Will Joining Cal MediConnect Affect My IHSS or Other Support?
There are many types of care available through Medi-Cal Long-Term Services and Supports, or LTSS. It includes a range of home- and community-based services. Learn more about the different types of LTSS, who qualifies, and what would change under a Cal MediConnect plan.
In-Home Supportive Services (IHSS)
In-Home Supportive Services, or IHSS, is a program that helps elderly, blind or disabled people live safely in their own homes by providing services for daily living activities. IHSS can provide services like cleaning, cooking, dressing, grooming, bathing and shopping. It is considered an alternative to out-of-home care, such as nursing homes or board-and-care facilities.
To qualify, a person must be over 65 years of age (or disabled or blind), be eligible for Medi-Cal, and live in his/her own home (long-term care and community care facilities). Once a person is eligible, a social worker will assist the person in finding a caregiver. To find out if you are eligible, click here.
Under the CCI, those who receive IHSS will not have to change their providers, and they can hire, fire and manage their providers as desired. The county IHSS social worker will still assess their needs and approve IHSS hours. Their rights to appeal will stay the same.
Nursing facility care refers to care for people who cannot live independently at home – that’s primarily paid for by Medi-Cal.
Under the CCI, those already in nursing facilities will be able to stay where they are, unless the facility doesn’t meet quality and safety standards. Those who enter a nursing facility after joining a MediConnect plan, however, must choose a nursing facility within the plan’s network. If you wish to move into your own home or a family member’s home, Cal MediConnect can help you get the services you need to live there safely.
Community-Based Adult Services (CBAS)
Community-Based Adult Services, or CBAS, offers services to older adults, or adults with disabilities, to help them continue to care for themselves and delay moving into an institutionalized setting, like a nursing facility. CBAS is available to adults eligible for Medi-Cal and includes:
- An individual assessment,
- Professional nursing services,
- Physical, occupational and speech therapies,
- Mental health services,
- Therapeutic activities,
- Social services,
- Personal care,
- A meal,
- Nutritional counseling, and
- Transportation to and from the participant’s home and the CBAS center.
To qualify, adults must meet various eligibility and medical necessity criteria, be enrolled in a Medi-Cal MLTSS or CMC health plan. To find out if you are eligible, contact your Medi-Cal or Cal MediConnect health plan.
Under the CCI, access to CBAS centers remains the same.
Multipurpose Senior Service Programs (MSSP)
Multipurpose Senior Service Programs (MSSP) offer a location where you can go for health care and social services management. MSSP is for elderly clients who qualify to live in a nursing home but wish to remain at home. The program’s goal is to leverage community services in order to delay a person’s movement into institutional care, like a nursing home. MSSP services include:
- Adult Day Care / Support Center: Non-medical care to meet the needs of adults with disabilities, including social, psychosocial and related support services.
- Housing Assistance: Minor home safety repairs and enhancements. Emergency response systems (ex: Lifeline®, Easy Call®).
- Chore and Personal Care Assistance: Chore Assistance refers to help with daily household living tasks rather than client care, while Personal Care Assistance includes help with bodily hygiene, personal safety and daily living activities.
- Protective Supervision: Helps frail, elderly clients who could suffer a medical emergency remain safely at home.
- Care Management: Helps clients connect with local care services, as well as assessing a client’s level of care.
- Respite: Supervising and caring for a client to provide respite for family members or others who normally care for the client.
- Transportation, Meal Services, Social Services, Communication Services: Help with travel to service providers, meals delivered for those who have no caretakers at home, mental health care, translating or interpretive services and emergency response systems for those who need them.
To qualify, a person must be 65 or older, live within a site’s service area, be served within MSSP’s cost limitations, be appropriate for care management services, and qualify for both Medi-Cal and placement in a nursing home.
Under the CCI, access to MSSP services will remain the same. To find out if you are eligible, contact the MSSP site in your service area.
If you decide not to join Cal MediConnect:
You will still need a Medi-Cal Managed Care plan. The plan will coordinate your Medi-Cal benefits, including LTSS.