More than 1,000 people in Tennessee will be able to receive assistance for home-based or community-based elderly care on Oct. 1 when a freeze on Medicaid money is lifted.
But within the next year, the state plans to implement a new program -- called Choices -- to replace the Medicaid program and provide more people with more options for long-term care.
Unlike Medicaid's current Home and Community Based Services Waiver, which gives financial assistance to 6,000 people in Tennessee for community-based and home-based care, Choices will provide the option of home- or community-based services to as many elderly and disabled residents as the state can afford, officials said.
"The whole idea is to offer Tennesseans more choices when it comes to long-term care needs," said Kelly Gunderson, director of communications for TennCare, which handles Medicaid in the state. "This will allow more Tennesseans who want to stay at home the ability to do so."
A freeze was put on the home and community waiver in May 2009 when people filled all 6,000 slots.
The slots came available July 1, 2008. By mid-May 2009, there were more than enough applicants to fill them and the waiver was closed, TennCare officials said.
State officials expect the new program to save money because it will "allow more people to remain at home and access those services if they choose to do so," she said.
Under Choices, patients can receive 24-hour care in a nursing home, visit an adult day care center in their community or remain in their homes, Ms. Gunderson said. Through the program, they can receive assistance such as aides for bathing, homemaker services to help with house cleaning and home-delivered meals, she said.
However, the cost of the services has to be the same as or cost less than living in a nursing home, she said.
Choices will be implemented in Nashville and the Middle Tennessee area by March 1, 2010, she said, while areas in West and East Tennessee, including Memphis, Knoxville and Chattanooga, are expected to be operating by late 2010.
"That's great," said Sharon Kelley, owner of Kelley's Senior Services in Chattanooga. "Many people have just been on the waiting list unable to be served."
Between the two programs, Ms. Kelley said, she may be able to provide care for least eight people who are on her waiting list for adult day care services in Cleveland, Tenn. The people have been unable to get state funding for long-term care services because there's been a freeze on Home and Community Based Services Waiver funding, she said.
Chris Grant, director of planning and communications at Alexian Brothers' PACE (Program of All inclusive Care for the Elderly), said the extra services are needed.
"There haven't been a lot of choices in Tennessee, so it's good that this is opening that up," she said.
DaNessa Cartwright, CEO of Caring Hearts Adult Day Care, said her center serves about 20 people a day but it could serve twice as many if funding is provided.
"Hundreds of people across the state have been waiting," Ms. Cartwright said.
CARE FOR ELDERLY
* Oct. 1 -- About 1,100 Home and Community Based Services Waiver slots will become available
* March 2010 -- Home and Community Based Services Waiver replaced by Choices; implementation will start in Middle Tennessee
* Late 2010 -- Choices program expected to be implemented in West and East Tennessee
BY THE NUMBERS
* $51,961 to $56,794 -- The cost TennCare pays per person each year for nursing home care. The lesser amount is for more active residents. The higher amount is for those who require closer attention.
* $12,000 to $15,000 -- The cost TennCare pays annually per person for Home and Community Based Services.