Who Qualifies for Home Health Care Financial Assistance in Oregon?

Individuals meeting certain low-income limits may qualify for home health care financial assistance in Oregon if they are eligible for the Program for All-Inclusive Care for the Elderly (PACE). PACE is a Medicare program and Medicaid service option designed to provide all-inclusive services for several health and care services.

PACE provides coverage for all necessary health care and long-term care services that are covered by Medicare and Medicaid. An Interdisciplinary Team (IDT) cooperates with eligible individuals and their families and care providers to create a custom care plan. The IDT may include doctors, registered nurses, licensed social workers and therapists, therapeutic aids, dietitians and other health care professionals.

Eligible individuals for PACE must meet the program’s five criteria to receive services. They must be 55 or older, assessed at the Oregon Service Priority Level (SPL) 1-13, be deemed safe to live in the community, be eligible for Medicaid or Medicare, live in a PACE service area and be willing to receive all of their health and care services through PACE.

Individuals who meet these criteria receive all medically necessary and long-term care services. Those who qualify for Medicare are responsible for a monthly premium but do not pay additional co-pays or deductibles. Those who qualify for Medicaid have all services covered. Those who do not qualify for Medicaid or Medicare may opt to pay privately for PACE services.

PACE is designed to cover services that support individuals in their homes, such as bathing and grooming, or instrumental activities of daily living. Many services can be provided in-home for eligible individuals. By providing these services in the home, seniors may remain in their homes and communities longer, making it an ideal option for those hoping to age in place and whose doctors agree it is an appropriate option.

Some services covered include:

• Adult day services
• Transportation
• Social services
• In-home care
• Physical, occupational and speech therapies

Seniors who don’t qualify for PACE may qualify for Oregon Project Independence, a program designed to help people who do not receive Medicaid remain in their homes. To qualify, individuals must be at least 60 years of age or be any age with Alzheimer’s disease or similar disorders, not receive Medicaid services and live in Oregon. Adults aged 19 through 59 may receive assistance in specific counties if they have qualifying physical disabilities.

This program provides in-home support with activities of daily living or instrumental activities of daily living and may also fund assistive technology devices, adult day care, respite care or nursing services. This program requires participants to pay a portion of their costs on a sliding scale based on household income after monthly medical costs.