Alert
Close

Take AARP’s Smart Driver course and you could save money on your car insurance. Learn more

HIGHLIGHTS

Open

AUTO BUYING PROGRAM

AARP Auto Buying Program

Download the ipad App

AARP-iPad-ePub-app

DRIVER SAFETY

Piggy bank on the road - AARP Driver Safety

Take the new AARP Smart Driver Course!

Contests and
Sweeps

Safe Driving in 2014 Sweepstakes

Learn how AARP Driver Safety can help you stay safe—and enter for a chance to win $1,000. See official rules. 

KEEP BRAIN ACTIVE!

AARP Games - Play Now!

AARP BOOKS

Planning for Long-Term Care for Dummies

Get expert advice on planning for your own or a relative’s future care needs.

Webinars

Learn From the Experts

Sign up now for an upcoming webinar or find materials from a past session.

Learning centers

Get smart strategies for managing health conditions.

 

Arthritis

Heart Disease

Diabetes

Most Popular

Viewed

share your thoughts

What does the health care law mean to you? Your story is important. We read and learn from every story and it helps us in our educational efforts. We may even use your comments (with permission) to brief legislators, inspire readers and more. Please share your story with us. Do

Tennessee

An Alternative to a Nursing Home

Choices enrolls 7,000 Medicaid patients in first year of providing home-based care

Tennessee State Page News March 2011 AARP Bulletin

Steve Witt, director of the Southeast Tennessee Area Agency on Aging and Disability, explains the Choices program, which provides in-home services, to parishioners at the Phillips Temple C.M.E. Church in Chattanooga. — Bryan Anselm

Betty Caldwell and her mother faced a painful dilemma. Caldwell, 64, had developed a heart condition that left her so exhausted she felt barely able to make the daily trip to her mother's nearby apartment in Kingsport.

Her mother, Elsie King, 90, a widow for almost 60 years, had raised three children on her own while working in a factory nearly all her adult life, and was fiercely independent. But she'd come to rely on her only daughter for help with meals, medications, cleaning and errands.

"We had gotten to this very difficult point," Caldwell said. "I was sick. My mom needs care, but she's not ready for a nursing home where she would be in a bed in a room."

They found a solution in Choices, a program implemented a year ago that provides in-home services as an alternative to nursing home care through Tennessee's Medicaid program, TennCare.

Choices represents an overhaul of how the state responds to the needs of older or physically disabled residents needing daily care. For years, Tennessee ranked at or next to the bottom among the states in providing home- and community-based services.

During the program's first nine months, enrollment in home- and community-based services jumped from 18 to 25 percent, which is about 7,000 people.

That includes 256 who went directly from nursing homes to home care. The program allows up to 9,500 people to be enrolled at any time.

The program began in Middle Tennessee last March and went statewide in August.

The Choices program provides a broad menu of services to those who would otherwise qualify for nursing home care based on their income and health, but who can safely live in their own homes. Services include installing wheelchair ramps and arm rails, providing in-home health care, bathing services, transportation, homemaker services, and, in certain cases, helping pay the monthly bills at assisted living facilities.

At-home services in the Choices program cannot exceed the average cost of nursing home care. So far, the average participant costs about $15,000 to $20,000 per year compared with the average annual cost of nursing home care, about $52,000, said Steve Witt, director of the Southeast Tennessee Area Agency on Aging and Disability, based in Chattanooga.

"If you can make it possible for people to stay at home — which is what most people want — it's better for the individual, the family and the taxpayer," Witt said.

Advocates are hoping to build on the early success of the program by adding other options — such as adult residential homes for people unable to live alone — while preparing to defend the program from any potential cutbacks.

"It's a very difficult time for federal and state budgets, and we'll be working to ensure there's not a disproportionate share of cuts just as more people need these services," said Rebecca Kelly, AARP Tennessee state director.

Topic Alerts

You can get weekly email alerts on the topics below. Just click “Follow.”

Manage Alerts

Processing

Please wait...

progress bar, please wait

Tell Us WhatYou Think

Please leave your comment below.

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Woman trying on glasses in optometrists shop

Members save up to 60% on eye exams and 30% on glasses at JCPenney Optical.

Prescription medication spilling out of bottle

Members get a free Rx card from AARP® Prescription Discounts provided by Catamaran.

AngiesList

Members can save 25% to 45% on their Angie's List membership.

Caregiving walking

Caregiving can be a lonely journey, but AARP offers resources that can help.