DEPARTMENT OF SOCIAL SERVICES
CONNECTICUT HOME CARE PROGRAM FOR ELDERS (CHCPE)
Effective January 1, 2010

Service Level

Description

Functional Need

Financial Eligibility

Care Plan Limits

Funding Source

Category 1

 

Limited home care for moderately frail elders

At risk of hospitalization or short term nursing home placement
(1 critical need deficit)

Individual Income
= no limit

Assets:
Individual = $32,868
Couple = $43,824

<25% NH Cost
($1,399.00/mo)

but

(15% copay may apply eff. 1/1/10)

STATE

Category 2A

Intermediate home care for very frail elders with some assets above the Medicaid limits

In need of short or long term nursing home care

Individual Income
= no limit

Assets:
Individual = $32,868
Couple = $43,824

<50% NH cost
($2,799.00/mo)

but

(15% copay may apply eff. 1/1/10)

STATE

Category 2B

Same as 2A

Same as 2A

Same as 2A

<80% NH cost
($4,544.30/mo)

but

(15% copay may apply eff. 1/1/10)

STATE

Category 3

Extensive home care for very frail elders who would otherwise be in a nursing home on Medicaid

In need of long term nursing home care (deficits in 3 critical need areas or ADLs)

Individual Income
= $2,022/month

Assets:
Individual = $1,600
Couple =
(both as clients) = $3,200
(one as client) =$23,512

100% NH Cost
($5,5980/mo)
 

(Social Services cap = $3,978)

MEDICAID

(state/federal)

Notes:
1. Clients with incomes of $1,806.00 and above are required to contribute to the cost of their care; eff.
1/1/10 all Category 1-2 may have to pay 15% copay..
2. There is no income limit for the State-Funded levels. The Medicaid Waiver income limit equals 300% of SSI.  In some circumstances a "pooled trust" account may be used to exclude excess income.
3. Services in all categories include the full range of home health and community-based services.
4. Care plan limits in all categories are based on the total cost of all state-administered services.
5. Some individuals may be functionally eligible for either category 1 or 2 services and financially eligible for Medicaid.  In such cases, home health services will be covered by Medicaid and other community-based services covered through state funds.
6. Married couples who are over the $23,512 asset limit for category 3 may still be eligible based on spousal asset protection rules (maximum $109,560; sometimes more if needed to meet community spouse minimum monthly needs..
7. Functional need is a clinical determination by the Department concerning the applicant's critical need for assistance in the following areas:  bathing, dressing, toileting, transferring, eating/feeding, meal preparation and medication administration.
8. Care plan cost limits are for CHCPE fee-for-service only.