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Long-term Services and Supports

Long-term services and supports (LTSS) help individuals live as independently as possible. LTSS is provided in a nursing facility or in an individual’s home and community. Services received at home and in the community are called Home and Community Based Services (HCBS). Services received are based on an individual’s needs, as documented in their person-centered service plan.

Home and Community Based Services covered by UPMC Community HealthChoices

Adult daily living
Day services in a community-based center to help with personal care, social, nutritional, and therapeutic needs, 4 or more hours a day on a regular schedule for one or more days every week.
Assistive technology
An item, piece of equipment, or product system to increase or maintain ability to communicate or do things for yourself as much as possible.
Benefits counseling
Counseling about whether having a job will increase your ability to support yourself and/or have a net financial benefit.
Career assessment
Review of your interests and strengths to identify potential career options.
Community integration
Short-term services to improve self-help, communication, socialization, and other skills needed to live in the community, provided during life-changing events such as a moving from a nursing home, moving to a new community or from a parent's home, or other change that requires new skills.
Community transition services
One-time expenses, such as security deposits, moving expenses, and household products, for participants who move from an institution to their own home, apartment or other living arrangement.
Employment skills development
Learning and work experiences, including volunteer work, where the participant can develop strengths and skills to be able to get a job that pays good wages.
Home adaptations
Physical changes to a participant’s home, such as ramps, handrails, and grab bars, to make the home safe and enable the participant to be more independent in the home.
Home-delivered meals
Prepared meals delivered to participants who cannot prepare or get nutritious meals for themselves.
Home health services
Nursing
Services of a registered nurse or licensed practical nurse that are ordered by a doctor, which include diagnosing and treating health problems through health teaching, health counseling, and skilled care prescribed by the doctor or a dentist.
Occupational therapy
Services of an occupational therapist ordered by a doctor, which include evaluating a participant’s skills and helping to change daily activities so that the participant can perform activities of daily living.
Physical therapy
Services of a physical therapist and ordered by a doctor, which include evaluation and treatment of a participant to limit or prevent disability after an injury or illness.
Home health aide
Services ordered by a doctor that include personal care such as help with bathing, monitoring a participant’s medical condition, and help with walking, medical equipment, and exercises.
Speech therapy
Services of a licensed American Speech-Language-Hearing associate or certified speech-language pathologist and ordered by a doctor, which include evaluation, counseling, and rehabilitation of a participant with speech disabilities.
Job coaching
Support to help learn a new job and keep a job that pays. Could include helping the participant to develop natural supports in the workplace and working with employers or employees, coworkers, and customers to make it possible for the participant to have a paid job.
Job finding
Helping the participant find and secure a job that fits their interests and abilities as well as the employer's needs.
Nonmedical transportation
Tickets, tokens, and mileage reimbursement to help a participant get to community and other activities.
Participant-directed community supports
Services and support for participants who want to direct their services, hire their own workers, and keep a budget for their services under Services My Way, which include helping the participant with basic living skills such as eating, drinking, toileting; and household chores such as shopping, laundry, and cleaning; and help with participating in community activities.
Participant-directed goods and services
Services, equipment, or supplies for participants who want to direct their services and keep a budget for their services under Services My Way, so that they can be safe and independent in their homes and be part of their community.
Personal assistance services
Hands-on help for activities of daily living such as eating, bathing, dressing, and toileting.
Personal emergency response system
An electronic device which is connected to a participant’s phone and programmed to signal a response center with trained staff when the participant presses a portable “help” button to get help in an emergency.
Pest eradication
Services to remove insects and other pests from a participant’s home that, if not treated, would prevent the participant from staying in the community due to a risk of health and safety.
Residential habilitation
Services delivered in a provider-owned or provider- operated setting where the participant lives, which include community integration, nighttime assistance, personal assistance services to help with activities of daily living such as bathing, dressing, eating, mobility, and toileting, and instrumental activities of daily living such as cooking, housework, and shopping, so that the participant get the skills needed to be as independent as possible and fully participate in community life.
Respite
Short-term service to support a participant when the unpaid caregiver is away or needs relief.
Specialized medical equipment and supplies
Items that allow a participant to increase or maintain the ability to perform activities of daily living.
Structured day habilitation
Day services in a small group setting directed to preparing a participant to live in the community, which include supervision, training, and support in social skills training.
Telecare
Health status measuring and monitoring telecare services
Uses wireless technology or a phone line to collect health-related data such as pulse and blood pressure to help a provider in knowing what the participant’s condition is and providing education and consultation.
Activity and sensor monitoring telecare service
Uses sensor-based technology 24 hours a day, 7 days a week by remotely monitoring and passively tracking participants’ daily routines.
Medication dispensing and monitoring telecare service
Helps a participant by dispensing medicine and monitoring whether the participant is taking the medicine as prescribed.
Therapeutic and counseling services
Cognitive rehabilitation therapy
Services for participants with brain injury that include consultation with a therapist, ongoing counseling, and coaching or cueing that focus on helping the participant to function in real-world situations.
Nutritional consultation
Services to help the participant and a paid and unpaid caregiver in planning meals that meet the participant’s nutritional needs and avoid any problem foods.
Counseling services
Counseling for a participant to help resolve conflicts and family issues, such as helping the participant to develop and keep positive support networks, improve personal relationships, or improve communication with family members or others.
Behavior therapy
Services to assess a participant, develop a home treatment/support plan, train family members/staff and provide technical assistance to carry out the plan, and monitor the participant in the implementation of the plan.
Vehicle modifications
Physical changes to a car or van that is used by a participant with special needs, even if the car or van is owned by a family member with whom the participant lives or another person who provides the main support to the participant, so that the participant can use the car or van.

To receive LTSS, you must have an assessment and be determined to be Nursing Facility Clinically Eligible. You can call the Independent Enrollment Broker at 1-877-550-4227 to request an assessment.

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