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Medicaid Coverage, Care, and Services

HOME AND COMMUNITY BASED LONG-TERM CARE is:

  • A range of medical and non-medical services, from personal care to nursing care;
  • Provided in the home or the community;
  • Sufficient to rehabilitate or compensate for loss of independent physical or mental functioning;
  • For people of all ages with chronic illness or disabilities (physical, mental or developmental);
  • For a short period of time to a lifetime; and
  • Necessary so that an individual may function at his or her maximum level of ability.

MEDICAID COVERAGE of home- and community-based long-term care is provided through 3 routes: (1) Medicaid State Plan, (2) Home Care for Children with Severe Disabilities, and (3) HCBC waiver.

THE 4 NEW HAMPSHIRE HCBC WAIVERS

  • HCBC-DD (developmental disability)
  • HCBC-ECI (elderly & chronically ill)
  • HCBC-ABD (acquired brain disorder)
  • HCBC-Children with developmental disabilities

MEDICAID ELIGIBILITY FOR HOME & COMMUNITY-BASED LONG-TERM CARE

Medicaid State Plan Home Care for Children
with Severe Disabilities (HC-CSD)		 HCBC Waiver
  1. General Requirements
  2. Categorical Requirements
  3. Financial Requirements
  1. General Requirements
  2. Categorical Requirements
  3. Financial Requirements
  4. Requires the level of care provided in an institution
  5. Cost of care is no more than the institutional cost of care
  1. General Requirements
  2. Categorical Requirements
  3. Financial Requirements
  4. Requires the level of care provided in an institution
  5. Cost of care is no more than the institutional cost of care

General Requirements include residency, social security number, developing potential income.
Categorical Requirements include being blind, disabled or aged.
Financial Requirements include asset tests for income and resources.

MEDICAID LONG-TERM CARE SERVICES

Medicaid State Plan & HC-CSD HCBC Waiver (services vary with waiver)
Home Health
  Nursing Services
  Nursing Assistant Services
  Medical Supplies & Equipment
Personal Care
Physical, Occupational & Speech Therapies
Adult Day Care
Case Management
Crisis Intervention
Environmental Modifications
Habilitation
Home Health 		Homemaker
Personal Care
Personal Emergency
Response
Respite
Supported Employment

MEDICAID LONG-TERM CARE COST COMPARISONS ' FY 2001

Nursing Home Care Waiver Care
Total Cost$209,805,127
Cost Per Capita (state population)$166.64
Number of Participants4,962
Average Cost Per Participant$42,282
Number on Wait List as of 9/30/030
$137,743,635
$109.41
4,301
$32,026
348 for HCBC-DD
14 fir HCBC-ABD