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Family and Social Services Administration

Aging Home > CHOICE (In-home & Community Services) CHOICE

The Community and Home Options to Institutional Care for the Elderly and Disabled (CHOICE) provides case management services, assessment, and in-home and community services to individuals who are at least 60 years of age or persons of any age who have a disability due to a mental or physical impairment and who are found to be at risk of losing their independence.

CHOICE funds may only be utilized after an applicant has been determined and documented ineligible for Medicaid or if currently eligible for Medicaid, after a determination that the requested service(s) is not available from Medicaid.

The following are services available under CHOICE:

Adult Day Service - Adult Day Service are community-based group programs designed to meet the needs of adults with impairments through individual plans of care. These structured, comprehensive, non-residential programs provide health, social, recreational, and therapeutic activities, supervision, support services, and personal care.

Attendant Care - Attendant Care is hands on assistance for older adults and persons with disabilities who have physical needs and is provided to allow the client to remain in their own home and carry out functions of daily living, self-care, and mobility. Assistance can include help with bathing, oral hygiene, hair care, shaving, dressing, applying cosmetics, transfer between bed and chair, meal planning, preparation and cleanup, toileting assistance, escorting client to medical appointments and other day-to-day activities. It should be noted that an attendant has to be a hired third party and can not be a loved one. 

Behavior Management - Behavior Management is training, supervision or assistance in appropriate expression of the emotions and desires, compliance, assertiveness, acquisition of socially appropriate behaviors, and the reduction of inappropriate behaviors.

Congregate Meals - Congregate meals are meals which comply with the Dietary Guidelines for Americans published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture and are available to eligible clients or other eligible participants at a nutrition site, senior center or another congregate setting. 

Counseling Support Groups - Counseling Support Groups are services or activities that assist the caregiver in the areas of health, nutrition, financial literacy, decision making and problem solving. This includes counseling provided by a licensed professional or support groups that allow caregivers to discuss their attitudes, feelings, and problems with other individual(s) to achieve a greater understanding of their situation, role, and problems that arise with care giving. This also includes training and education for the caregiver to assist them in acquiring knowledge and skills that allow them to provide care.

Environmental Modifications - Environmental modifications are minor physical adaptations to the individual’s own home or family owned home, as required by the individual’s Plan of Care/Cost Comparison Budget. Rented homes or apartments are allowed to be modified only when a signed agreement from the landlord is obtained. The modifications must be necessary to ensure the health, welfare and safety of the individual and enable them to function with greater independence in the home, and without which the individual would require institutionalization.

Gerontology Counseling - Gerontology Counseling is the process of helping older individuals to overcome losses, to establish new goals while in the process of discovering that living may be limited in years but not necessarily in quality, and to reach decisions based on the importance of being in the present as well as looking for future opportunities.

Habilitation Day Group - Habilitation Day Group is assistance with acquisition, retention, or improvement in self-help, socialization and adaptive skills which takes place in a non residential setting that is separate from the home or facility in which the individual resides.   Services are normally furnished four (4) or more hours per day on a regularly scheduled basis for one (1) or more days per week unless provided as an adjunct to other day activities included in an individual's care plan.

Handy Chore - Handy Chore are minor home maintenance activities, that are planned and monitored, that are essential to an individual’s health and safety. They can include plumbing, heating, storm door, window, and screen repairs; gutter and roof patching; heavy cleaning; broken step repair; installation of health and safety equipment such as handrails, ramps, deadbolts, fire extinguishers, smoke detectors, locks.  Ground maintenance is also included and can be lawn moving, snow removal, and minimal hard cleanup to assure safe entrance and departure from premises. 

Homemaker - Homemaker is direct and practical assistance with household tasks and related activities. Services assist clients who have lost ability to perform instrumental activities of daily living that allow them to live in a clean, safe, healthy home environment. The service is available when the client is unable to meet daily needs and there is no informal caregiver who could meet those needs.  Activities can include dusting, vacuuming, cleaning the kitchen and bathroom, doing dishes,  laundry, making beds, disposing of trash, yard clean up and mowing, snow removal, grocery shopping, preparing meals, running errands and several others. 

Home Delivered Meals - Home Delivered Meals are meals brought to the client’s home which comply with the Dietary Guidelines for Americans and published by the Secretaries of the Department of Health and Human Services and the United States Department of Agriculture.

Home Health Aide - Home Health Aide duties include the provision of hands-on personal care, performance of simple procedures as an extension of therapy or nursing services, assistance in ambulation or exercises, and assistance in administering medications that are ordinarily self-administered. Any home health aide services offered by a Home Health Agency and must be provided by a qualified home health aide.

Individual Counseling - Individual Counseling services are provided by a licensed psychologist with an endorsement as a health service provider in psychology, a licensed marriage and family therapist, a licensed clinical social worker, or a licensed mental health counselor. 

Information Assistance - Information Assistance ensures that adults and disabled individuals have access to all available benefits and services. This includes providing answers to questions, assisting clients to receive needed service, and follow up to make sure that referred services are appropriate.  

Legal Assistance - Legal Assistance assists older adults understand and maintain their rights, exercise their choices, help them benefit from available services and resolve disputes. The program also promotes the need for lifetime planning through the understanding and the use of advance directives. 

Licensed Practical Nurse - A Licensed Practical Nurse furnishes services in accordance with agency policies, prepares clinical and progress notes, assists the physician and registered nurse in performing specialized procedures, prepares equipment and materials for treatments observing aseptic technique as required, and assists the patient in learning appropriate self-care.

Nutrition Counseling - Nutrition Counseling helps individuals who are at nutritional risk, because of their health or nutritional history, dietary intake, medication use or chronic illnesses, with options and methods for improving their nutritional status. The service is performed by a health professional in accordance with state law and policy.

Nutrition Education - Nutrition Education is a program that promotes better health by providing accurate and culturally sensitive nutrition, physical fitness, or health (as it relates to nutrition) information and instruction to participants and caregivers in a group or individual setting. The program is overseen by a dietitian or individual of comparable expertise.

Occupational Therapy - Occupational Therapy provides evaluation, treatment, and training programs such as gross and fine motor function, self-care, sensory and perceptual motor function. It also includes remedial techniques that include the design, fabrication, and adaptation of materials and equipment to an individual’s needs.

Outreach - Outreach assists with identifying potential clients or their caregivers and encouraging their use of existing services and benefits.

Pest Control - Pest Control services are designed to prevent, suppress, or eradicate anything that competes with humans for food and water, injures humans, spreads disease and/or annoys humans and is causing or is expected to cause more harm than is reasonable to accept. Pests include insects such as roaches, mosquitoes, and fleas; insect-like organisms, such as mites and ticks; and vertebrates, such as rats and mice.

Physical Therapy - Physical Therapy provides treatment and training programs designed to preserve and improve abilities for independent functioning, such as gross and fine motor skills, range of motion, strength and muscle tone, activates of daily living, and mobility to prevent progressive disability through such means as the use of purposeful activities, orthopedic and prosthetic devices, assistive and adaptive equipment, positioning, behavior adaptation, and sensory stimulation.

Private Duty Nurse - Private Duty Nursing are nursing services for recipients who require more individual and continuous care than is available from a visiting nurse or routinely provided by the nursing staff of the hospital or skilled nursing facility.

Personal Emergency Response Systems (PERS) - PERS is an electronic device which enables certain individuals at high risk of institutionalization to secure help in an emergency. The individual may also wear a portable help button to allow for mobility. The system is connected to the person’s phone and programmed to signal a response center once a “help” button is activated. The response center is staffed by trained professionals.  PERS is limited to those individuals who live alone, or who are alone for significant parts of the day, and have no regular caregiver for extended periods of time, and who would otherwise require extensive supervision, professionals.

Private Hire Attendant Care - Attendant Care is hands on assistance for older adults and persons with disabilities who have physical needs and is provided in order to allow the client to remain in their own home and carry out functions of daily living, self-care, and mobility. Assistance can include help with bathing, oral hygiene, hair care, shaving, dressing, applying cosmetics, transfer between bed and chair, meal planning, preparation and cleanup, toileting assistance, escorting client to medical appointments and other day-to-day activities.

Residential Based Habilitation - Residential Based Habilitation is assistance with the acquisition, retention or improvement in skills related to activities of daily living, such as personal grooming and cleanliness, bed making and household chores, eating and the preparation of food, and the social and adaptive skills necessary to enable the individual to live in a non-institutional setting.  

Respite Care - Respite Care are temporary substitute supports or living arrangements for care recipients in order to provide a brief period of relief or rest for caregivers. This can   include in-home respite (personal care, homemaker, and others), respite provided by attendance of the client at a senior center or other non-residential program and institutional respite which is provided by placing the resident in a non-institutional setting such as a nursing facility for a short period of time as a respite service for the caregiver, or a summer camp in the case grandparents caring for children.

Registered Nurse - The registered nurse makes the initial evaluation visit, regularly reevaluates the patient's nursing needs, and initiates the plan of care and necessary revisions. They also furnish those services requiring substantial and specialized nursing skills, initiate appropriate preventive and rehabilitative nursing procedures, prepare clinical and progress notes, coordinate services, and other related needs, participate in in-service programs, and supervise and teach other nursing personnel.

Speech Therapy - Speech Therapy is provided by a licensed speech pathologist and includes screening, assessment, direct therapeutic intervention and treatment for speech and hearing disabilities such as delayed speech, stuttering, spastic speech, aphasic disorders, injuries, lip reading or signing, or the use of hearing aids.

Vehicle Modification  - Vehicle Modifications are the addition of adaptive equipment or structural changes to a motor vehicle that permit an individual with a disability to be safely transported in a motor vehicle. Vehicle modifications, as specified in the Plan of Care/Cost Comparison Budget, may be authorized when necessary to increase an individual’s ability to function in a home and community based setting to ensure accessibility of the individual with mobility impairments. These services must be necessary to prevent or delay institutionalization. The necessity of such items must be documented in the plan of care by a physician’s order. Vehicles necessary for an individual to attend post secondary education or job related services should be referred to Vocational Rehabilitation Services.

Specialized Medical Equipment and Supplies - Specialized Medical Equipment and Supplies are medically prescribed items required by the individual’s Plan of Care/Cost Comparison Budget which is necessary to assure the health, welfare and safety of the individual, and allow an individual to function with greater independence in the home, and without which the individual would require institutionalization. Items include but are not limited to direct selection communicators, alphanumeric communicators, scanning communicators, speech amplifier, electronic speech aids/devices, standing boards/frames, adaptive switches/devices, specially adaptive locks.

Transportation - Transportation services allow individuals to gain access to community services, activities and resources, specified by the plan of care. There are two levels of transportation: Level 1 in which the individual does not need medical assistance to travel and Level 2 in which the individual does need medical assistance to travel.

 

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