As someone who spent more than a decade caring for both of her parents when they fell ill, Beaver County resident Barbara Yorns understands how important — and how hard it is — to safely care for people with serious long-term care needs at home, rather than in a nursing home.
“I gave up my career,” Barbara, who is now in her sixties and struggling to manage a serious liver condition said. “I gave up having a family of my own, and I worry that no one will be there to take care of me.”
Pennsylvania’s new managed care program for older adults and people with disabilities, Community HealthChoices (CHC), intends to help people like Barbara stay healthier and live well at home. But how? Here’s the theory, as we understand it:
If people with complex medical and social needs (a chronic illness or disability, unsafe or unstable housing) get better coordinated care, more in-home help with everyday needs like making meals and keeping the house clean, and reliable access to transportation, they can stay healthier and avoid high-cost, high-risk settings like the hospital or emergency room.
Turning that theory into a reality — one that improves the quality of life for people like Barbara — has been our focus, as we advocate to strengthen and improve CHC across its 3-year rollout in the Commonwealth.
It’s important to note that Community HealthChoices does not change someone’s Medicare benefits or their behavioral health coverage. People will continue to see the same Medicare doctors they do today, and count on Medicare to cover most of their benefits. Medicaid (ACCESS) steps up to cover anything Medicare doesn’t, and that will remain the case under CHC.
This is a big change, and we know that despite the very best of intentions, there is always some distance between how a program works “in theory” and how it works “in reality.” That’s why we want to hear from you! If you have any questions or want to join our advocacy efforts, visit: pahealthaccess.org/chc