Pathways to Care
Provides meals to Participants who cannot prepare or obtain nutritionally adequate meals for themselves, or when the delivery of such meals will decrease the need for more costly supports to provide in-home meal preparation.
What is Home Delivered Meals?
Form is to allow a Participant to authorize the use or disclosure of their protected health information (PHI) in ways that are not otherwise permitted or required under the HIPAA Privacy Rule.
What is Authorization for Sharing Health Information Form (HIPAA Authorization)?
Enable Participants to gain access to LTSS services as specified in their Person-Centered Service Plan/Plan of Care (PCSP/POC). This service is offered in addition to medication transportation services, but it does not replace them.
What is Non-Medical Transportation?
Primarily provide hands-on assistance, including cueing and supervision as described below, to enable the Participant to integrate more fully into the community and ensure the health, welfare, and safety of the Participant.
What is Personal Assistance Services (PAS)?
The evaluation and treatment of any person by the utilization of the effective properties of physical measures such as mechanical stimulation, heat, cold, light, air, water, electricity, sound, massage, mobilization, and the use of therapeutic exercises and rehabilitative procedures including training in functional activities, with or without assistive devices, for the purpose of limiting or preventing disability and alleviating or correcting any physical or mental conditions, and the performance of tests and measurements as an aid in diagnosis or evaluation of function.
What is Physical Therapy?
An electronic device (stationary or portable "help" button) which enables Participants to secure help in an emergency
What is Personal Emergency Response System (PERS)?
Form was developed to assist the health plan with identifying individuals that have the legal authority to make health care decisions on behalf of the Participant.
What is Personal Representative Form?
Modifications keep drivers with disabilities on the road and create more accessible vehicles.
What is Vehicle Modifications?
Designed to assist Participants in meeting, at a minimum, personal care, social, nutritional and therapeutic needs. Adult Daily Living services are necessary, as specified by the service plan, to enable the Participant to integrate more fully into the community and ensure the health, welfare and safety of the Participant.
What is Adult Daily Living Services?
Provide personal care and support services to individuals in their homes to help the Participant complete Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs).
What is Home Health Aide?
Intended to aid in maintaining an environment free of insects, rodents, and other potential disease carriers to enhance safety, sanitation, and cleanliness of the Participant’s residence, making the Participant's home fit for them to live there.
What is Pest Eradication?
Provide a Registered Dietician or Certified Nutrition Specialist to assist the Participant and/or their paid and unpaid caregivers in:
What is Nutritional Consultation Services?
Physical adaptations to the primary private residence of the Participant, as specified in the Participant's person-centered service plan (PCSP) and determined necessary in accordance with the Participant’s assessment, to ensure the health, welfare and safety of the Participant, and enable the Participant to function with greater independence in the home.
What is Home Adaptations?
Provides funds for one-time expenses to support an individuals transitioning from an institution or another provider-operated living arrangement into a community setting.
What is Community Transition Services?
Provided by a licensed American Speech Language Hearing Associate or certified speech-language pathologist in accordance with applicable State standards including the evaluation, counseling, habilitation and rehabilitation of individuals whose communicative disorders involve the functioning of speech, voice or language, including the prevention, identification, examination, diagnosis and treatment of conditions of the human speech language system.
What is Speech and Language Therapy?
Integrates social and healthcare services supported by innovative technologies to sustain and promote independence, quality of life, and reduce the need for nursing home placement. By utilizing in-home technology, more options are available to assist and support individuals so that they can remain in their own homes and reduce the need for re-hospitalization.
What is TeleCare?
Provided to support individuals on a short-term basis due to the absence or need for relief of unpaid caregivers normally providing care.
What is Respite?
An umbrella term covering any item, piece of equipment, software program, or product system used ensure the health, welfare, independence and/or safety of the Participant.
What is Smart Home/Assistive Technology?
Provides the Participant with learning and work experiences, including volunteer work, where the Participant can develop strengths and skills that contribute to employability in paid employment in integrated community settings.
What is Employment Skills Development?
Direct services prescribed by a physician, nurse practitioner, or physician assistant, to meet a Participant's medical needs.
What is Home Health Services?
Consist of heavy household chores that are necessary to maintain the functional use of the home or provide a clean, sanitary, and safe environment
What is Chore Services?
Provides an accurate, individualized financial and benefit assessment for Participants interested in gaining and/or maintaining employment. It does so by providing:
What is Benefits Counseling?
A physical health benefit that covers wheelchair lifts, stair lifts, vertical lifts, incline glide lifts, ceiling tract lifts, metal ramps, individual grab bars, and other mobility products, and other items that are:
used by a Participant with mobility impairment/limitation to enter and exit the home
used to support activities of daily living
removable or reusable, which includes instances where these items are installed using screws or bolts and are removed by removing the screws or bolts without damage to the item.
What is Home Accessibility DME (HADME)?
ILOS (in lieu of services) refers to Medicaid-funded services that can be substituted for traditional services or settings covered under a state plan.
This ILOS initiative targets those who meet a Nursing Facility Clinically Eligible (NFCE) level of care but do not need intensive physical intervention by nursing facility staff and would be safely served in an assisted living setting with long-term services and supports in place, equivalent to what the recipient would have in a nursing facility.
Assisted living residences (ALR) are not considered institutional settings, allowing Participants to maintain independence and connection to the community.
What is Assisted Living Residence in Lieu of Services (ALR ILOS)?
Services must be performed by a Registered Nurse (RN) or a Licensed Practical Nurse (LPN). Nurses diagnose and treat human responses to actual or potential health problems. These services may include wound care, suctioning, medication administration, managing monitoring equipment, and training a Participant-directed Direct Care Worker (DCW) to provide care to a Participant.
What is Nursing Services?