State of New Jersey - Department of Health & Senior Services
Jersey Assistance for Community Caregiving (JACC)
Caregiver Assistance Program (CAP)
Consumer-Directed Tasks Performed by
Client Employed Providers in JACC and CAP
Purpose: To outline DHSS’ policy on the tasks that may be performed by Client
Employed Providers in the JACC and CAP program.
Referenced Documents:
JCN 461
WPA-2
JCN 520
JCN 5201
JCN 563
JCN 618
JCN 465
ATT 2 B-2
Use of CEPs: Participant’s Capacity for Self-Direction
Plan of Care
Plan of Care Process
Plan of Care Document Instructions
Client-Employed Provider Process
Using Client-Employed Providers
Client Workbook
Qualifications of Client-Employed Providers
Parameters:
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The use of the Client Employed Providers (CEPs) in the programs shall be
consistent with all-governing law and regulations.
The program model shall afford sufficient protection to the individual receiving
services.
The program model shall afford an arena for the caregiver to provide appropriate
care in a competent manner.
The program model shall afford sufficient protection of the public interest.
The program model shall be consistent with the DHSS Mission and shall embody
the values of Independence, Dignity, and Choice.
The program practices shall be consistent with, and contribute to, the program
purpose.
Program Purpose:
JACC and CAP are initiatives that increase community-based alternatives for
individuals needing assistance, enhancing their ability to exercise choice among care
options. By expanding the type of services available as well as the range of qualified
providers in these programs, we support the values of dignity, independence, and
choice, promoting the opportunity for individuals to “age in place”. The programs are
designed to respond to the anticipated growth of the aging population by opening up
the provider market, being responsive to individual needs, and strengthening the
infrastructure of natural supports, thereby maximizing benefit to recipients and
optimizing system resources.
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Program services:
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Case Management
Respite Care
Homemaker Services
Environmental Accessibility Modifications
Personal Emergency Response Systems
Home-Delivered Meal Service
Caregiver/Recipient Training
Social Adult Day Care
Adult Day Health
Special Medical Equipment and Supplies
Transportation
Chore Services
Attendant Care
Home-Based Supportive Care
Consumer-Directed in CAP and JACC
Clients served in JACC and CAP are predominately elderly and all require a nursing
facility level of care. Although eventual decline in functioning can be anticipated,
program practices still need to reflect the values of dignity, choice, independence. At all
times one must know whose values he/she is respecting, and one must understand
“where the client is”.
Consumer-Directed in these programs emphasizes collaboration, participation, and
responsibility. We have identified the “four C’s” of consumer-directed as:
Collaboration: Clients, case managers, family, champions, specialists, etc. all
work together, joining in the responsibility and opportunity to
identify resources and develop a plan of supports and services that
meets the individual’s needs in the least intrusive, most effective
and efficient manner.
Choice:
The client has choice, to the greatest extent possible and desired,
in determining what, who, when, and how of her service provision.
Control:
The client has control, to the greatest extent possible and desired,
in managing and directing her supports and services, from a simple
indication of preferences to the active direction of one’s own
employees.
Change:
The client has the opportunity and the responsibility to identify and
initiate change in the service plan when required or desired.
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Services that can be provided by Client-Employed Providers
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Chore service
Transportation
Home-Based Supportive Care (HBSC)
Attendant Care
Of these Attendant Care involves health-related tasks. Attendant Care is always
provided by CEPs alone. The other services may alternately be provided by
qualified, approved agencies.
CEP PROCESS STANDARDS:
1. In working with participants, the case manager and other paid staff must be
cognizant of mission, values and principles, to assure respect of the participant’s
dignity, choice, independence, and dignity of risk.
2. An individual must have choice and control in her care to the greatest extent
possible and desired.
3. The opportunity to assume reasonable risk must be afforded to the participant.
4. Collaboration between the client and case manager in developing, implementing,
managing, and, when required, changing the Plan of Care (POC), are fundamental
elements of CAP/JACC.
5. Each client presents unique circumstances in terms of economic, personal and
social support systems. Individuals vary in terms of medical condition, functional
ability, quantity and quality of natural support networks, economic level, etc. All of
these factors impact the provision of care and need to be properly considered when
completing a Plan of Care.
6. The ability to render a personal care service to one individual does not
independently qualify one to render the same service to another individual. Past
performance is, however, a legitimate aspect of provider qualification.
7. The Plan of Care is the living document that drives services. Any unique
requirements for service, including qualifications and training required of service
providers or of the client, should be specified in the document. Thus, the Plan of
Care contents are the outcome of an assessment, planning, and decision-making
process that identifies activities and limits determined to be consistent with the
concepts of reasonable risk and appropriate care.
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8. In developing the Plan of Care, input should be secured from all parties that have
important, beneficial, required, or desired expertise or information pertinent to the
individual’s situation. The case manager has the authority to request
evaluations/input of specialists; the individual may include her family/champion as a
resource, etc.
9. The skill level of individuals who would be CEPs is as varied as randomness
permits. Thus, it is undesirable to prescribe a list of tasks in which the CEPs would
be permitted to engage. Alternately, we must define a Plan of Care process in
which triggers prompt the Plan contributors to carefully consider and determine
qualifications and training needs required of service providers, in addition to the
basic qualifications outlined in Qualifications for Client-Employed Provider
(Attachment 2 to Appendix B-2).
Controls and safeguards:
Given the population, it is likely that some difficulties could ensue over the ability of an
individual to conduct, or continue to conduct, the management of her own CEPs. We
do and/or can address this several ways:
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The opportunity always exists to involve expertise in the form of assessment,
reassessment, consultation, etc. from appropriate professionals, and to implement
an action plan as a result, which may include a change to the Plan of Care.
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It may be necessary to provide an alternate service, such as Home Health, to
accomplish the need, if within the cost cap and requirements of the particular
services.
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It may be necessary to refuse to fund a service if the individual continues to
jeopardize his health, safety, or welfare. This must be determined on an individual
basis.
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