Medicaid / HUSKY Health Connecticut Home Care Program for Elders (CHCPE)

Last updated: May 29, 2024

 

Overview of the Connecticut Home Care Program for Elders

The Connecticut Home Care Program for Elders (CHCPE) is a statewide program that provides long-term services and supports for seniors who have difficulty completing their Activities of Daily Living (ADLs). ADLs, which include bathing, personal hygiene, dressing, mobility, eating, and toileting, must be performed daily in order for one to live independently. Intended to delay and prevent untimely nursing home admissions, CHCPE provides in-home personal care assistance, adult day care, personal emergency response systems, home delivered meals, and homemaker services, such as basic housecleaning, laundry, and meal preparation.

CHCPE program participants can reside in their own personal home, the home of a loved one, a managed residential community (assisted living residence), or in adult family living (adult foster care home).

Previously, CHCPE allowed a program participant to self-direct their own personal care services. This allowed them to select and manage their own caregivers. While this is no longer an option via CHCPE, persons who are enrolled in the Medicaid-funded CHCPE category can self-direct their personal care via CT’s Community First Choice Program.

CHCPE is not necessarily an entitlement program. This means applicants who meet eligibility requirements are not guaranteed immediate receipt of CHCPE services. Participant enrollment slots may be limited, or funding may run out, and when this happens, a wait list for program participation forms.

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The Connecticut Home Care Program for Elders Program offers several categories of assistance, including both Medicaid-funded and non-Medicaid (state-funded) assistance. There are two Medicaid-funded categories. The first is authorized through a 1915(c) Medicaid Waiver called the Connecticut Home and Community Based Services Waiver for the Elderly. The second is a 1915(i) State Plan Home and Community Based Services benefit. In Connecticut, Medicaid is called HUSKY Health, and the Medicaid program specific to the aged, blind and disabled is called HUSKY C.

 The CHCPE Program offers both Medicaid-funded and non-Medicaid (state-funded) home and community based services to delay and prevent nursing home admissions. While we cover financial and functional eligibility criteria for state-funded assistance, this page is more focused on persons applying for Medicaid-funded assistance.

 

Benefits of the Connecticut Home Care Program for Elders

Follows is a list of benefits available through CHCPE. A needs assessment determines the exact services and supports a program participant will receive.

– Adult Day Health / Adult Day Care
– Adult Family Living (AFL) Services – the care recipient lives with a caregiver (in either person’s home) and receives 24/7 supervision, personal care assistance, and homemaker services. While relatives can be the caregiver, spouses are excluded.
– Assisted Living Services – includes personal care assistance and nursing visits
– Assistive Technology
– Bill Payer
– Care Management
– Care Transitions
– Chore Services
– Chronic Disease Self-Management
– Companion Services
– Home Delivered Meals
– Homemaker Services – assistance with preparing meals, light housecleaning, laundry
– Mental Health Counseling
– Minor Home Modifications – for safety and accessibility
– Personal Care Assistance – non-medical assistance with daily living activities, such as bathing, dressing, toileting, and eating
– Personal Emergency Response Systems
– Recovery Assistant
– Respite Care – in-home and out-of-home care to relieve a primary caregiver
– Transportation Assistance – non-medical

While program participants can live in assisted living residences (managed residential communities) and adult foster care homes (adult family living), CHCPE does not pay for room and board.

Persons receiving state-funded CHCPE services must pay 3% of service costs.

Persons receiving Medicaid-funded CHCPE services may have to contribute towards their care costs if their income exceeds 200% of the Federal Poverty Level (FPL). In 2024, this equates to $2,510 / month.

 

Eligibility Requirements for Connecticut Home Care Program for Elders

CHCPE is for Connecticut residents who are elderly (65+). As mentioned previously, there are both Medicaid-funded and non-Medicaid (state-funded) categories of CHCPE assistance. The various categories allow seniors to receive various levels of care, which correspond with financial and functional criteria. Additional eligibility criteria are as follows.

 There are multiple categories of assistance available via CHCPE. These categories, both Medicaid-funded and state funded (non-Medicaid), allow persons with varying degrees of financial means and functional needs access to long-term services and supports that promote independent living.

 

Financial Criteria: Income, Assets & Home Ownership

Income

State-Funded CHCPE
There is no applicant income limit.

Medicaid-Funded CHCPE
The applicant income limit for the 1915(i) State Plan Home and Community Based Services Benefit is equivalent to 150% of the Federal Poverty Level (FPL). In 2024, this is $1,882.50 / month.

The applicant income limit for services via the Connecticut Home and Community Based Services Waiver for the Elderly is 300% of the Federal Benefit Rate (FBR). In 2024, this is $2,829 / month.

For both avenues of Medicaid-funded assistance, if a couple is married and both spouses are applicants, each spouse is considered individually. This means that each spouse can have monthly income up to the limit mentioned above for the specific category of assistance. When only one spouse is an applicant, the income of the non-applicant spouse is not counted towards the income eligibility of their spouse. Furthermore, based on a non-applicant’s monthly income, they might be entitled to a Spousal Income Allowance from their applicant spouse. This is called a Monthly Maintenance Needs Allowance.

In Connecticut, there is a minimum income allowance set at $2,555 / month (eff. July 2024 – June 2025). This allows an applicant spouse to supplement their non-applicant spouse’s monthly income, bringing their income up to this amount. In 2024, the state also sets a maximum income allowance of $3,853.50 / month. While this potentially allows a non-applicant spouse a higher income allowance, any additional amount above the minimum income allowance is dependent on one’s shelter and utility costs. A Spousal Income Allowance, however, can never push a non-applicant’s total monthly income over $3,853.50.

Assets

State-Funded CHCPE
The asset limit in 2024 for a single applicant is $46,242, and for a couple, it is $61,656. The couple asset limit remains the same regardless of if one or both spouses are applicants.

Medicaid-Funded CHCPE
In 2024, the applicant asset limit is $1,600 for the 1915(i) State Plan Home and Community Based Services Benefit, as well as for the Connecticut Home and Community Based Services Waiver for the Elderly. For married couples, with both spouses as applicants, the asset limit is set at $3,200. When only one spouse is an applicant, the assets of both the applicant and non-applicant spouse are still limited. This is because Medicaid considers the assets of a married couple to be jointly owned. In this case, the applicant spouse can retain up to $1,600 in assets, while the non-applicant spouse is allocated a larger portion of the couple’s assets as a Community Spouse Resource Allowance (CSRA) to prevent spousal impoverishment.

The CSRA allows the non-applicant spouse to keep 50% of the couple’s assets, up to $154,140. If 50% of the couple’s assets falls under $50,000, the non-applicant spouse can keep all of the couple’s assets, up to this amount.

Some assets are not counted towards Medicaid’s asset limit. This generally includes an applicant’s primary home, household furnishings and appliances, personal effects, and a vehicle.

Assets should not be given away or sold under fair market value prior to applying for long-term care Medicaid. This is because CT Medicaid has a 60-month Look-Back Rule for applicants of long-term home and community based services. Violating this rule results in a Penalty Period of Medicaid ineligibility.

 To determine if you might have assets over Medicaid’s countable limit, and if so, receive an estimate of the amount, use our Spend Down Calculator.  

Home Ownership for Medicaid Applicants
The home is often the highest valued asset a Medicaid applicant owns, and many persons worry that Medicaid will take it. For eligibility purposes, Medicaid in Connecticut considers the home exempt (non-countable) in the following circumstances.

– The applicant lives in the home or has Intent to Return, and in 2024, their home equity interest is no greater than $1,071,000. Home equity is the current value of the home minus any outstanding mortgage. Equity interest is the portion of the home’s equity value that is owned by the applicant.
– A spouse lives in the home.
– The applicant has a child under 21 living in the home.
– The applicant has a disabled or blind child living in the home.

While one’s home is generally safe from Medicaid’s asset limit, it is not safe from Medicaid’s Estate Recovery Program. Learn more about the potential of Medicaid taking the home here.

 

Medical Criteria: Functional Need

To meet the functional need for all categories of CHCPE, an applicant must either be at risk of nursing home admittance (or hospitalization) or meet a Nursing Facility Level of Care (NFLOC). This equates to having a need for assistance with Activities of Daily Living (ADLs), such as bathing, dressing, eating, toileting, transferring (i.e., getting in / out of bed), and taking medications.

State-Funded CHCPE
At a minimum, one must be at risk of hospitalization or nursing home admission. This means one must require assistance with at least 1 ADL. Persons who require a Nursing Facility Level of Care are also eligible, which equates to the need for assistance with 3 or more ADLs.

Medicaid-Funded CHCPE
The 1915(i) State Plan Home and Community Based Services Benefit has the lesser functional need criteria of the two Medicaid-funded categories of CHCPE. An applicant must be at risk of requiring nursing home care, but cannot require a Nursing Facility Level of Care . “At risk” is defined as needing assistance with 1 or 2 ADLs.

For the Connecticut Home and Community Based Services Waiver for the Elderly, an applicant must require a Nursing Facility Level of Care . This generally equates to an individual requiring assistance with a minimum of 3 ADLs. Relevant to many persons with Alzheimer’s disease or a related dementia, orientation, memory, judgment, and problematic behaviors, such as wandering or disrobing in public, are also considered. A diagnosis of dementia in and of itself does not mean one will meet a NFLOC.

 Learn more about long-term care Medicaid in Connecticut.

 

Qualifying for Medicaid-Funded Assistance When Over the Limits

Having income and / or assets over Medicaid’s limit(s) does not mean an applicant cannot still qualify for Medicaid. There are a variety of planning strategies that can be used to help persons who would otherwise be ineligible to become eligible. Some of these strategies are fairly easy to implement, and others, exceedingly complex. Below are the most common.

Connecticut has a Medical Spend-Down Program for applicants who have high medical expenses relative to their income. Via this program, applicants are permitted to spend “excess” income on medical expenses and health care premiums, such as Medicare Part B, in order to meet Medicaid’s income limit. Unfortunately, this option is not available to persons who are seeking services via the 1915(i) State plan Home and Community Based Services Benefit.

When persons have assets over the limits, Irrevocable Funeral Trusts are an option. These are pre-paid funeral and burial expense trusts that Medicaid does not count as assets. Another option are Medicaid-Compliant Annuities that turn countable assets into a stream of income. There are many other options when the applicant has assets exceeding the limit.

Inadequate planning or improperly implementing a Medicaid planning strategy can result in a denial or delay of Medicaid benefits. Professional Medicaid Planners are educated in the planning strategies available in Connecticut to meet Medicaid’s financial eligibility criteria without jeopardizing Medicaid eligibility. Furthermore, there are additional planning strategies that not only help one meet Medicaid’s financial criteria, but can also protect assets for family as inheritance. These strategies often violate Medicaid’s 60-month Look-Back Rule, and therefore, should be implemented well in advance of the need for long-term care. However, there are some workarounds, and Medicaid Planners are aware of them. For these reasons, it is highly suggested one consult a Medicaid Planner for assistance in qualifying for Medicaid when over the income and / or asset limit(s). Find a Medicaid Planner.

 

How to Apply for the Connecticut Home Care Program for Elders

Before You Apply

Prior to submitting an application for CHCPE, applicants need to ensure they meet the eligibility criteria. Applying when over the income and / or asset limit(s) will be cause for denial of benefits. The American Council on Aging offers a free Medicaid Eligibility Test to determine if one might meet Medicaid’s eligibility criteria. Take the Medicaid Eligibility Test.

As part of the application process, applicants will need to gather documentation for submission. Examples include copies of Social Security and Medicare cards, bank statements up to 60-months prior to application, proof of income, and copies of life insurance policies, property deeds, and pre-need burial contracts. Unfortunately, a common reason applications are delayed is required documentation is missing or not submitted in a timely manner.

As mentioned previously, CHCPE is not necessarily an entitlement program. The Connecticut Home and Community Based Services Waiver for the Elderly limits the number of participant slots to approximately 18,186 beneficiaries each year. Approximately 230 of these slots are reserved for persons participating in CT’s Money Follows the Person Program. If a wait list exists, one’s access to CHCPE is based on one’s date of application.

 

Application Process

Seniors can apply for the Connecticut Home Care Program for Elders online here, or alternatively, call the Community Options Unit at 800-445-5394 and select option 4 to initiate the application process. Additionally, a program application, formally called the Connecticut Home Care Program for Elders (CHCPE) Request for Referral can be downloaded here. At the time of this writing, the income and asset limits were not updated on the application for 2024.

As part of the application process, a care manager will conduct an in-home functional assessment.

Learn more about the Connecticut Home Care Program for Elders here. Alternatively, persons can call the Community Options Unit at 1-800-445-5394 (option 4) or contact their local Area Agencies on Aging (AAA) office.

The Connecticut State Department of Social Services’ (DSS) Community Options Unit, previously called the Alternate Care Unit, administers the CHCPE Program.

 

Medicaid Approval Process & Timing

The Medicaid application process can take up to 3 months, or even longer, from the beginning of the application process through the receipt of the determination letter indicating approval or denial. Generally, it takes one several weeks to complete the application and gather all of the supportive documentation. If the application is not properly completed, or required documentation is missing, the application process will be delayed even further. Based on federal law, Medicaid offices have up to 45 days to review and approve or deny one’s application (up to 90 days for disability applications). Despite the law, applications are sometimes delayed even further. Furthermore, if a waist list exists, approved applicants may spend many months, or even years, waiting to receive benefits.

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