Who Qualifies for Home Health Care Financial Assistance in Washington?

Individuals in Washington may qualify for home health care financial assistance if they qualify for Apple Health, Washington’s Medicaid system and also have a qualifying chronic condition. Those under Washington Apple Health Classic Medicaid coverage may qualify for Health Home, a program that covers support services for long-term support needs. Additionally, the New Freedom waiver allows seniors living in certain counties the ability to direct their care and manage their service budget.

Individuals who qualify can receive services to offer assistance with activities of daily living and instrumental activities of daily living. They may also receive services such as skilled nursing and therapy services in the home. As a result, seniors who may otherwise need to move into a care home can remain in their homes and communities with the additional support provided by these programs.

The Health Home Program is designed to provide in-home services to eligible Medicare and Medicaid enrollees to improve health outcomes and cost savings. Apple Health clients of all ages with at least one chronic condition, are at risk of another and have a PRISM predictive risk score of 1.5 may qualify for the Health Home program.

Qualifying seniors can receive a person-centered health action plan, receive support for self-managing chronic conditions and receive care coordination and transitions as needed. All of this culminates in fostering independence and keeping seniors in their homes. Enrollees work with Health Home Care Coordinators, who keep enrollees engaged and set health action goals and plans to promote good health. Together, the enrollee and Health Home Care Coordinator create a Health Action Plan that guides the eligible individual’s care. This program covers specific services, including:

• Care management
• Care coordination
• Health promotion
• Comprehensive transitional care
• Individual and family support
• Referrals for community and social services support

New Freedom is a Medicaid-funded program allowing eligible individuals to manage their own service plan and budget so they can receive services in their homes. Individuals who receive long-term care waiver programs can voluntarily opt into New Freedom. This program grants eligible individuals the chance to control their budget and choose the best services to meet their individual care needs. However, this program is currently limited to King and Pierce counties in Washington.

Eligible individuals receive a budget and spending plan based on needs and preferences and then can hire their own personal care aides, specialized therapies, personal assistance services, caregiver training, environment modifications and assistive goods and services.