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Dept. of Human Services issues request for applications for enrollment broker for community-based long-term care services

A vendor is needed to provide enrollment services, choice counseling, and beneficiary support services for older Pennsylvanians and adults with physical disabilities who need long-term service and supports through the DHS Office of Long-Term Living

The Department of Human Services issued a Request for Applications seeking a vendor to provide enrollment services, choice counseling, and beneficiary support services for older Pennsylvanians and adults with physical disabilities who need long-term service and supports through the DHS Office of Long-Term Living.

“Helping people served by DHS’ long-term services and supports program navigate this system in a seamless, consumer-focused manner is a priority for my department,” said DHS Secretary Teresa Miller. “We look forward to reviewing applications submitted through this RFA and ensuring that Pennsylvanians who enter this system are supported and feel confident as they enroll in a managed care program and choose their care and support providers.”

The enrollment broker will serve people who need to access long-term services and supports, including the Community HealthChoices program, the Living Independence for the Elderly Program, and other home and community-based long-term care programs like the OBRA Waiver and Act 150 program. The enrollment broker will help enrollees navigate the enrollment process and understand their rights as a health care consumer, their options for a managed care organization and care providers, and their ability to make their own choices about their health care and long-term services and supports.

CHC is Pennsylvania’s managed care program for eligible individuals who are 21 or older and dually eligible for Medicaid and Medicare, and for eligible individuals who are 21 or older who have physical disabilities requiring long-term services and supports either in a nursing facility or in their home. CHC was developed to improve access to and coordination of medical services and person-centered long-term services and supports. As of January 2020, CHC is fully-implemented across Pennsylvania and serves nearly 369,000 Pennsylvanians.

Pennsylvania’s LIFE program also allows participants to remain in their homes and communities and still receive necessary medical and supportive services. The program was first implemented in Pennsylvania in 1998, and is known nationally as the Program of All-Inclusive Care for the Eldery (PACE). People who are 55 and older who meet the level of care for a skilled nursing facility or special rehabilitation facility, are able to be safely served in the community, and live in an area served by a LIFE provider are eligible for LIFE. LIFE participants must also meet financial eligibility requirements or privately pay for services. LIFE currently serves nearly 7,500 Pennsylvanians.

The RFA will be active until Oct. 2. Interested applicants can consult the RFA to read requirements and submit an application. The RFA is available online at eMarketplace.

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