no special laundry needs:
Minute range: 30-120Individual has special laundry needs:
Minute range: 120-240
Meal preparationWarming, cutting, serving prepared food
Meal planning
Helping prepare meals Light Breakfast
Snacks
Cooking full meal. Indicate meals to be cooked. The maximum time per meal is 30 minutes.
Breakfast
Lunch
Supper
Additional time for leftovers. Allow an extra 15 minutes per day for cooking enough for leftovers for the next meal, if needed.
Grinding and pureeing food
Minute range: 10-90
Shopping Preparing a shopping list
Picking up extra items
Minute range: 10-30Going to the store; shopping for all items
Picking up medications
Putting items away
Minute range: 35-90Total assistance with shopping
Minute range: 35-90Employment-related personal care associated with travelTOTAL Minutes/Hours for All Tasks Per WeekTOTAL Minutes/Hours for All Tasks Per Month
Instructions for Completing the Above Task and Hour Standards Grid
The Task and Hour Standards (THS) grid is used to provide the basis for calculating the number of approved and authorized minutes and hours of attendant care, respite care, personal care, and self-directed personal assistance that are medically necessary for an adult beneficiary aged 21 or older.
Whenever there is a change in condition for the beneficiary or a change in assistance from other sources, the DHS RN or contractor will update the THS grid for the beneficiary. The updated THS grid may result in a change the minutes/hours of attendant care, respite care, personal care, or self-directed personal assistance approved for the beneficiary.
The DHS nurse/contractor will assign a Needs Intensity Score to the beneficiary for each task based on the beneficiarys and/or representatives responses to questions during the ARIA assessment conducted by an RN from the Independent Assessment Contractor. A Needs Intensity Score is required for completion of the THS grid.
Steps for completing the THS grid to calculate the number of medically necessary and reasonable minutes/hours of attendant care, respite care, personal care, or personal assistance for the beneficiary per week/month:
Identify the beneficiarys Needs Intensity Score (0, 1, 2, or 3) for each task from the ARIA assessment results and from information collected by the DHS RN during the PCSP meeting with the participant. If the Needs Intensity Score for the task is 0, the beneficiary will not be approved for any minutes for that task and THS grid would not be completed for the task. If the beneficiarys Needs Intensity Score is 1, 2, or 3, the grid will be completed for the task and the Needs Intensity Score will determine which minute range (Columns 2, 4, and 6) is applicable for the task.
Columns 3, 5, and 7: (Complete only one of these three.) The DHS nurse/contractor will calculate the number of minutes within the minute range for that Needs Intensity Score that are appropriate for the beneficiary based on conditions specific to the beneficiary. For example, if a beneficiary has cognitive or behavioral issues, the nurse may find that the maximum number of minutes in the range for bathing is warranted. On the other hand, assigning the maximum number of minutes for grooming for a beneficiary who is bald would probably not be appropriate.
In exceptional circumstances and based on documented need, the DHS nurse/contractor may approve minutes in excess of the minute range for the task, so long as the justification of need is documented in writing, the justification is based on the beneficiarys assessed or observed medical needs, the justification is not for the convenience of the provider or attendant, and the DHS nurse/contractor obtains written supervisory approval.
Column 8: Insert the frequency with which the task is performed based on the reasonable needs and preferences of the beneficiary. The frequency with which a given task is performed for a beneficiary will be calculated by the DHS nurse or contractor, drawing upon information from the ARIA assessment results and, as applicable, the information collected by DHS nurses during the PCSP meeting with the beneficiary and/or information submitted by the beneficiarys provider.
Column 9: Multiply the total minutes assigned for the task in Columns 3, 5, or 7 by the frequency with which the task is performed (Column 8) to arrive at the total minutes per week. Insert that product in Column 9.
Column 10: If the beneficiary is receiving assistance with the task from another source such as (a) informal caregivers (e.g., relatives, neighbors, and friends), (b) community-based agencies such as Meals on Wheels, and/or (c) Medicare or a Medicare Advantage health plan), calculate approximately how many of the assigned minutes for the task are being performed by the other source (e.g., 45 minutes for bathing because the beneficiarys mother needs total assistance and the daughter performs the entire bathing task once a week) and insert in Column 10. The amount of support with ADLs and IADLs provided by other sources is primarily calculated by the DHS nurse or contractor based on ARIA assessment results, during PCSP meetings with the participant, and from information supplied by providers.
Column 11: Subtract the number of Minutes of Assistance Per Week from Another Source in Column 10 from the number of Total Minutes Per Week in Column 9. Divide that number by 60 to arrive at the number of hours per week. Enter both minutes and hours per week in this column.
Column 12: Multiply the number of hours per week in Column 11 by 4.334 to arrive at the number of hours per month.
Arkansas Medicaid Task and Hour Standards (THS)
For Use in Calculating Medically Necessary Hours of Services for Adult Beneficiaries
ARChoices Attendant Care & Respite Care, Personal Care Services, and IndependentChoices Self-Directed Personal Assistance
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