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What are Community-Based Services?

As part of long term care, many communities provide services and programs to help seniors and people with disabilities with a variety of personal activities. These services include Meals-on-Wheels, transportation services, personal care, chore services, adult day care and a variety of activities in senior centers. These services are usually free or at low cost to individuals who qualify. Local organizations, called Area Agencies on Aging, coordinate these services to promote the independence and dignity of older adults.

Your State Medicaid program may pay for home health services including skilled nursing care, home health care, personal care, chore services, and medical equipment. You must qualify for Medicaid to receive these services.

The following community-based services may be available in your community:

  • Adult day care

Adult day care services provide health, social, and recreational activities in a supportive setting for adults who have functional and/or cognitive impairments that do not need 24-hour care. Some programs offer services in the evenings and on weekends, in addition to standard business hours. Programs may provide services for individuals with specific impairments such as Alzheimer's or mental illness.

Services include health monitoring - blood pressures, food or liquid intake, weight; assistance with walking, toileting or taking medications; social activities mental simulation; meals and snacks; exercise activities; safe and secure environment; personal care - bathing, shampoo or shaving; Alzheimer's or dementia care; transportation to facility and activities.

State Medicaid programs may pay for health care that is provided in State licensed facilities, including therapy services, mental health services, administration of medications, psychological evaluations, dressing of wounds, and assistance with feeding. Private long-term care insurance may also pay some of these costs, but Medicare will not.

  • Senior centers

Senior centers are located in many communities to provide a wide range of services to you. The Administration on Aging, U.S. Department of Health and Human Services estimates that there are from 10,000 to 16,000 senior centers located throughout the U.S. Senior centers provide a varying array of services, including nutrition, recreation, social and educational services, wellness and fitness activities, information and program referral services, and Internet training. Most of the services are provided free or at low cost to participants.

  • Financial management
  • Transportation

Transportation services are available in many communities through aging services programs, regional mass transportation systems, and private sources. These services may include door-to-door taxicab services, public bus transportation, or vans with wheelchair accessible transportation.

Medicare does not pay for any transportation services except ambulance services, but Medicaid may pay for transportation services to get you to a medical appointment if you are eligible. Fees for transportation services are generally small and often people pay out-of-pocket for transportation services.

  • Meals On Wheels
  • Telephone reassurance

Individuals who live alone and have medical or other health needs may fear that they would not be able to summon help in an emergency. Several types of emergency telephone response systems address this concern.

Emergency response systems use the telephone to check on an individual on a regular basis. A family friend, relative, or professional service may make a daily call at one or more set times throughout the day. This telephone reassurance program may be free to you because a family member or friend provides this service or it is provided by your state or local aging organization.

If you did not answer the phone, the check-in caller would be alerted to a possible problem. If the caller detected a change in condition or voice based on regular contact with you, the caller would take appropriate action.

Commercial emergency response systems may also available. These services require that you wear a beeper on your wrist or around your neck. If you have a fall or other emergency, the press of a button would alert the 24-hour response system. This system requires that you pay an initial fee and a monthly fee of $25 to $40 for this service.

  • Case management

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