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Mike Robb, executive director for Center for Community Resources, said Community Health Choices “is a managed-care insurance program. Lump funding from Medicaid will be managed by the insurance companies to pay for services in the home.”
New approach to senior living

BUTLER — Pennsylvania is taking a new approach to elder care. The goal is to help senior citizens continue living in their own homes and communities, independently and safely, as long as possible.

Community Health Choices is scheduled to begin July 1, 2017, in Butler and 13 other counties in Southwestern Pennsylvania.

The rest of the state will follow in 2018 and 2019, under a phase-in plan developed by the state departments of Human Services and Aging, according to state officials and Mike Robb, executive director of Center for Community Resources.

“This is a managed-care insurance program,” Robb said in a recent interview in his office at 212 S. Main St., Butler. “Lump funding from Medicaid will be managed by the insurance companies to pay for services in the home.”

CCR hopes to play the key role of services coordinator in the new scheme, a role Robb describes as “something like a senior services concierge.”

Human services coordinator is CCR’s niche. The 13-year-old agency devotes itself to “connecting people to a network of supports and services essential for actively learning, working and living in the community,” according to its mission statement.

State officials have awarded contracts to three insurance providers to administer Community Health Choices statewide: AmeriHealth Caritas, Pennsylvania Health and Wellness (Centene) and UPMC. CCR has submitted proposals to become a regional services coordinator for all three providers, Robb said.

There will be eligibility guidelines for funding, for individual Medicaid-eligible clients, and also for the specific services and service providers. The Office of Long Term Living, a division of the state Department of Human Services, oversees a collection of rules for eligibility reimbursement known as the OLTL aging waiver.

Under the aging waiver, individuals age 60 and older are eligible if they qualify for clinical nursing facility care and are financially eligible for Medicaid.

Services available through the aging waiver include home adaptations; specialized medical equipment and supplies; assistive technology; adult daily living services; community transition services; home delivered meals; home health services; transportation; personal assistance services; personal emergency response system; respite care; TeleCare; and therapeutic and counseling services.

The agency refers services to a host of community service providers, including its two sister corporations, Nonprofit Development Corp. and Alliance for Nonprofit Resources. The service providers — and CCR — are paid with Medicaid funding passed through the designated insurer. Reimbursement rates have not been negotiated yet.

Nonprofit Development Corp. activities include buying, rehabilitating and adapting rental homes for the aged and disabled. NDC also cleans apartments for those who have difficulty doing so.

“That might seem unimportant, but if it keeps a resident compliant with the rules, they can stay in their home,” Robb said. “And it’s a less costly option.”

The Community Health Choices program is geared to benefit Pennsylvanians with disabilities as well as senior citizens, according to the Department of Human Services. Other eligibility waivers apply to disabled adults who receiving Medicare and Medicaid assistance.

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