The CBA program provides persons age 21 and older with meaningful choices regarding long  term care services.  This goal is accomplished primarily by facilitating the development and utilization of services which allow individuals to avoid premature nursing facility placement.  It also provides current nursing facility residents an opportunity to return to the community.  Individuals receive services through the CBA program that are necessary to provide a safe alternative to nursing facility placement. CBA provides SN, PT, OT, ST services; personal assistance services; payment for prescription drugs, adaptive aids, medical supplies and home modifications.

Principles and Practices:   

The principles and practices which form the foundation for the program are based on the following values:

Client Eligibility Criteria:

To be determined eligible by the Department of Aging and Disability Services (DADS) for the 1915 (c) Medicaid waiver program provided as an alternative to care in a nursing facility, an applicant must:

1)     be age 21 or above;

2)     meet the level-of-care criteria for medical necessity for nursing facility care;

3)     choose home and community-based services as an alternative to nursing facility placement based on an informed choice with approval conditional on feasible alternatives available under the program;

4)     have an individual plan of care for CBA services whose cost does not exceed 95% of the cost for nursing home care;

5)     meet the financial eligibility criteria. Be eligible for Medicaid and SSI benefits;

6)     have ongoing needs for CBA services whose projected costs, do not exceed the maximum service ceilings set for those services as listed below:

       a)  Adaptive Aides and Medical Supplies services category cannot exceed $10,000 per individual per Individual Plan of Care year;

       b)  minor home modifications services category cannot exceed $7500 per individual;

       c)   respite care cannot exceed 30 days per individual per Individual Plan of Care year;

7)     reside either in a home or in a licensed personal care facility or adult foster care home contracted with the Department of Aging and Disability Services to provide Community Based Alternatives (CBA) services. CBA services will not be delivered to residents of hospitals, nursing facilities, ICF-MR facilities, or unlicensed personal care facilities; and

8)     meet two or more of the below criteria:

       a)    assistance with one or more of the activities of dressing, personal hygiene, eating, toilet use, or bathing;

       b)   have a functional decline in the past 90 days;

       c)  have a history of fall two or more times in the past 180 days;

       d)   have a neurological diagnosis of Alzheimer’s, Head Trauma, Multiple Sclerosis, Parkinsonism or Dementia;

       e)   have a history of nursing facility placement within the last 5 years;

       f)   have multiple episodes of urine incontinence daily;