Using Medicaid to Cover Services for Elderly Persons in Residential Care Settings: State Policy Maker and Stakeholder Views in Six States. Community Options Program


Services are provided through the state's Community Options Program (COP) only if they cannot be provided through the waiver program or the Medicaid state plan. The purpose of the state COP program is to divert or relocate persons of all ages and target groups from nursing homes. The COP program is funded through state and county revenues. The state also has a program that provides help for caregivers of persons with Alzheimer's disease or other causes of dementia.

In some instances, COP funding may be used to pay for room and board in Community Based Residential Facilities. Policies regarding room and board payment vary by county and depend, in part, on whether the county has state-only funds available at the time they are needed for this purpose. One study found that the average COP payment for room and board for a waiver client in a CBRF was $147 per month.

COP funding may not be used to pay for room and board in RCACs per state law because these costs are perceived as too high and paying for them would disproportionately reduce the amount of money available for home care services.

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