Case Studies of Six State Personal Assistance Service Programs Funded by the Medicaid Personal Care Option. I. Program Overview: Size of Population and Expenditures, Program Objectives

12/01/1991

The Texas Primary Home Care (PHC) Program is administered by the Texas Department of Human Services (TDHS) through the Community Care Section of Aged and Disabled Services (CCAD). It is the second largest Medicaid PC-Option program in the country, serving an average of 32,500 people per month, with total direct service expenditures of roughly $119,000,000 in FY 1990. It serves Medicaid eligibles who need at least 6 hours of assistance with activities of daily living, and services are capped at 30 hours per person per week. Services are coordinated at a regional level, and multiple private provider agencies are contracted in each region.

The program was created primarily in response to the state's decision to eliminate reimbursement for low medical need (ICF Level II) nursing home clients. The program's objectives are to provide cost-effective services for these individuals in the home community rather than in institutions, and to bring "care to those who could not access custodial placement". It was conceived as a large scale PAS program able to meet the needs of a wide range of individuals and access federal matching funds.

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