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10/22/2015 10:17 AMMADISON, CT – Senator Ted Kennedy, Jr. (D-Branford) was joined by Department of Social Services Commissioner Roderick Bremby in Madison Oct. 20 to talk about the successful "Fast Track" pilot program they implemented earlier this summer. This program has already helped many seniors receive prompt approval for home health care and avoid costly nursing home or hospital stays.
"By expediting home care applications, we are ensuring that people get the care they need as soon as possible, all while saving taxpayer dollars," said Senator Kennedy. "More Connecticut seniors can benefit from receiving care in their own homes when we can implement creative solutions together. I have made it a priority to work with DSS on expedited eligibility for this program so that we can save public money while ensuring that seniors eligible for home care services can receive them promptly. I am grateful to Commissioner Bremby and the DSS staff for their dedication to this innovative program."
"Simply put, the Fast Track pilot is a way to speed up and streamline access to home care services for eligible Connecticut residents," said Commissioner Bremby. "It doesn't apply to all applications, because this is one of the most complex areas of Medicaid eligibility. But for many of the application without complex documentation needs, we are getting vital services to people faster and more effectively. We greatly appreciate the interest and involvement of Senator Kennedy in this initiative. He rolled up his sleeves and worked directly with our professional staff to help determine the best approach to addressing this need."
"VNA Community Healthcare's mission is to help individuals live safely at home, that is why we are so excited about this new proposal put forth by Senator Kennedy. Allowing older adults access to home and community based services faster will enable them to stay at home and out of institutions," commented Janine Fay, President & CEO of VNA Community Healthcare and its affiliates, Strong House Adult Day Center of Madison and Lifetime Care at Home, making the agency one of the largest nonprofit home healthcare agency in the state.
The Fast Track approval program went into effect this July with the goal of streamlining home care applications to promote timely home care accessibility and prevent taxpayer spending on costly institutional care. In the programs first three months of operation, 127 applicants have been served with expedited homecare services through Fast Track. DSS is currently working with applicants and community agencies to increase the rate of Fast Track approval.
During the 2015 legislative session, Kennedy introduced Senate Bill 271 to establish a financially prudent, data-driven presumptive eligibility pilot program within the Connecticut Home Care Program for Elders (CHCPE) that would provide expedited eligibility determinations so that seniors can receive home and community-based services as an alternative to nursing home care.
In response, the Department of Social Services implemented "Fast Track" to eligibility for the CHCPE, modeled after the program laid out in Senate Bill 271. This accelerated eligibility pilot program will allow DSS to preliminarily determine an applicant's eligibility for home care services within two to three business days after the applicant is identified as "Fast Track Eligible." This pilot program began in July and is expected to run for at least six months. The pilot program allows DSS to evaluate cost savings and determine best practices for offering a state-wide Fast Track program in the future.
Currently, if a person goes into a nursing home, they may receive nursing home care while their application for Medicaid is pending. Once they are deemed eligible for Medicaid, the nursing facility is retroactively paid for services from the date of application. However, if a person is living in the community and applies for Medicaid-funded home care, the person does not receive any services paid by Medicaid and can wait for months while their application is processed, depending on the complexity of their finances. This can lead to premature entry into nursing home care, with Medicaid footing the bill.
Expedited approval aligns with Connecticut's commitment to prioritize choice in where and how people receive long-term services and supports. Connecticut has set a goal of having 75% of senior care be done at home, with only 25% of care being given at a nursing home. Increasing access to home care saves taxpayer money while providing better and more appropriate services for clients. The average Medicaid cost per day for home care is $58, according to the legislative Office of Fiscal Analysis, compared to an average daily cost of $205 for a nursing home stay.
While DSS is largely compliant with federal standards on timely processing of long-term care applications, faster approval of CHCPE applications is estimated to save over $6,000 each month for each senior who is diverted from a skilled nursing facility.
Applications for long-term care are complicated in that they involve a five-year 'look-back' period as part of the eligibility process, to prevent fraud and to ensure that applicants have not made inappropriate transfers of assets to quality for publicly funded services. The state's standard of promptness for processing long-term care applications is 45 days if the client has provided all documentation necessary. At times, the process can extend beyond 45 days when there is need for further documentation. The DSS pilot spurred by Senator Kennedy's initiative is helping expedite the less complex applications and begin home care services more quickly.
Connecticut seniors can apply for the Connecticut Home Care Program for Elders (CHCPE) Medicaid waiver program if they find themselves at risk of nursing home placement and are in need of financial assistance. If approved for the program, seniors can continue to live at home while having their individual health needs met through a variety of services, including home delivered meals, companion services, access to adult day health centers, personal care attendant services, homemaker assistance and more.
Consumer information about CHCPE is available from the Department of Social Services at 1-800-445-5394 (toll-free); or www.ct.gov/dss/chcpe.