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ltc-32_user_guide

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									                                  New Jersey Department of Health and Senior Services
                                      NEED-BASED CARE ALLOCATION TOOL
                                                USER GUIDE

      LEGEND:
        ADL           Activities of Daily Living                  IADL         Instrumental Activities of Daily Living
        ADHS          Adult Day Health Services                   MDS-HC       Minimum Data Set–Home Care
        ADRC          Aging and Disability Resource Connection    NBCAT        Need-Based Care Allocation Tool
        DHSS          Department of Health and Senior             OCCO         Office of Community Choice Options
        GO            Global Options                              PAS          PreAdmission Screen(ing)
        HBSC          Home Based Supportive Care                  PCA          Personal Care Assistant Services
        HCBS          Home & Community Based Services


1.    The NBCAT is an ADL and IADL support tool, an              12.   ADHS hours can be combined with either PCA or
      objective tool using objective measures.                         HBSC hours.
2.    The tool is modeled after the PCA Beneficiary              13.   ADL or IADL support hours for all state and/or
      Assessment Tool that was developed by the                        federal publicly-funded services are to be
      Department of Human Services, Division of                        combined and should not exceed the total
      Disability Services. It has been tailored by DHSS                hours/score computed using this tool.    Care
      using language adapted from the MDS-HC                           Managers must take all publicly-funded ADL or
      assessment tool.                                                 IADL support hours into consideration when
3.    Each ADL or IADL section consists of a series of                 constructing the Plan of Care.
      subsets which carry specific parameters and                14.   The tool reflects a snapshot in real time. Record all
      corresponding scores.                                            formal and informal services currently being
4.    The parameters used in the tool range from                       utilized by the Participant.
      independent through completely dependent on                15.   GO is meant to supplement, not replace, the
      others for assistance.                                           assistance already being provided by family,
5.    The tool is scored based on a point system, a                    friends, and neighbors.
      weighted scale index.                                                While not freely encouraging conversion of
6.    The scoring scale in each section is not always in                    informal unpaid or privately paid caregiving
      incrementally equal order (e.g., Bathing = 0, 2, 4,                   support hours to formal support hours,
      5, 6) nor are sections equally weighted/scored                        caregiver stress/fatigue can be taken into
      (e.g., Eating = 0-4 versus Bathing = 0-6).                            account when constructing the Plan of Care.
7.    The Total Need-Based Score translates to the               16.   Based on professional judgment of the Care
      number of hours allocated for ADL or IADL formal                 Manager, if additional care hours are needed
      care assistance.                                                 above and beyond the hours computed using the
8.    There is no diagnosis section because the tool is                tool, the process is as follows:
      not diagnosis-driven. It is a need-based tool that is                Less than or equal to 40 hours or $2841 --
      to be used as a guide for service planning.                           the Care Manager completes the justification
9.    The NBCAT is used only for GO in-home service                         at the end of the NBCAT entering the amount
      planning. The tool is not used to plan Assisted                       of hours they believe are justified to address
      Living, Nursing Facility or JACC services.                            the health needs of the participant. The Care
                                                                            Coordinator or Care Management Supervisor
10.   The tool is completed by the Care Manager at the                      reviews the NBCAT, seeks justification from
      time of the initial NBCAT screening when planning                     the CM and if agrees signs the increase.
      services, as part of the annual Re-evaluation/Plan
      of Care process, when a subsequent NBCAT                             If greater than 40 hours or $2841 -- the Care
      screening is needed to reflect a significant change                   Manager prepares justification paperwork
      in caregiver or functional status, and for GO                         and submits the request to their County
      transition planning at the Nursing Facility                           Liaison for review and action.
      Interdisciplinary Team Meeting.          The Care          17.   The original copy of the tool will be retained in the
      Manager will use the tool as a guide when                        care management file and a copy is to be provided
      developing the Plan of Care.                                     to the Participant or the Participant Authorized
11.   PCA and HBSC, provided by an agency or a PEP,                    Representative.
      are mutually exclusive of one another. The
      Participant must choose either PCA or HBSC.


LTC-32 (User Guide)
SEP 11

								
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