The Includes Those Family Assistance Services and Related Programs That Support Quality of Life

Home- and Customs-Based Services (HCBS) are types of person-centered care delivered in the home and customs. A variety of health and human services can be provided. HCBS programs address the needs of people with functional limitations who demand assist with everyday activities, like getting dressed or bathing. HCBS are often designed to enable people to stay in their homes, rather than moving to a facility for care.

HCBS programs generally fall into ii categories: health services and homo services. HCBS programs may offer a combination of both types of services and do not necessarily offer all services from either category.

Types of HCBS Care

Health Services run across medical needs

• Home health intendance, such equally:
  • Skilled nursing care
  • Therapies: Occupational, speech, and physical
  • Dietary management by registered dietician
  • Chemist's
• Durable medical equipment
• Instance management
• Personal care
• Caregiver and customer training
• Health promotion and illness prevention
• Hospice care (comfort care for patients likely to die from their medical weather)

Homo Services support daily living

• Senior centers
• Adult daycares
• Congregate meal sites
• Home-delivered meal programs
• Personal care (dressing, bathing, toileting,eating, transferring to or from a bed or chair, etc.)
• Transportation and access
• Home repairs and modifications
• Home safety assessments
• Homemaker and chore services
• Information and referral services
• Financial services
• Legal services, such as assist preparing a will
• Telephone reassurance

Creating and maintaining an HCBS programme benefits the community and the individuals served in many means. Even so, at that place are several challenges to consider that come forth with this blazon of program.

Benefits and Challenges of HCBS

Benefits

• Price effectiveness: usually less than half the cost of residential intendance
• Culturally responsive: spiritual and cultural activities and support available
• Familiarity: patient enjoys the comfort of their ain home or small residential facility in the community
• Can provide counseling or clergy to assist with bereavement
• Some waivers allow family members to be paid caregivers

Challenges

• Access to providers
• Availability of qualified caregivers
• Caregiver burnout
• Lack of 24/7 medical professional availability
• Nonfamily caregivers may have limited access in remote locations, especially during winter
• Potential cultural bias or barriers in the acuity assessment process
• Skilled nursing care includes merely medical services performed by a registered nurse. Other daily tasks fall primarily to family members
• Those needing intendance do not always want family members to act every bit their caregivers due to potential for corruption or fiscal manipulation
• Tribes demand to consummate processes that are ofttimes long and complex, such equally creating an elderberry corruption code or establishing a memorandum of agreement with the state, to create an HCBS program

Learn more than about HCBS at Medicaid.gov.

Frequently Asked Questions

Who is Eligible for HCBS?

Eligibility varies by state. Run across the State Resources Map to acquire more.

Who Funds HCBS?

HCBS programs are often funded by land waivers. Waivers are part of a land'due south Medicaid program, but they provide a special group of services to a certain population. Waivers commonly crave medical and fiscal eligibility, only state waiver eligibility requirements may non be exactly the aforementioned as state Medicaid eligibility. Other funders for HCBS might include your tribe or private long-term care insurance held by your patients.

Resource

Check these resources for more information on funding for HCBS:

• Medicare Special Needs Plans may cover people who receive nursing intendance as function of the abode-based services they need. Learn more well-nigh these plans and how they work.
• Read an overview of HCBS waivers at Medicaid.gov.
• Learn more than about using land waivers as a style to fund LTSS.

Who Runs HCBS Programs?

Inside individual states, HCBS care is provided past pb agencies and other service providers. A lead bureau acts as the primary care coordinator for its region—for example, a canton's department of human and social services. A tribe can apply with its state to become a pb agency, based on land eligibility requirements.

Service providers contract with the lead agency in their surface area to provide services. If a tribe is not a pb agency, it volition contract with the appropriate county, state, or managed care system in its region to provide services and coordinate intendance.

To more fully access Medicaid and land HCBS, the Oneida Nation became the atomic number 82 agency for a land waiver. Read their story.

Acquire More than Nigh HCBS

The HCBS model tin can include many kinds of programs and types of care. For tribes but first to provide LTSS in their communities, or tribes who do not take the resources to consider facility-based care, HCBS can be a good identify to beginning.

There are many possible approaches for your program, and many ways that programs tin partner together to provide a wider range of services to their communities.

Special HCBS Programs

CMS offers several national programs that can back up certain types of HCBS in tribal communities:

Program of All-Inclusive Intendance for the Elderly (PACE) combines many services into one comprehensive program and oftentimes combines Medicare and Medicaid eligibility.

Money Follows the Person (MFP) Rebalancing Demonstration Grant includes a tribal initiative that focuses on building HCBS specifically in Indian Country.

Examples in Indian Country

At that place are many examples of successful HCBS programs in Indian Country. Check out some of these resources to run across what other programs are doing:

• Watch Tanana Chiefs Conference Customs Wellness Outreach Program-a video contour on HCBS in rural villages in the Alaskan interior.
• View Chickasaw Nation Elder Wellness Programs-a webinar on the holistic HCBS programs provided by Chickasaw Nation to support quality of life for elders.
• Spotter Phoenix Native Wellness-a video contour on an urban Indian health program that provides HCBS to over 300 tribes.
• Read a profile page on the network of HCBS offered by Zuni Pueblo through a variety of partnering agencies.
• Acquire nigh the Cherokee Nation's successful Pace program.
• Read Long-Term Services and Supports in Indian Land: Issues Affecting American Indians and Alaska Native Consumers with Disabilities (PDF)-a report containing many helpful programme examples.
• Read Supporting American Indian and Alaska Native People in the Customs: Opportunities for Dwelling house- and Community-Based Services in Indian Country. (PDF)

Transitional Intendance

Transitional care is the process of maintaining quality of care while elders and persons with disabilities transition to or from hospital or nursing habitation facilities and residential or home settings.

The purpose of transitional care is to prevent gaps in intendance for an private moving from ane intendance system to another to ensure the transfer is successful. The process includes a review of the person's health condition, medication management, and follow-up intendance.

Transitional intendance occupies an increasingly important role every bit HCBS becomes the LTSS delivery machinery of choice.

There are several prove-based models to support intendance transitions, including:

• Better Outcomes for Older Adults through Safe Transitions (BOOST)
• The Bridge Model
• Care Transitions Intervention (CTI, or "Coleman Model")
• Geriatric Resources for Assessment and Care of Elders (GRACE)
• Guided Care®

Transitional Care Resources

To larn more about options for providing transitional care, check out these additional resources:

Habitation-based Care for Makah Tribe Elders

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Source: https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/LTSS-TA-Center/info/hcbs

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