Long-Term Services and Supports Integration

This page describes the many types of care available through Long-Term Services and Supports, or LTSS. It includes a range of home- and community-based services such as In-Home Supportive Services (IHSS), Community-Based Adult Services (CBAS), and Multipurpose Senior Services Program (MSSP), in addition to care in nursing facility services when needed.

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. Services IHSS can provide include 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 has been found eligible, a social worker will assist the person in finding a caregiver.

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.

For more information, read these FAQs about IHSS or this fact sheet about IHSS services.

Community-Based Adult Services, or CBAS, offers services to older adults, or adults with disabilities, to restore or maintain their capacity for self-care and delay moving into an institutionalized setting. Its services are classified as benefits for adults eligible for Medi-Cal. CBAS services include:

• 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 residence and the CBAS center.

To qualify, adults must already qualify for Medi-Cal, as CBAS services count as Medi-Cal benefits.

Under the CCI, access to CBAS centers remains the same.
To learn more about CBAS, read this fact sheet on CBAS centers. (Word document version) (Sept 2012).

 

Multipurpose Senior Service Programs (MSSP) locations provide social and health care management 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. Services provided with MSSP funds 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: Physical adaptations, assistive devices, emergency
• 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, visiting / counseling, and translating / 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 – the only change that will occur during the second year is that instead of Medi-Cal, a Cal MediConnect plan will oversee and pay for MSSP services. Counties will still implement those programs, so they should function as they were under Medi-Cal.
During the second year, some MSSP services may move in-house – which means the program may be administered by Cal MediConnect instead of county agencies – although that is an optional change that some CMC plans may not implement.
Nursing facility care refers to long-term care for people who cannot live independently at home – care 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 is deemed not up to standards. Those who enter a nursing facility after joining a MediConnect plan, however, must choose a nursing facility within the plan’s network.
To learn more about the different LTSS programs in greater detail, visit CalDuals’ sections on Essential Reads for LTSS Integration.

Below are links to all the important information posted to this site the integration of these LTSS benefits into health plans.