Page Reviewed / Updated - Mar. 2016
The OPTIONS Program provides care and support services to elderly and / or disabled Tennessee residents in their homes. Services include personal care, meals, and assistance maintaining the home. These are provided free of charge to persons under certain income levels. Individuals with incomes exceeding those levels pay for services based on a sliding scale. If a co-payment is charged, the fees are well less than would be if one were required to purchase the services from a home care provider directly.
Each applicant is assessed to determine what their care needs and functionality limitations are, and also to ascertain the amount of care that can reasonably be provided by their family members given the financial resources they have. Once these factors have been considered, a care plan is created. Re-assessments of care requirements and revisions of care plans occur annually at a minimum.
OPTIONS also allows for “self-direction care”. Using this option, friends and family members (but not spouses) can be hired to provide personal care.
OPTIONS program eligibility is based on a combination of factors. First and foremost, the applicant must be a Tennessee state resident. Persons aged 60 and older must require assistance to perform their Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) as certified by a medical professional. These include actions, such as mobility, toiletry, hygiene, dressing, light housekeeping, and cooking. Persons between the ages of 18 and 60 must be disabled as determined by the Office of Social Security.
The candidate’s financial asset information is requested on the application. Having “countable assets” greater than the Medicaid limit of $2,000 does not preclude participation. However, priority may be given to those persons with assets less than these limits.
The OPTIONS Program does not have a hard income limit, but the cost of services is determined by the applicant’s income. Those individuals whose incomes exceed 600% of the federal poverty level (approximately $71,280 / year) can receive services, but they must pay the full cost of those services.
Each applicant is assessed during the application process and a plan of care is developed which specifically states the care services for which they are eligible. These services are limited to a specific dollar value, which can change from year to year. The most recent information available sets that limit at $7,000. Possible services include:
Personal care - assistance with the activities of daily living such as bathing, grooming, personal hygiene, transferring, medication management, eating and toileting.
Homemaker services - assistance in the management of one's home and non-personal care essentials such as housekeeping, laundry, changing linens, light yard work and shopping for essentials.
Home delivered meals - includes both the delivery of hot, prepared meals which are ready to eat and meals to be stored and heated later for consumption.
Case Management – assistance with providing information, determining services that are needed, and connecting eligible applicants with the services.
The cost of services depends on the applicant's income. Those with incomes under 200% of the federal benefits rate can receive services free of charge. In 2016, this means an annual income of less than $17,592. Participants with incomes between 200% - 600% of the federal benefits rate (between $17,592 and $52,776) pay a share of cost of up to 45% of their income. Those with incomes over 600% of the federal benefits rate are responsible for the complete cost of services.
This program is funded by the state of Tennessee and is under the administration of the Commission on Aging and Disability. The administration has a network of local Area Agencies on Aging and Disability that manage the application process for consumers. Find your local Area Aging Agency or call 1-866-836-6678 statewide. The Tennessee Commission on Aging and Disability maintains a webpage on the program, but rather scarce information is provided.