+1 956 781 3254

207 S. Cage Blvd Suite A, Pharr TX 78577

Ph ·(956) 781-3254   Fax ·(956) 781-3210  

207 S. Cage Blvd Suite A, Pharr TX 78577

Ph · (956) 781-3254   Fax · (956) 781-3210

24-hour RN on-call service

 

24-hour Ambulation Available

Primary Home Care (PHC)

Assistance with Activities:

Occupational therapy is a client-centered health profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life.

This is a branch of rehabilitative health that uses specially designed exercises and equipment to help patients regain or improve their physical abilities.  PT is appropriate for many types of patients, from infants born with musculoskeletal birth defects, to adults suffering from sciatica or the after effects of injury or surgery, to elderly post stroke patients.

San Jose refers caregivers who offer respite services for elderly individuals to full-time family caregivers. Our respite care services that the referred caregivers provide can allow you the freedom to take a much-needed break from your caretaking responsibilities on occasion. As a responsible caregiver, you should embrace respite care as an opportunity to recharge, refresh and renew your caretaking spirit, energy and enthusiasm.

PHC: Primary Home Care

PCS: Personal Care Services

CBA: Community Based Alternatives 

What is PHC?

Primary Home Care is a nontechnical, medically related personal care service that is open to Medicaid-eligible adults and children whose health problems cause them to be functionally limited in performing activities of daily living according to a practitioner’s statement of medical need.  PHC services are provided by an attendant.

 

Eligibility Requirements

· Be age 21 or older.

· Need help with at least one personal care task.

· Have an unmet need for services.

· Have a practitioner’s statement of medical need.

· Financial eligibility is determined by the verification of the applicant’s Medicaid status by the Texas

 Department

 of Aging and Disability Services.

 

Who is a Candidate for PHC Services?

· Person with a disability.

· Person who is elderly that needs help with all daily living activities.

· Daily living activities would include, but not limited to bathing, dressing, meal preparation, grooming,

 feeding, exercise, toileting, cleaning, laundry, walking, escorting, assistance with medication, and shopping.

· Person who has Medicaid and/or Medicare (Medicare entry process is different than Medicaid).

What is PCS? 

Personal Care Services is like PHC except for children.

The state provides caregiver relief to families of disabled children.

Thus, an attendant is provided to families that can prove that help is needed at the household for mothers and/or fathers that care for disabled children.

An example would be a young child who is disabled, in which the mother provides car all day and needs time to go pay bills, buy groceries, etc.

PCS Eligibility: 

 

Anyone under 21 years old.

Who has a disability.

Who has a caregiver.

Who has Medicaid. 

What is CBA?

*Community Based Alternatives is designed to offer home and community based services at cost-effective alternatives to institutional care in Medicaid certified nursing facilities.  Therefore, this program is an alternative to nursing homes.

*CBA program offers minor home modification to meet the needs of patient.  

An example would be converting a bathroom into a handicap abled lavatory.

*Also includes personal assistance services, nursing services, physical therapy, occupational therapy, speech therapy, adaptive aids, medical supplies and respite care.

CBA Eligibility

*CBA— Community Based Alternatives Individuals must have a need for skilled nursing care; meet at least two nursing facility risk criteria; be eligible for Medicaid; be age 21 or older; and have a service plan that falls within specified annual spending levels based on the Texas Index for Level of Effort for nursing facility services.

*Furthermore, individuals enrolling in the CBA program must select a home and community support services provider for basic CBA services. Individuals requesting assisted living / residential care, adult foster care, out-of-home respite services, emergency response services, and home delivered meals must also select individual providers for those services.

Medicaid Estate Recovery Program (MERP)

 The primary goal in this program is the state attempting to recoup the money it spent caring for the client. To recoup the money, the state has a right to assets belonging to the client at the time of their death. This applies to people who are over 55 years of age and applied for long-term care services after March 1, 2005.

 Serveral loopholes are present and applicable in these situations as the state is not concise nor clear about the extent of these process to the clients often affected by it.

Transfer Client VS. Initial Client

· An initial client means that the client is new to services.  A referral form must be filled out and called into the state. The state then receives the referral and has 14 days to go assess the client.  After the assessment the case worker has 14 to 21 days to complete paperwork. Please note the normal wai period can last up to a month.

· A transfer client is much faster than an initial. The client and only the client can call their case worker to request a change in provider agencies. At this point, the case worker has 14 days to complete paperwork and submit it to a new agency.  Please note this process can have a waiting period up to 7 days.

Private Pay

 When looking for assisted living community or senior care, private pay refers to paying for care out-of-pocket. Private pay is any type of funds that are available to the senior or the senior’s family, privately such as savings or assets.Every long-term care provider, such as an assisted living community, independent living community, nursing homes, home care and hospice, will accept private pay. It is the most common form of payment for these long-term care providers, and in some cases is the only payment option.

 Call your local Care Advisor at (866) 510-9738 to discuss monthly budget and what amenities and services are included in that price to provide an estimate of what your monthly budget will be.