CBA / Primary Home / Family Care – Texas
Waiver Services – New Mexico
Private Duty Services

Star Providers has services to focus on people who are elderly and adults with disabilities as cost-effective alternative of the home setting compared to institutional care in nursing facilities. These services are in-part reimbursed by Texas Department of Health & New Mexico Department of Health in addition to ‘Private Duty’ where the clients pay out of pocket for the services given below:
Community Based Alternatives (CBA): Service Details
The Community Based Alternatives program provides home and community-based services to people who are elderly and adults with disabilities as cost-effective alternatives to institutional care in nursing facilities. Case management is provided by DHS staff. Services include:

• Adaptive aids and medical supplies
• Adult foster care
• Assisted living/residential care services
• Emergency response services
• Minor home modifications
• Occupational therapy
• Personal assistance services
• Physical therapy
• Respite care
• Speech pathology services
  

Eligibility:

Age: The individual must be age 21 or older.

Financial Eligibility: The individual must be a Medicaid recipient or be determined eligible for this program. This determination is based on the income and resource requirements for Medicaid benefits in nursing facilities. The caseworker applies exclusions to income and resources. The countable income must not exceed $1,593 per month with resources of $2,000 for an individual. Spousal impoverishment provisions apply.
Medical necessity: The individual must meet the same medical necessity determination requirements as applicants for nursing facility care.

Texas Department Of Health (TDH), located at 2330 West 10th Street in Odessa, TX can be reached by phone at (432) 335-3600. TDH Case-Worker qualifies and co-ordinates the services of the agency and client.

If a patient is identified as a potential client for these services, following are the various ways of starting the service:

1. Direct the patient or family member to contact TDH at 335-3600 for service evaluation.

2. Physician’s office can contact TDH and request a ‘client evaluation for services’ by TDH.

3. Physician’s office can contact ‘Star Providers’ at 580-7707 to be followed up by ‘Star Team’.

Service Coverage Area: Odessa * Midland

Primary Home Care / Family Care: Service Details

Primary home care is a non-technical, medically related personal care service prescribed by a physician as part of a client's plan of care. Primary home care is available to eligible Medicaid clients whose health problems cause them to be functionally limited in performing activities of daily living. Each client's services are provided by a primary home care attendant.

Family care is a block grant funded non-skilled, non-technical service provided to eligible aged or disabled adults who are functionally limited in performing daily activities. Services may be provided by a person able to have a family-like relationship with the client (example: a family member, a friend, or a neighbor). Services available are:

1. Personal care. These services include assistance with activities related to the care of the client's physical health. These activities include:

A. bathing;
B. dressing;
C. preparing meals;
D. feeding;
E. exercising;
F. grooming;
G. caring for routine hair and skin needs;
H. taking self-administered medication;
I. toileting; and
J. transferring/ambulating.

2. Home management. These services include assistance with housekeeping activities that support the client's health and safety. These activities include:
A. changing bed linens;
B. housecleaning;
C. laundering;
D. shopping;
E. storing purchased items; and
F. washing dishes

3. Escort Services. Accompanying the client on trips to obtain medical diagnosis or treatment or both. This service does not include the direct transportation of the client by the attendant.

Texas Department Of Health (TDH), located at 2330 West 10th Street in Odessa, TX can be reached by phone at (915) 335-3600.

TDH Case-Worker qualifies and co-ordinates the services of the agency and client. If a patient is identified as a potential client for these services, following are the various ways of starting the service:

4. Direct the patient or family member to contact TDH at (432) 335-3600 for service evaluation.

5. Physician’s office can contact TDH and request a ‘client evaluation for services’ by TDH.

6. Physician’s office can contact ‘Star Providers’ at (866) 360-7937 to be followed up by ‘Star Team’.