The Alabama Department of Senior Services (ADSS) is the operating agency for several Medicaid Waiver Programs. These programs provide home and community-based services to individuals whose needs would otherwise require care in a nursing facility. The services provided through these programs allow individuals to remain in the community. To access waiver services, individuals must have Medicaid coverage or meet financial eligibility criteria and qualify medically.
Medicaid Waiver for the Elderly and Disabled (E&D Waiver)
The Elderly and Disabled Waiver program provides services to the elderly and individuals with disabilities at risk for nursing facility placement. Case managers work with clients to develop a person-centered plan of care based on the client’s medical needs. Depending on their plan of care, individuals in this program may receive personal care, homemaker, respite, adult day health, companion services, and/or home-delivered frozen meals.
Personal Choices provides self-directed home and community-based services. It is designed to offer older adults and individuals with disabilities more choices and flexibility in the type of care they receive. Clients enrolled in the program can use their allotted budgets to get the personal care they need. They can also save for other items that sustain or improve their health.
View the ADSS Personal Choices Program Page here.
View the ADSS Personal Choices brochure here.
The ACT waiver provides services to individuals with disabilities or long-term illnesses who live in a nursing facility and wish to transition to a home or community setting. ADSS works with Medicaid Transition Coordinators and ACT Case Managers to facilitate the transition of clients from the nursing home back into the community. A variety of services is available to ensure a successful transition into the community and to provide ongoing care in the community based on the client’s medical needs. Most transitions occur within 180 days of the application date.
The TA waiver provides services to individuals age 21 or older with complex skilled medical conditions who are ventilator dependent or have a tracheostomy and who would otherwise require care in a long-term care setting to remain in the community. The plan of care and case management services are based on individual client needs. ADSS provides targeted case management for the TA program. Services include private duty nursing, personal care/attendant service, medical supplies, assistive technology, and targeted case management.
ADSS continues to work with the Alabama Medicaid Agency on a case management system called the Primary Care Case Management (PCCM), which promotes a person-centered approach to care delivery while assisting in the management of the medical and Long-Term Services and Support (LTSS) needs of Medicaid clients. It supports clients receiving LTSS in the least restrictive setting of their choice. The program operates as a section 1915(b) waiver and includes participants in the Elderly and Disabled Waiver Program and the Alabama Community Transition Program, as well as individuals residing in institutional settings. The program is called the Integrated Care Network, and the provider selected to manage the program is the Alabama Select Network (ASN). ADSS works closely with ASN to refine processes that help our clients receive the care they need in a timely manner and meet the goals of the program. Those goals are: to Improved education and outreach about LTSS options; More comprehensive and integrative case management; and Increased percentage of the LTSS population residing in the HCBS setting.
Hospital To Home Program
Hospital to Home helps individuals return home after a hospitalization. Ideal candidates for Hospital to Home are full Alabama Medicaid beneficiaries who are admitted from home to an acute-care facility and are at risk of permanent placement in a long-term care facility.
Available Services
Services may vary according to program and additional services may be available other than those listed.
Case Management: A case manager is a person who works with the client to determine what help is needed to remain safely at home. The case manager makes changes in services when needed and keeps the client informed of all available resources.
Personal Care: Personal care services help clients with daily activities such as bathing, dressing, and eating.
Homemaker Services: Homemaker services provide assistance that will help maintain a safe and clean home environment.
Companion Services: Companion services are for clients who cannot perform activities of daily living without additional support or supervision.
Respite Care: Respite care provides relief for caregivers who care for individuals who are unable to care for themselves. Respite Care can include skilled and unskilled care.
Adult Day Services (where available): Adult day services are available in some areas and are designed to maintain and promote the health of the client through individual group activities.
Nutrition and Meals: This service is designed to provide meals if needed. Each meal provides approximately 1/3 of the recommended daily nutritional values set forth by national standards.
For more information contact your local Area Agency on Aging (AAA) and Aging & Disability Resource Center (ADRC) at 1-800-AGE-LINE (1-800-243-5463) or click here.