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Home and Community Support ServicesHome and Community Support Services (HCSS) are only appropriate when oversight and/or supervision are necessary as a discrete service to maintain the health and welfare of a participant living in the community. HCSS may also include personal care assistance with Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). HCSS is not companion service. Oversight and/or supervision are necessary to protect a cognitively impaired individual for adverse outcomes related to his/her activities (for example, wandering or leaving the stove unattended). Oversight and/or supervision include cueing, prompting, directing and instructing. If a participant's need for oversight/supervision warrant HCSS during the night, the HCSS staff must remain awake throughout the duration of time assigned to the participant.     Since HCSS staff are trained as Personal Care Aides (PCA Level 11, they are qualified to perform the scope of PCA level I and II tasks and functions, including some or total assistance with ADL (i.e. dressing, bathing, hygiene/grooming, toileting, ambulation, transferring and eating), and/or IALD (i.e. housekeeping, shopping, meal preparation and laundry) essential to the maintenance of the participant's health and welfare in the community.     It is important to consider the interest and needs of the waiver participant when assigning HCSS support. The ability of the HCSS staff to support the strengths, interest and needs of the participant will promote a better working relationship and help to meet the established goals for the service. It is the right of the participant to request a change in HCSS staff. Attempting to find the best match between the HCSS staff and participant from the start decreases the occurrence of staff turnover and Serious Reportable incidents while increasing participant satisfaction and success in the community. Qualifications     HCSS must only be provided by a licensed home care services agency (LHCSA) licensed under Article 36 of the NYS Public Health Law. All regulations governing the LHCSA will be in effect for the provision of this service, (EG patient right patient service policies and procedures, plan of care, medical orders, clinical supervision, patient care records, governing authority, contracts, personnel records and reports.  HCSS Staff must:    Be at least 18 years old.    Be able to follow written and verbal instruction.      Have the ability and skills necessary to meet the waiver participant's needs the will be addressed through this service.      Have a valid certificate to indicate successful completion of a forty (40) hour training program for Level II PCA or PCA Alternate Competency Demonstration equivalency testing that is approved by DOH_      Attend basic orientation training and service specific training as specified in the HCBS/TBI program manual section VII prior to providing any billable services, and/orNHTD waiver program manual.      Attend six (6) hours of in-service education per year that includes annual HCBS/TBI and NHTD waiver.    Meet all health requirement specified in 1 ONYCRR 766.11