This program provides subsidy payments to help caregivers maintain low-income seniors in their own home or in the home of a caregiver. The senior must be at risk for nursing home placement. The monthly subsidy payment is made to the caregiver for support and health maintenance and to assist with specialized health care needs.

History

Home Care for the Elderly (HCE) seeks to prevent premature or inappropriate institutionalization by helping caregivers of frail, low-income seniors. HCE provides a financial subsidy to caregivers of persons aged 60+ who are eligible for nursing home care through Medicaid, but who are receiving care in a family-type living arrangement in the community.

There are two types of HCE subsidies. Basic subsidy is a set monthly payment made to the caregiver to assist with the general cost of providing care. The payment amount is based on the income of the person receiving the care, but is generally $106 per month. Special subsidy is a flexible payment that reimburses caregivers for purchases of special supplies, equipment, or services needed to maintain the health and well-being of the elderly person. This supplement is not received by every HCE client and varies in amount per month. HCE is managed by the lead agency in each county and subsidy payments are made through the Area Agency on Aging.

Your legal rights as a Caregiver

The provisions of sections 430.601 through 430.606, Florida Statutes as created by Chapter 95-418 Laws of Florida, establish the HCE Program. The legislative intent is to encourage the provision of care for the frail elderly at risk of institutionalization in family-type living arrangements in private homes.

Chapter 58H-1, Florida Administrative Code (F.A.C.), Home Care for the Elderly Program, is the promulgated rule mandated by Section 430.603, F.S.

Service provided

• Basic Subsidy Basic Subsidy is a monthly payment for support and maintenance, to assist with the cost of housing, food, clothing, and incidentals, not covered by Medicare, Medicaid and other insurance.
• Case Management begins with initial client intake and continues through the application process, assessment of need, service planning for client, provision or arranging for provision of services, review and reassessment of client need, and revision of service plans as appropriate.
• Chore is defined in Home Care for the Elderly as performance of house or yard tasks including such jobs as seasonal cleaning, essential errands, yard work lifting and moving, simple household repairs, pest control, and household maintenance for eligible persons who are unable to do these tasks for themselves because of frailty or other disabling conditions.
• Counseling in Home Care for the Elderly uses the casework mode of relating to a client (via interview, discussion or lending a sympathetic ear) to advise and enable the older person and/or his/her family to resolve problems (concrete or emotional) or relieve temporary stresses encountered by them. This may be done on a one-to-one basis or a group basis and may be conducted by paid, donated, and/or volunteer staff.
• Education and Caregiver training/support service is designed to encourage the provision of day to day care for the client by the persons in his/her family and social circle. The goal is to instruct the caregiver with the training needed to assist the client in activities of daily living. Caregivers are any persons within the family and social structure who provide care for the HCE participant, on a 24 hour basis.
• Home Delivered Meals in Home Care for the Elderly is a hot, cold frozen, dried, canned, or supplemental food (with a satisfactory storage life) meal that meets one-third of the current daily Recommended Dietary Allowances, served in the home to a functionally impaired homebound older person.
• Home Health Aide service for Home Care for the Elderly is defined as the provision of medically oriented health care services by a trained home health aide employed by a licensed home health agency to an individual in the home under the supervision of a health professional.
• Homemaker in HCE means the accomplishment of specific home management duties including housekeeping, meal planning and preparation, shopping assistance, and routine household activities by a trained homemaker.
• Home Nursing service is part-time or intermittent nursing care administered to an individual by a licensed practical nurse, registered nurse, or advanced registered nurse practitioner, in the client's place of residence, pursuant to a plan of care approved by a licensed physician.
• Housing Improvement involves environmental modification or physical adaptation made to a home to ensure the health and safety of the client and enable optimal functioning for independence. These modifications include any changes to the structural design of the home that have a direct medical or remedial benefit for the client for the prevention of premature institutionalization. Repairs to the home which enable the caregiver to correct hazardous situations revealed in the home study are also included, funding permitting.
• Medical Therapeutic Services in Home Care for the Elderly are those corrective or rehabilitative services which are prescribed by a physician or other appropriate health care professional. Such therapies are necessary services for individuals who have suffered physical damage or debilitation due to disease, trauma or advancing age and may include occupational therapy, physical therapy, respiratory therapy, and services for individuals with speech, hearing and language disorders.
• Medical Transportation under Home Care for the Elderly is defined as the provision of rides and/or escort services to and from medical services. Medical Transportation services are defined as visits to physicians, dentists, psychiatrists, physical therapists, clinics, hospitals, mental health centers, pharmacies, medical supply houses, or any similar facility or service provider. The service can include intermediate stops to fill prescriptions and buy medical supplies in conjunction with such visits.
• Other Services not defined yet under HCE may be used. Advise the AAA and DOEA on what the service is prior to reporting it for payment.
• Personal Care in HCE means services to assist the functionally impaired elderly with bathing, dressing, ambulation, housekeeping, supervision, emotional security, eating and assistance with securing health care from appropriate sources.
• Respite in Home Care for the Elderly is defined as a demand for relief or rest from the constant/continued supervision for the caregiver, companionship, therapeutic and/or personal care for a functionally impaired older person for a specified period of time.
• Medical Supplies/Services are supplies and medical services used by the client, caregiver, or service staff, which are essential to adequately care for the needs of the client. These supplies and medical services enable the client to perform activities of daily living or stabilize or monitor a health condition. These are supplies and medical services that are not covered by traditional Medicaid Medical Supplies/Durable Medical Equipment/Medical Services programs for adults. Examples of supplies are diapers, bed pans, mobility aids and nutritional supplements. Examples of medical services are pharmaceuticals and oxygen.