Tennessee OPTIONS for Community Living Program

Program Description

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 one’s home. These services are provided free of charge to persons under certain income levels. Individuals with income 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.

Tennessee seniors who require care and wish to remain living at home, can receive free estimates for bathroom access and safety alternations such as the addition of a walk-in tub.   Learn more.

 

Eligibility Guidelines

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 there may be a cost of share for services, which is determined by the applicant’s income. 

Persons receiving services cannot also be eligible to receive benefits from TennCare (Tennessee's Medicaid program) or any of its associated Waivers, such as TennCare CHOICES in Long-Term Care Program.  

 

Benefits and 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 may change from year to year, and may differ based on geographic location within the state. The most recent information available, as of April 2017, shows that limit to be $5,000 / year in some areas and $7,000 / year in other areas. On average, eligible applicants receive approximately $3,500 / year worth of services. Possible services include:

  • Personal care - assistance with 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.
  • Personal Emergency Response System (PERS) –a medical alert system that is used in the event of an emergency. This benefit is determined on a case-by-case basis.

The cost of services depends on the applicant's income and is determined by a cost share worksheet, which is based on the Federal Benefit Rate (FBR). For those who are at or below 200% of the FBR, services are received free of charge. As of 2017, this means a single individual may have approximately a monthly income up to $1,470, or in other words, an annual income up to $17,640. For married couples, the monthly income limit is approximately $2,206, and the annual income limit is $26,472.

Participants with income between 200% and 600% of the FBR (approximately between $1,470 / month and $4,410 / month for single individuals and between $2,206 / month and $6,618 / month for married couples) pay a share of cost of up to 45% of their income.

Those with income over 600% of the FBR are responsible for the complete cost of services. As of 2017, this includes single individuals with an approximate monthly income over $4,410 ($52,920 / year) and married couples with an approximate monthly income over $6,618 ($79,416 / year).

 

How to Apply / Learn More

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.

 Applicants should be aware that in past years a waiting list for services has existed.  This means that an applicant may be qualified but still has to wait to receive services.  Prioritization on the waiting list is based on income.