Global Options (GO) for Long-Term Care

by: Thomas D. Begley, Jr.

Effective January 1, 2009 the Department of Health and Senior Services (DHSS) received approval from the US Centers for Medicare and Medicaid Services (CMS) to consolidate three Medicaid-supported home and community base services programs into a single program known as Global Options (GO) for Long-Term Care.

Provisions of the GO Program include:

  • Participants will have the option to hire and direct their own service providers.
  • Care managers will have greater flexibility in modifying individual care plans.
  • The program is designed to supplement, not replace, the assistance already being provided by family, friends and neighbors.
  • GO participants work with a care manager to create an individualized plan of care based on a comprehensive assessment for the participant’s health care needs.
  • Clinical and financial eligibility for Medicaid nursing facility level of care.
  • 65 or older or between ages between 21 and 64 but determined disabled by SSA or the New Jersey Health Services Disability Review Section.  Reasonable indication that the recipient might need the level of care provided in a hospital, a nursing facility or an intermediate care facility in the near future (1 month or less) unless he or she receives home and community-based services.  GO is not available for persons who are mentally ill, mentally retarded or developmentally disabled.
  • Assisted Living
  • Adult Family Care
  • Respit Care
  • Home Based Supportive Care
  • Environmental Accessibility Adaptations
  • Personal Emergency Response Systems
  • Home Delivered Meal Service
  • Caregiver/Participant Training
  • Social Adult Day Care
  • Special Medical Equipment and Supplies
  • Chore Services
  • Care Management
  • Transition Services and Transitional Care Management
  • Transportation
  • Attendant Care

Eligibility requirements for GO include:

Services that may be provided include:

The service package is based on an assessment of the individual=s level of care as determined in collaboration with a care manager.

Services are provided by traditional Medicaid community agencies, new qualified non-traditional entities, or qualified Participant-Employed Providers (individuals hired by the participant).  Services providers must meet qualification requirements which have been approved by the federal government.

Medicaid estate recovery applies to beneficiaries age 55 or older receiving benefits under GO.

A Community Choice Counselor or county assessor completes the enrollment forms and sends them to the County Board of Social Services.  A PAS is required for nursing home placement/GO.  A person in a nursing home for 21 days may be discharge into GO.  A person receiving SSI may be eligible for GO only if the person has an assessed need for two Waiver Services.  If a person’s only service need is estate plan services, he or she would not qualify for GO. Medicaid eligibility must be verified before a person can be considered for GO.  There is no longer a Wait List and individuals waiting for CCPED or CAP may be enrolled in GO.  For new persons never enrolled in a Medicaid Waiver, they need to be in a nursing home for 21 days and discharged into GO.  Persons currently receiving GO Waiver Services do not need to remain in a facility for 21 days.