CT Home Care Program for Elders: A Gem Worth Knowing About (1-800-445-5394)

Lucky me, I learned about the Connecticut Home Care Program for Elders run through the DSS Alternate Care Unit. Their number for information is 800-445-5394.The pamphlet I picked up reviews some basic 'facts of life' such as nursing home care costing many tens of thousands of dollars a year. When the booklet was printed it was "$60,000 and up". Those might seem like bargain prices in 2018, where monthly fees can easily top 10K in CT so that would mean an annual cost of a smooth $120,000 and Up!

This post is Basically a Summary of the Booklet, not my own insights (unless indicated and not about terms of the program, just practical tips.)

Some terms may have changed, so look up current information. Also when dialing any number sometimes it is not necessary to use the "1" for long distance. I know that's strange, but if a call won't go through with dialing the number one, try Not dialing it. 

Medicare does not usually pay for nursing facility care, the booklet continues. Medicare is what peope who are age 65 and up get as a form of federal health insurance. The Part A of Medicare covers about 80% of expenses. To obtain Part B of Medicare, one needs to purchase a plan with a monthly fee. Then Part D of Medicare covers drug presciption costs as explained. I am not trained to relate this information in a formal manner, yet have learned over many years the basics.

Always check with an official certified person for medical, legal and other important help about options and before signing onto a program if possible. Many states have qualified assistors to help one assess one's options currently and over time as needs may arise or changes occur in finances or support.

The handy booklet explores the common pattern of someone who needs more assistance as they age or have a condition that may factor into them going into a nursing facility. Often the person spends a great deal of their savings to pay for their own care (sometimes called Independent or Private Pay or Out of Pocket Coverage.)

The CT Home Care Program for Elders can help people afford to stay in their home or that of a family or friend with assistance for chores and activities of daily living (ADLs, such as getting dressed, bathing, toileting, eating, shopping, going to appointments and other household tasks.)

People who may qualify for these programs designed to help someone age in place in a home versus a nursing facility include CT residents who are age 65 or oler, meeting the program's 'functional criteria or being at risk for nursing home placement' as well as meeting the program's income  and asset guidelines.  A person must meet all of those criteria to qualify. Some people may be able to qualify as their financial or personal care situation changes if they do not initially meet the program guidelines.

To find out if someone qualifies, there are three steps to take. First, a person can call the toll free number, 800-445-5349 to start the screening process or learn more about the program guidelines.

If someone is in a nursing facility or are about to apply to one, the nursing facility can provide you with a Home Care Request Form. Hospital staff can also give this to someone in a hospital.

Sending in the form or calling will get the screening process started. If someone appears to meet income and asset guidelines, a Health Screen and Eligibility Determination Document/ Application needs to be completed before an eligibility determination can be made.

The second step is to have a Health Screen  completed. A person does not have to pay for this. The Health Screen is a brief evaluation of one's health status and daily living needs. The Health Screen is  Not a physical exam. If one is in the hospital, the staff may complete that for someone and return it with the Home Care Request Form to the Alternate Care Unit at the Department of Social Services, 11th Floor, 25 Sigourney Street, Hartford CT 06106.  A person may mail in the form if doing the Health Care Request Form and call for a Health Screen at 1-800-445-5394.

The third step is receiving the assessment of one's forms--the Health Screen( which should take less than a week) and if one qualifies for an assessment by a care manager.

If a person is not yet on State Medical Assistance (Title XIX or Title 19) an Eligibility Determination Document/Application or W1F would need to be completed if needed. Instructions on how to complete it would be given.

If an assessment is in order, a care manager will visit a person where one lives whether in a home or where one is staying in a nursing home or in a hospital.

After sharing more information and determining if one is interested in accessing the program, the care manager will gather detailed information about the person's health needs and living circumstances.

The care manager will assess what services a person may  need to remain at home or with someone at their home. Then the care manager will review what services may be available to help one reamin at home rather than go to a faclility.These may include homemaker and home health care services, chore services, meal delivery, adult day care center services and much more.

There are limits on how much the state can pay for home care services depending on one's needs. Depending on one's income, a person may be expected to contribute toward the cost of one's services. A care manager would inform someone of whether a person would need to pay for part of one's care.

In some cases, the Department may pursue a legally liable spouse to contribute to cover costs of the recipient of the program. The State of CT has the right to recover monies from the estates of individuals who receive services from this program, including any private insurance premium paid on behalf of the individual.

Remember, one needs to sign and return the CT Home Care Program for Elders Request Form to the Department of Social Services, Atlernate Unit BEFORE entering a nursing facility, even if one does not meet the income and asset guidelines. Also one has the right to appeal and have one's case reviewed if one disagrees with any action taken under this program.

For more information on the grievance procedure, ask your care manager or call the toll-free number, 1-800-445-5394. The final decision is The Person Receiving Help to receive any or all services offered. If there are questions from someone working on another's behalf, it is fine to call and make inquiries about the program or likely with written permission for others to help the primary recipient with the process.

The Fax Number is 860-424-5300. The office of the Alternate Care Unit of DSS is open Monday through Friday, 8:30 am to 4:30 pm. Every case is unique so making inquiries early and having attention to details may be helpful. The process can take a while so gaining information if not starting a process early can be useful.  As one may qualify, case managers can likely assist a person with many matters along these program and other guidelines.