State launches new Medicaid in-home services option, expands choices for support

A new home-care option is being introduced for adults who qualify for Medicaid-funded in-home services and supports.

The new option, called Agency with Choice, was created by Oregon House Bill 4129. It is for people who are eligible for Medicaid long-term services and supports through the Oregon Department of Human Services (ODHS) and Oregon Health Authority (OHA).

Agency with Choice provides help with managing the recruitment, required training, scheduling, and supervision of an in-home care provider including supporting individuals with their back-up care needs. Agency with Choice is one of several in-home care options now available for people eligible for Home and Community Based Services through the ODHS Office of Aging and People with Disabilities (APD). It is also available to individuals served through OHA Behavioral Health Division's Home and Community Based Services.

"Agency with Choice builds on Oregon's commitment to honoring the preferences of older adults and people with disabilities," said APD Director Nakeshia Knight, Ph.D. "It joins a broad continuum of long-term care options designed to help people receive the right level of support in the way that works best for them."

APD's Agency with Choice program is for individuals who:

• Are age 60 or older;
• Are age 18 and older with a disability;
• Qualify for Medicaid long-term services and supports through APD; and
• Choose to receive these services and supports in their own home.

Individuals who are currently eligible for these services received a letter from APD describing the new option. There are no changes being made to other in-home care options.

OHA's Agency with Choice option is available to individuals with mental health conditions who are eligible for Medicaid-funded in-home personal care services. Individuals of all ages can enroll in Agency with Choice if they are eligible for personal care services through the State Plan Personal Care program. Individuals age 21 and older may also enroll in Agency with Choice if they get services through the 1915(i) Home and Community Based Services (HCBS) program.

To qualify for 1915(i) HCBS, individuals must:

• Be age 21 or older;
• Have a current diagnosis of a Serious Mental Illness (SMI) as defined in OAR 410-173-0005;
• Have the need for help in at least two instrumental Activities of Daily Living; and
• Require the provision of one or more 1915(i) services at least monthly.

As directed by HB 4129, APD and OHA provide Agency with Choice through a contractor. GT Independence was selected through a competitive process managed by OregonBuys to provide Agency with Choice in Oregon.

Links to online and other resources for more information

• Read an online flyer about Agency with Choice offered through APD and find it in other languages on this ODHS web page.
• Learn about APD long-term services and supports care options on the ODHS website. Explore in-home options for receiving Medicaid long-term services and supports.
• Learn about 1915(i) HCBS, including OHA's mental health residential and personal care services in the home on the 1915(i) HCBS website. Oregonians who may qualify and have questions should contact OHA's 1915(i) Policy Unit at [email protected].
• Inquire about a referral or assessment for mental health personal care for State Plan Personal Care or 1915(i) HCBS at Comagine Health at [email protected].
• Learn more about GT Independence on the company's website and its Oregon services website.
• Contact a local office serving older adults and people with disabilities using the ODHS office locator tool.
• Learn about other help available for older adults and people with disabilities by visiting the Aging and Disability Resource Connection of Oregon's website.