2-03CommChoicesInit

COMMUNITY CHOICES INITIATIVE

The Community Choices program is a joint initiative funded by the Executive Office of Elder Affairs (EOEA) and the Division of Medical Assistance (DMA) to keep seniors in their communities and out of nursing homes. The program was signed into law by former Governor Jane Swift as part of the fiscal year 2003 budget. The program's approximate monthly benefit of $1,500 provides more funding than the basic home care program's maximum benefit of $234, or the Enhanced home care program of about $800 monthly, enabling an elder with greater service needs to remain living in the community.

The Aging Service Access Point (ASAP) designs an individual service plan that may include: interdisciplinary case management, homemaker, personal care, respite care, enhanced personal care, supportive home care aide, companionship, environmental accessibility adaptations, supportive residential care, chore, dementia day care, grocery shopping and delivery services, home-delivered meals, laundry services, supportive day care programs, and transportation. Clients also have access to services such as adult day health, personal emergency response systems, and home health services that are available to MassHealth members.

Criteria for enrolling in the Community Choices program include age 60 years or older, MassHealth member or eligible, and eligible for the MassHealth Home and Community Based Waiver (HCBW). The main pertinent provision of the HCBW is that the member is eligible for nursing home care.

Also, interdisciplinary teams at the ASAPs will determine if the elder meets the following clinical criteria:

  1. Was actively seeking nursing facility care within the last six months; or
  2. Recently experienced a serious medical event, regression in physical or cognitive functional ability or a cumulative deterioration in functional ability ; or
  3. Was discharged from a nursing facility within the last thirty days; or
  4. Is at risk of nursing facility admission due to the instability or lack of capacity of informal or formal supports

    AND

  5. Has one or more of the following clinical characteristics:
    • Needs 24 hour supervision because of complex health conditions; or
    • Experiences a significant cognitive impairment; or
    • Is unable to manage/administer prescribed medications; or
    • Experiences frequent episodes of incontinence; or
    • Requires daily supervision and assistance with multiple activities of daily living, such as eating, bathing, dressing, etc.).

If elders do not meet the asset requirement for MassHealth, but meet the Community Choices clinical criteria, they are still eligible for the program. They will have to "spend down" their assets to qualify for MassHealth before the Choices program will begin to pay.

The Community Choices program has funding through July 2003. During this time, the EOEA and DMA will closely monitor the program. The agencies will analyze the information and report to the Legislature in April 2003 to enable the Legislature to determine the effectiveness and efficacy of the Choices initiative, and decide about its future.

-Thanks to Susie Black for bringing the Community Choices Program to our attention.
Also, thanks to Roberta Todd at Boston Senior Home Care for providing much of the information about the program.


02/03