Assisted Living

Financial Assistance for Assisted Living in Texas

The following post contains helpful resource information from assistedliving.org/Texas

 

STAR+PLUS
STAR+PLUS is a multifaceted program which provides reimbursement for people seeking assisted living. The STAR+PLUS Home- and Community-Based Waiver is a part of the program that helps seniors who are assessed as nursing home-eligible continue receiving their Medicaid benefits without being institutionalized. Eligible applicants are reimbursed for services that promote independence, such as assistance with personal grooming tasks, basic mobility, and caregiver respite. Services may be provided by direct care aides at an assisted living facility or by home health contractors.

Who is Eligible?
The STAR+PLUS program has absorbed many Texas Medicaid plans and services, so understanding whether you qualify can be difficult. This is due to the many caveats that may apply if you are eligible for multiple state programs under the STAR+PLUS umbrella, or for other programs like Supplemental Security Income. Eligibility requirements are listed on the Texas Health and Human Serviceswebsite, though understanding what you may qualify for is likely to require the assistance of a dedicated case worker.

Eligible applicants are people who need an institutional level of care and qualify for Medicaid. Medicaid applicants over 65 should have a maximum income of $2,250 and countable assets of no more than $2,000, though eligibility criteria varies with marital status, level of assistance needed, and other factors.

How to Apply
This waiver is a non-entitlement program, which means that it can only support a limited number of active participants. Applying for the waiver is likely to result in one’s name being added to a waiting list for enrollment, so it is advised that interested parties sign up as far in advance as possible. Applicants are encouraged to seek qualified counseling to help them navigate the enrollment process and eligibility requirements of STAR+PLUS. To begin the application process, contact The Office of the Ombudsman at (866) 566-8989, or consult the Texas Area Agencies on Aging by calling (800) 252-9240. Find your local Area Agency on Aging by consulting the directory in this guide.

The Community First Choice (CFC) Program
The Community First Choice program is a lot like the STAR+PLUS HCBS waiver in what it offers, except that CFC is a Medicaid entitlement program, meaning there are no maximum recipient caps and no waiting lists for enrollment. Community First Choice offers Medicaid reimbursement to low-income assisted living residents for the provision of assistance with activities of daily living, such as personal grooming tasks, mobility, and basic house chores. People already enrolled to receive other Medicaid waiver services may elect to switch to the Community First Choice Program.
Services provided under the CFC Program may include:
• Personal assistance with activities of daily living
• Skills education for self-care and independent living
• Emergency response services
• Training for support staff management
• Consumer-directed service options

Who is Eligible?
Applicants for the Community First Choice program must qualify for Medicaid and must be assessed by a physician as nursing home-eligible. Coverage of personal care services through this program is provided based on an assessment of which services an individual requires.

How to Apply
Interested parties can apply online at YourTexasBenefits.com, or call 2-1-1 for guidance and consultation. Your local Area Agency on Aging can also help with Medicaid and non-Medicaid applications. To initiate an assessment and determine your eligibility, consult the directory in this guide to find a nearby Area Agency on Aging.

PACE
Serving the cities of El Paso, Amarillo, and Lubbock, PACE is the Texas branch of the national Program for All-Inclusive Care for the Elderly. It is a Medicaid-administered program intended to provide total coverage of all medical and personal care needs for especially frail seniors, helping them to avoid institutionalization. This program reimburses for a broad array of services that may be provided by assisted living facility staff or home health contractors.
PACE provides these services:
• Personal care services and home healthcare
• Adult day healthcare
• Medical care
• Coverage for all necessary prescription drugs
• Hospital and nursing home care when necessary
• Social services
• Caregiver respite

Who is Eligible?
• Individuals aged 55 and older who are nursing home-eligible
• People who live in an area covered by PACE services
• Those who can live safely at home or in an assisted living community
Private payment is accepted for individuals not receiving Medicare or Medicaid and fees for these participants will not exceed average costs for nursing home care in Texas. However, space in the program is limited, and preference is given to applicants who have greater medical and financial needs. Most recipients of PACE are dually eligible for both Medicaid and Medicare. All applicants must have family or caregivers who can provide limited support during short intervals of respite.

How to Apply
To find out if you’re eligible and to learn about what PACE offers, contact your local HHS office by dialing 2-1-1, or 7-1-1 for the hearing impaired. You can also consult your local Area Agency on Aging for more details and application assistance. Find your local Area Agency on Aging by searching the directory included in this guide.

More Ways to Finance Assisted Living
Some additional ways to finance assisted living costs include:

Free Assisted Living Resources in Texas
Texas is home to hundreds of nonprofits and government resource providers that assisted living residents can look to for added support. Some of these organizations, like the Area Agencies on Aging, operate in every state across the country, while others are dedicated only to specific regions in the state of Texas. All of these services are free to use. However, some organizations listed here may have income and health-related requirements intended to preserve resources for those who are most in need.

The Aging & Disability Resource Center
This center was opened by the HHS as part of the national No Wrong Door initiative, and it is intended to streamline public access to resources and information concerning long-term services and supports. The Aging & Disability Resource Center helps to reduce confusion and facilitate access to care for long-term care recipients in all 254 counties of Texas. Contact them by calling (855) YES-ADRC, or (855) 937-2372. Find out more online by visiting hhs.texas.gov.

The Long-Term Care Ombudsman Program
Most states have a Long-Term Care Ombudsman program which organizes volunteers to act as advocates for recipients of LTC benefits. Ombudsmen periodically visit residents of ALFs and nursing homes to verify the quality of their care and environment, field complaints and concerns, help them protect their rights, and keep them in touch with the service providers and authorities they may rely on. The services of ombudsmen are always free and confidential, and their organizations avoid conflicts of interest by remaining unaffiliated with service providers and government agencies. The Texas LTC Ombudsman program can be reached via e-mail at ltc.ombudsman@hhsc.state.tx.us and toll-free at (800) 252-2412.

211 Texas
The Texas Health and Human Services Commission provides 211 Texas as an anonymous social service hotline with 25 information centers across the state. They are available to take calls 24/7, and can help citizens understand and gain information on any programs administered by Health and Human Services, which includes long-term care facilities like assisted living and other supports for seniors.
Reach 211 Texas by simply dialing 2-1-1, or visit them online at 211Texas.org.

Area Agencies on Aging
The AAA is a national, federally funded organization. It acts as a central agency, unifying hundreds of community outreach programs and supports for citizens over 60 years of age. Texas hosts 27 Area Agencies on Aging, making this a convenient resource for people in all regions of the state.

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How to take the worry out of providing long-distance care to seniors

By caringfromafar.com

Photo by Pexels

Are you taking up the role of caregiver for a parent or older loved one? Wondering how to provide that care when you live far away? Long-distance caregiving doesn’t have to be so stressful if you take care of the following essential steps.

Get Familiar with Your Loved One’s Medicare Options

The number one concern for seniors is their health, and the number one source of senior healthcare coverage is Medicare. If you are providing care for a loved one from afar, you need to spend some time making sure they have the best Medicare coverage for their situation. Learn the pros and cons of coverage and supplemental plans, as well as important deadlines.

Primarily, you both should know that the Annual Election Period for coverage started on October 15, and you have until December 7 to help your family member make their choices. This crucial enrollment period is the only time you can make changes to current plans, and the deadline is fast approaching, so sit down with a checklist so you can go over all the options in detail. Pick a time when you can visit in-person so that you can have your family member’s Medicare card, copies of the previous year’s medical bills, and a list of any pertinent healthcare information (provider names, prescriptions, etc.). If you can’t do this in-person, use a video call service to connect and have your loved one show or scan you copies of needed materials.

Make Sure Your Family Member Is Safe at Home

Did you know that falls send more seniors to the hospital than any other injury? More importantly, most serious falls happen at home when seniors live on their own. This statistic is not meant to make you feel guilty, but rather to stress the importance of making sure your loved one’s home is free of any fall hazards, both inside and out. If you can make a trip, take a walk around your loved one’s home and look out for issues that could cause them to slip or trip. Clutter can be a recipe for disaster, so make sure any random objects are safely stowed off the floor and out of the path of your family member.

Bathrooms are another sore spot in senior homes, so you may want to help your loved one make changes, such as installing grab bars or putting a seat in the shower. When you need to make these upgrades from afar, you’ll need to find a contractor you can trust. Check reviews online, or ask friends for referrals, so you can find reliable, affordable help to assist your senior loved one with these projects, as well as future issues they may have in their home.

Stay in Touch with a Local Network of Help

When you are providing care from a distance, there will likely come a day when your loved one will need some help and you may not be immediately available to assist them. This is why it is important to build rapport with any neighbors, friends, or community members who may be able to help your family member in their time of need. It’s a major step in effectively providing care for loved ones without adding more stress to your life.

Don’t be afraid to ask neighbors to check in with your parent or loved one, or at least let you know if there is cause for concern. This may include severe weather, odd behavior, or anything else out of the ordinary. Your network can help your loved one get prepared for emergencies, get help when needed, or simply connect with you. As an added layer of protection and connection, look into medical alert services for your parent as well.

Providing care to a senior loved one, when you do not live nearby, can be nerve-wracking. But if you can do some planning, connect with locals, and find ways to keep them safe at home, you can take a lot of the guesswork out of being an effective long-distance caregiver.

 

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5 advantages of early election of hospice benefits in assisted living and skilled nursing

Published in McKnight’s Senior Living by Rhea Go-Coloma, LMSW

For many, hospice care is associated with care received in the home. When provided early enough for residents in assisted living facilities and nursing homes, however, hospice care can provide important benefits for the resident and facility operator alike.

Hospice care, which is covered by Medicare and most private health insurance plans, eases pain and alleviates discomfort when a resident’s illness no longer is responding to treatment.

In fact, about one-third of assisted living residents receive end-of-life care at the community they have made their home. When residents become terminally ill, however, operators must provide care that may go beyond their capabilities.

When this happens, residents may be better served in a hospital or nursing home setting, but frequently it’s in the best interests of the resident to remain in the assisted living community. This is largely because residents have grown accustomed to the people and environment and feel the most at home.

When an assisted living community resident opts for hospice care, he or she also may be able to remain in the facility during the last months of life. This is best achieved when the assisted living community operator partners with an outside hospice provider. In this situation, it’s important for both organizations to work closely together to provide the best possible care for the resident.

Whether the hospice care is being provided in an assisted living community or nursing home, good communication between the family, staff, hospice staff and caregivers is important. Equally critical for success is early adoption of hospice care.

Early adoption of hospice makes all the difference

When adopted early, hospice care offers significant benefits for residents and families. Significantly, hospice healthcare specialists help residents and their families prioritize wishes and goals, creating a greater sense of ease and comfort.

Team-oriented hospice healthcare specialists work with the staff members of the assisted living community or nursing home to coordinate and plan care. Here’s a look at the five most important advantages of early election of hospice care for residents, families and facilities striving to meet the needs of these individuals:

Family support. Early involvement of an interdisciplinary team of hospice specialists helps families on many fronts: teaching family members how to care for the person who is ill, providing support and counseling to family and friends, offering education about the care process.

The hospice team also is there to help families clarify patient wishes, establish physician and patient relationships and balance family dynamics during this stressful time. Bottom line: hospice provides a way for residents to have a diverse group of committed professionals advocating for their needs.

Care goals. Hospice gives families the time they need to discuss goals of care, including an advance directive, a legal document that spells out end-of-life care ahead of time. The hospice team — including doctors, nurses, therapists, healthcare aides, clergy and social workers — addresses every aspect of a resident’s illness, with emphasis on controlling and reducing pain and discomfort. Team members provide symptom management and pain relief, increase quality of life and relieve patient suffering.

Family counseling. Guidance and support are a crucial feature of hospice, helping families deal with the range of emotions that surround this difficult time, offering guidance from social workers and chaplains. Hospice also offers bereavement and grief counseling after a loved one has passed, and it helps with some of the after-death tasks that need to be completed. Ultimately, choosing hospice care early makes end-of-life a calming and successful experience during a difficult time.

Dignity for the resident. Hospice offers the resident a chance to die with dignity. Hospice patients are not hooked up to loud machines, their vital signs are not constantly checked by medical personnel and they do not undergo invasive procedures to prolong life. It’s about respecting patient wishes.

By making arrangement to provide hospice care, operators of assisted living communities and nursing homes can make it possible for residents and families to focus on spending time with their loved one and not dealing with the red tape and medical procedures associated with hospital care.

 

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