What is the Total Aging In Place Program?
The Total Aging In Place Program is a managed long term care plan (insurance plan) and a provider of long term care services. The program is designed to help participants to continue to live safely in the community. The program provides and coordinates needed health care services that participants can receive at the program’s modern Day Center, in their home, or in a nursing home should that become medically necessary.

Is it possible for anyone to join the Total Aging In Place Program?
All the following criteria must be met in order for a participant to be eligible to join:
• Be at least 55 years old
• At the time of enrollment, live in the Erie County service area, designated by the following zip codes:
14026, 14043, 14051, 14068, 14072, 14150, 14207, 14214, 14215, 14216, 14217, 14221,
14223, 14225, 14226, 14227, 14228, 14260, 14261
• Require nursing home level of care
• Need the long term services of the program for at least 120 days
• Be able to live safely in the community with the assistance of the program
• Have a physician who is willing to collaborate with the program or be willing to change physicians
• Be Medicaid eligible or be willing to pay privately

What services does the Total Aging In Place Program cover?
The Total Aging In Place Program covers the following services:
• Coordination of Care
• Social Day Care
• Recreation Therapy
• Personal Care
• Congregate Meals
• Socialization
• Home Health Care
• Nursing*
• Home Health Aide/Personal Care Aide*
• Physical Therapy*
• Occupational Therapy*
• Speech Therapy*
• Nursing Home Care
• Adult Day Health Care
• Respiratory Therapy
• Social Work Services
• Nutrition Services
• Optometry and Eyeglasses
• Audiology and Hearing Aids
• Dentistry
• Podiatry
• Prosthetics and Orthotics
• Durable Medical Equipment
• Home Delivered Meals
• Personal Emergency Response System
• Non-Emergent Medical Transportation
• Social and Environmental Supports
• These services are provided either directly by members of the Total Aging In Place Program Care Team or through one of the program’s network providers.

* These services can also be provided in a setting other than your home.

How are these covered services paid for?
Covered services are paid for by the Total Aging In Place Program from funds received from Medicaid. When a service is paid for by Medicare or another third party payer, that payer will be billed first.

If a participant has a Medicaid spend down, the participant must pay the spend down amount to the program on a monthly basis in order to maintain their enrollment.

If a participant is enrolled in the program on a private pay basis, the participant must pay the monthly premium in order to maintain their enrollment.

How are non-covered services handled by the Total Aging In Place Program?
There are other services that are not covered by the Total Aging In Place Program but they are coordinated for the participant. The Total Aging In Place Program Care Team helps identify available and appropriate providers of the needed service, arrange necessary appointments, and arrange transportation to and from the provider. For these services, the provider bills Medicare or Medicaid directly on a fee-for-service basis.

Some of the services that are coordinated are:
• Physician Services
• In-Patient and Out-Patient Hospital Care
• Laboratory and Radiology Services
• Mental Health Services
• Alcohol and Substance Abuse Services
• Chronic Renal Dialysis
• Emergency Transportation

Is it possible for a participant to keep the same primary care physician?
Yes, as long as their physician agrees to work with the Total Aging In Place Program and refer to the program’s network of providers for covered services.

May a participant receive services from any provider?
No, a participant must use a network provider of the Total Aging In Place Program in order for the service to be covered. If a service is paid for by Medicare, the participant can use a provider of choice for the service. However, if Medicare stops paying for the service and it becomes a Total Aging In Place Program covered service, then the participant must use a network provider to continue to receive the service.

How does the Total Aging In Place Program help participants to continue to live safely at home?
The Total Aging In Place Program helps participants to continue to live safely and as independently as possible in the comfort of their own homes by providing participants with the care they need. All care is managed and coordinated by an interdisciplinary team of health care professionals trained in the care of older adults. This Care Team is made up of a nurse, therapists, a social worker, a nutritionist, and health care aides. The Care Team has ongoing communication with each other, the primary care physician, and the participant and/or their responsible party to tailor the plan of care to meet the participant’s needs. As the participant’s needs change, the Care Team revises the plan of care accordingly.

Who decides where the services will be provided?
Covered services can be provided at the Total Aging In Place Program’s Day Center or in the participant’s home. The Care Team, the primary care physician, and the participant determine the location of where the services are provided that would best meet the participant’s needs.

What is the Day Center?
The Day Center is considered the program building. It has been designed with spacious rooms for activities, personal care, physical therapy, and occupational therapy services. It has a full commercial kitchen so that meals and snacks can be served to participants while at the Day Center. The Care Team works at the Day Center and is available to see participants when they attend. Activities at the Day Center are coordinated by the Activities Coordinator to provide socialization and recreation to participants. The Day Center also houses the administrative offices for the Total Aging In Place Program. The Day Center is open Monday through Friday from 8:30 a.m. to 5 p.m. 

Is there assistance available when the Day Center is closed? 
Yes, a member of the Care Team is available 24 hours a day, seven days a week, 365 days a year by calling the Total Aging In Place Program’s toll free number, 1-866-822-8185.

What happens if a participant needs to go to a nursing home?
There may be occasions where the participant, the Care Team, and the primary care physician agree that the participant’s care needs would best be met by a short or long term nursing home stay. If this occurs, the Care Team will coordinate placement in one of the program’s contracted nursing homes (a network provider) and will also continue to coordinate all of the participant’s care for as long as he/she is in the nursing home.

Facts
• Medicaid eligibility must be validated with the Erie County Department of Social Services to determine appropriate coverage for the Total Aging In Place Program.
• All enrollments must be approved by the Erie County Department of Social Services.
• All enrollments are effective as of the first (1st) of a given month.
• Participants must consent to a comprehensive evaluation by the program’s interdisciplinary Care Team as part of the assessment to determine eligibility for the Total Aging In Place Program.
• The participant’s primary care physician must work with the program in order to maintain enrollment. A participant can choose to change to a physician that does work with the program. The Total Aging In Place Program Care Team will assist the participant if they desire to change physicians.
• Apartments at Stovroff Towers on Weinberg Campus are available to enrollees in the program. They are adjacent to the Day Center.