Services Help in the Home Eligibility Assessment

Eligibility Assessment

PCA conducts a thorough in-home assessment of an older adult’s physical, mental, social and functional abilities and needs, using evidence based assessment tools approved by the Pennsylvania Department of Aging to quantify level of care and needs in the home. There are two primary options for long-term care services in the home that can be accessed through PCA, based on the person’s care needs and financial resources: Community HealthChoices (CHC) and the OPTIONS program.

What is Community HealthChoices?

Community HealthChoices is Pennsylvania’s mandatory managed care program for dually-eligible individuals and individuals with physical disabilities. CHC was developed to: 1. Enhance access to and improve coordination of medical care and; 2. Create a person-driven, long-term support system in which people have choice, control, and access to a full array of quality services that provide independence, health, and quality of life. Long-term services and supports (LTSS) help eligible individuals to perform daily activities in their homes such as bathing, dressing, preparing meals, and administering medications.

For the Community HealthChoices program, services are provided at no charge to the individual. To qualify, participants:

• Must be a Pennsylvania resident
• Must be a U.S. citizen or lawful resident
• Must be age 21 or older
• Must meet nursing-home level of care
• Must meet income and asset requirements

What is the OPTIONS program?

OPTIONS is a program that allows individuals to receive services and supports in their homes and communities. Funded primarily through the Aging Block Grant, the OPTIONS Program serves individuals who are either financially or clinically ineligible for Medical Assistance Long-Term Services and Supports. OPTIONS services are provided to eligible consumers age 60 and older to assist them in maintaining independence at the highest level of functioning in the community. All other resources (individual, local, state and/or federal) will be considered and utilized before OPTIONS services are provided.
To qualify for the OPTIONS program, participants:

• Must be a Pennsylvania resident
• Must be a U.S. citizen or lawful permanent resident
• Must be age 60 or older
• Must experience some degree of frailty in regard to physical and/or mental status that impacts daily functioning