MN Alternative Care

The Alternative Care (AC) Medicaid Waiver program is crucial in healthcare by offering essential home and community-based services to individuals aged 65 and older. It is specifically designed for those who require the level of care typically provided in a nursing facility but prefer to remain in their communities. Notably, the program also extends support to family caregivers who dedicate their time and effort to caring for their loved ones.

Overview of the Alternative Care Medicaid Waiver

The Alternative Care (AC) Medicaid Waiver is a vital program that aims to provide elderly individuals aged 65 and older with an opportunity to receive long-term care services in their homes or communities instead of moving into a nursing facility. The program caters to those who need a level of care typically found in such facilities but prefer to maintain their independence and live in familiar surroundings. The AC program strives to promote a sense of autonomy and dignity among its beneficiaries by offering home and community-based services.

The AC Medicaid Waiver is a crucial lifeline for individuals who are not yet financially eligible for Medical Assistance (MA) but require support in daily living activities and healthcare management. Through this waiver, participants gain access to services tailored to their unique needs and preferences, allowing them to live fulfilling lives within their communities.

The overarching goal of the AC program is to enhance the quality of life for elderly individuals, ensuring they can age in place comfortably while receiving the necessary care and support. By preventing unnecessary institutionalization, the program maintains the individual's sense of identity and belonging and reduces the strain on healthcare facilities and resources.

Eligibility Requirements for Alternative Care Medicaid Waiver

To qualify for the Alternative Care (AC) Medicaid Waiver, individuals must meet specific criteria, including:

1. Residency: Applicants must be residents of Minnesota.
2. Citizenship: Eligible candidates must be US citizens, US Nationals, or qualified non-citizens.
3. Ability to Pay Fee: In some cases, a fee may be applicable, and individuals must demonstrate the ability to pay it.
4. Age: Applicants must be aged 65 years or older.
5. Assessment for Nursing Facility Care: Individuals should undergo a long-term care consultation (LTCC) or MnCHOICES assessment, confirming the need for a nursing facility level of care.
6. Support Plan: Candidates must have a support plan to reasonably ensure their health and safety reasonably, considering the individual budget established based on their case mix classification.
7. Financial Eligibility: An individual's income and assets should be sufficient to sustain no more than 135 days of nursing facility services, and they should have no other payer for needed community-based services.
8. Exclusion Criteria: Individuals cannot be on AC if they are currently on Medical Assistance (MA) or have income less than or equal to 120% of the Federal Poverty Guidelines (FPG) with assets below the MA asset limit.

Temporary AC: The AC program can temporarily serve individuals who are financially ineligible for AC for up to 60 days under the following circumstances:

• They have submitted an MA application to their county or tribal office, pending processing.
• They have income less than or equal to 120% of the FPG and assets less than the MA asset limit.

Choosing between AC and MA: Individuals can choose between AC and MA if they meet all other program requirements for AC, have income greater than or equal to 120% of the FPG, and possess assets under the MA asset limit. They can decide which program best suits their needs and preferences.

Services and Supports under the Alternative Care Medicaid Waiver

The AC program offers a comprehensive range of services and supports designed to meet the diverse needs of its participants. These services aim to promote community living, enhance independence, and ensure the well-being of elderly individuals. The following list outlines the various services covered under the AC program:

1. Adult Companion Services: Providing social interaction and support for participants.
2. Adult Day Services: Offering daytime care and supervision in a group setting.
3. Adult Day Services Bath: Assisting with bathing for individuals attending adult day services.
4. Case Management: Coordinating and managing individualized care plans.
5. Case Management Aide: Assisting with non-medical tasks related to case management.
6. Case Management Conversion: Supporting transition from a nursing facility to community living.
7. Chore Services: Assisting with household tasks and activities.
8. Consumer Directed Community Supports (CDCS): Allowing participants to self-direct their services.
9. Discretionary Services: Additional services based on specific needs.
10. Environmental Accessibility Adaptations (EAA): Modifying homes for increased accessibility.
11. Family Adult Day Services (FADS): Adult day services provided by a family member.
12. Family Caregiver Services: Including caregiver training and counseling.
13. Home-Delivered Meals: Providing nutritious meals at home.
14. Home Health Services: Offering skilled nursing and home health aide assistance.
15. Homemaker Services: Assisting with household tasks and maintenance.
16. Individual Community Living Supports (ICLS): Supporting individuals with community activities.
17. Nutrition Services: Providing dietary guidance and support.
18. Personal Care Assistance (PCA): Assisting with personal care and daily living activities.
19. Personal Emergency Response Systems (PERS): Offering emergency response equipment.
20. Respite Care: Providing temporary care for caregivers to take breaks.
21. Specialized Equipment and Supplies: Supplying specialized aids for individuals with specific needs.
22. Transportation (Non-Medical): Assisting with non-medical transportation needs.

These services are crucial in empowering participants to lead fulfilling lives while residing in their communities and receiving the necessary support to maintain their well-being and independence.

Compensation for Family Caregivers

Under the Alternative Care (AC) Medicaid Waiver, compensation for unpaid family caregivers is available through the "Consumer Directed Community Supports" (CDCS) option. CDCS allows eligible participants to self-direct their services, which means they have the autonomy to hire and manage their caregivers, including family members. This self-directed approach enables family caregivers to receive payment for the care they provide to their loved ones. It is an essential recognition of family caregivers' valuable role in supporting the well-being and independence of elderly individuals. Through this option, the AC program aims to advocate for the fair compensation of family caregivers, acknowledging them as an integral part of the healthcare system and providing them with the compensation they deserve for their dedicated efforts.