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MSSP and CBAS (Medi-Cal care management for seniors and adult day health centers that keep people out of nursing homes): who qualifies, what you get, how to apply, and what happens next

The Multipurpose Senior Services Program gives Medi-Cal members 60 and older who need nursing-facility care a care team and services at home; Community-Based Adult Services is a day health center for Medi-Cal adults 18 and older at risk of institutional care. This page carries both programs' tests and services from the California Department of Aging. Apply by calling the local MSSP site or CBAS center found by county.

What MSSP and CBAS are, in one paragraph

These are two Medi-Cal programs that keep a person who needs nursing-facility level care living at home. The Multipurpose Senior Services Program (MSSP) is care management for people 60 and older: a team assesses the person, writes a care plan, coordinates services and buys some that are not otherwise available (rule:mssp_definition, rule:mssp_coordination). Community-Based Adult Services (CBAS) is a day health center for adults 18 and older, with nursing, therapy, meals and transportation (rule:cbas_definition, rule:cbas_services). The California Department of Aging lists both and their local sites.

60+ / 18+
the minimum ages for MSSP and for CBAS; both require Medi-Cal (California Department of Aging, rule:mssp_age_60, rule:cbas_age_18)

Who may qualify

TestMSSPCBAS
Age60 or older (rule:mssp_age_60)18 or older (rule:cbas_age_18)
Medi-CalEligible under a qualifying primary aid code (rule:mssp_medi_cal)Currently eligible under a qualifying primary aid code (rule:cbas_medi_cal)
Care needCertified or certifiable for a skilled nursing facility (rule:mssp_snf_level)Meets specific medical necessity criteria (rule:cbas_medical_necessity)
CostYearly services must cost less than a skilled nursing facility (rule:mssp_cost_cap)not stated

The Medi-Cal income and asset rules are on Medi-Cal (California Medicaid health coverage): who qualifies, what you get, how to apply, and what happens next. Most MSSP participants also get In-Home Supportive Services (rule:mssp_ihss).

How to apply, and what happens after

Find the local MSSP site or CBAS center by county on the California Department of Aging's Find Services in My County page (rule:mssp_find, rule:cbas_find), and call it. MSSP: a team does a full health and psychosocial assessment and writes a care plan with the person, their doctor and family (rule:mssp_assessment, rule:mssp_care_plan). CBAS: the center's health professionals assess the person and plan services (rule:cbas_assessment).

Both continue as long as Medi-Cal does. A person who disagrees with a Medi-Cal action has 90 days to request a state hearing (rule:hearing_90), at (800) 743-8525 (rule:hearing_phone); where the Medi-Cal plan made the decision, the plan appeal comes first, within 60 days (rule:plan_appeal_60).

The procedure, stage by stage, as data
JSONThe procedure, stage by stage, as data
9 items
10 keys
"id""stage:discover"
"order"1
"name""Discover"
"what_happens""An older or disabled Medi-Cal member, family or doctor learns MSSP (60+) and CBAS (18+) can keep a person who needs nursing-facility care at home"
"who_acts""Person / family / doctor"
"timeline""No deadline"
"evidence""Medi-Cal card"
"failure_mode""Nursing-home placement without knowing the alternatives"
"model_role""Name both programs and the difference in age and service"
"automation_class""C - referral and assessment based"
10 keys
"id""stage:screen_eligibility"
"order"2
"name""Screen eligibility"
"what_happens""MSSP: 60+, Medi-Cal, certifiable for a skilled nursing facility (rule:mssp_age_60, rule:mssp_medi_cal, rule:mssp_snf_level). CBAS: 18+, Medi-Cal, medical necessity (rule:cbas_age_18, rule:cbas_medi_cal, rule:cbas_medical_necessity)"
"who_acts""Model + person"
"timeline""Minutes"
"evidence""Age, Medi-Cal status, care needs"
"failure_mode""No Medi-Cal yet"
"model_role""Route to Medi-Cal first when needed"
"automation_class""A"
10 keys
"id""stage:referral"
"order"3
"name""Submit referral"
"what_happens""Contact the local MSSP site or CBAS center found by county (rule:mssp_find, rule:cbas_find)"
"who_acts""Person / family / provider"
"timeline""UNKNOWN: no page read today states a response time"
"evidence""Medi-Cal number, doctor contact"
"failure_mode""Calling a site outside the county"
"model_role""Give the county finder"
"automation_class""B"
10 keys
"id""stage:interview_verification"
"order"4
"name""Interview / verification"
"what_happens""MSSP: complete health and psychosocial assessment by a team (rule:mssp_assessment). CBAS: assessment by the center’s health professionals (rule:cbas_assessment)"
"who_acts""Site / center team"
"timeline""UNKNOWN"
"evidence""Medical records"
"failure_mode""Assessment below the required level"
"model_role""Prepare the list of daily needs"
"automation_class""C"
10 keys
"id""stage:decision"
"order"5
"name""Decision"
"what_happens""Enrollment when criteria are met and, for MSSP, care costs stay below nursing-facility cost (rule:mssp_cost_cap)"
"who_acts""Site / center / Medi-Cal"
"timeline""UNKNOWN"
"evidence""Notice"
"failure_mode""Not enrolled without a written reason"
"model_role""Ask for the decision in writing"
"automation_class""C"
10 keys
"id""stage:issuance_use"
"order"6
"name""Issuance / use"
"what_happens""MSSP: care plan, care coordination and purchased services (rule:mssp_care_plan, rule:mssp_coordination, rule:mssp_services). CBAS: day health center with nursing, therapy, meals and transportation (rule:cbas_services, rule:cbas_transport)"
"who_acts""Site / center"
"timeline""Ongoing"
"evidence""Care plan"
"failure_mode""Missing services the plan lists"
"model_role""Check the care plan against the service list"
"automation_class""C"
10 keys
"id""stage:renew_recertify"
"order"7
"name""Renew / recertify"
"what_happens""Both continue while Medi-Cal continues; the Medi-Cal renewal is the person’s step"
"who_acts""County + person"
"timeline""Medi-Cal: yearly"
"evidence""Medi-Cal renewal"
"failure_mode""Lost Medi-Cal ends both"
"model_role""Track the Medi-Cal renewal month"
"automation_class""B"
10 keys
"id""stage:appeal_fair_hearing"
"order"8
"name""Appeal / fair hearing"
"what_happens""State hearing on a Medi-Cal action (rule:hearing_90, rule:hearing_phone); a plan decision goes to the plan first (rule:plan_appeal_60)"
"who_acts""Person + CDSS State Hearings Division"
"timeline""90 days; plan appeal 60 days"
"evidence""Notice"
"failure_mode""Missing the deadline"
"model_role""Give the deadline from the notice date"
"automation_class""B"
10 keys
"id""stage:overpayment_exit"
"order"9
"name""Overpayment / exit"
"what_happens""Services end with Medi-Cal, a move, nursing-facility placement, or when MSSP costs would exceed nursing-facility cost (rule:mssp_cost_cap)"
"who_acts""Site / center"
"timeline""At change"
"evidence""Notice"
"failure_mode""A gap in care at discharge"
"model_role""Plan the next service before exit"
"automation_class""C"

The same facts open other programs

Age, Medi-Cal status and care needs are the facts these programs ask. They also open:

References (7)
What this article shares with the graph
JSONWhat this article shares with the graph
6 keys
"program_id""B016"
"graph""california-benefits-graph"
"related_program_ids" 7 items
"B011"
"B015"
"B073"
"B070"
"B063"
"B013"
"B014"
"related_programs" 7 keys
"B011""Medi-Cal (Medicaid) (level: Federal/State; administrator: CA Dept of Health Care Services + counties / Covered California; graph url: https://www.dhcs.ca.gov/services/medi-cal)"
"B015""In-Home Supportive Services (IHSS)"
"B073""PACE (Program of All-Inclusive Care for the Elderly) (level: Federal/State; administrator: DHCS / PACE organizations; graph url: https://www.dhcs.ca.gov/services/medi-cal)"
"B070""Whole Person Care successor: CalAIM Enhanced Care Management + Community Supports (level: State/County; administrator: DHCS / Medi-Cal managed care plans; graph url: https://www.dhcs.ca.gov/CalAIM)"
"B063""Older Americans Act meals (Meals on Wheels / congregate)"
"B013""Medicare Savings Programs (QMB / SLMB / QI / QDWI)"
"B014""Medicare Part D Extra Help (Low-Income Subsidy)"
"triggered_by_events" 1 item
"event:senior_needs_care_at_home_aging_parent_own_decline"
"shares_facts_with" 2 keys
"person.identity.date_of_birth" 5 items
"B001"
"B011"
"B013"
"B023"
"B063"
"benefits.currently_receiving[]" 4 items
"B001"
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"B047"

Official addresses

Related pages
Beside
PACE (Program of All-Inclusive Care for the Elderly: all medical and social care from one team, at home instead of a nursing home): who qualifies, what you get, how to apply, and what happens nextIn-Home Supportive Services (IHSS) (paid in-home care for aged, blind and disabled Californians on Medi-Cal): who qualifies, what you get, how to apply, and what happens nextMedi-Cal (California Medicaid health coverage): who qualifies, what you get, how to apply, and what happens nextCalAIM Enhanced Care Management and Community Supports (care teams, housing help, meals and respite through the Medi-Cal health plan): who qualifies, what you get, how to apply, and what happens nextOlder Americans Act meals (Meals on Wheels / congregate) (free group meals and home-delivered meals for Californians 60 and older): who qualifies, what you get, how to apply, and what happens next
References (21)
  1. Multipurpose Senior Services Program | California Department of Aging: what MSSP is — California Department of Aging“provides both social and health care management services to assist individuals remain in their own homes and communities”
  2. Multipurpose Senior Services Program | California Department of Aging: care coordination — California Department of Aging“MSSP provides on-going care coordination, links participants to other needed community”
  3. Multipurpose Senior Services Program | California Department of Aging: cost cap — California Department of Aging“The total annual combined cost of care management and other services must be lower than the cost of receiving care in a skilled nursing facility.”
  4. Multipurpose Senior Services Program | California Department of Aging: assessment — California Department of Aging“A team of health and social service professionals provides each MSSP participant with a complete health and psychosocial assessment to determine needed services.”
  5. Multipurpose Senior Services Program | California Department of Aging: care plan — California Department of Aging“The team then works with the MSSP participant, their physician, family, and others to develop an individualized care plan.”
  6. Multipurpose Senior Services Program | California Department of Aging: services list — California Department of Aging“Minor home repair/maintenance”
  7. Multipurpose Senior Services Program | California Department of Aging: respite — California Department of Aging“Respite services”
  8. Multipurpose Senior Services Program | California Department of Aging: who can get MSSP — California Department of Aging“Persons 60 years of age or older who are eligible for Medi-Cal under a qualifying primary Medi-Cal aid code and who are certified or certifiable for placement in a skilled nursing facility.”
  9. Multipurpose Senior Services Program | California Department of Aging: finding a site — California Department of Aging“You can locate a MSSP provider in your area by selecting your county on the”
  10. Multipurpose Senior Services Program | California Department of Aging: IHSS — California Department of Aging“While most of the program participants also receive In-Home Supportive Services”
  11. Community-Based Adult Services | California Department of Aging: what CBAS is — California Department of Aging“is a community-based day health program that provides services to older adults and adults with chronic medical,”
  12. Community-Based Adult Services | California Department of Aging: alternative to institutional care — California Department of Aging“The CBAS Program is an alternative to institutional care for Medi-Cal beneficiaries who can live at home with the aid of appropriate health, rehabilitative,”
  13. Community-Based Adult Services | California Department of Aging: assessment — California Department of Aging“Each CBAS center has health professionals who assess each potential participant to identify and plan services needed to meet the individual's specific health and”
  14. Community-Based Adult Services | California Department of Aging: services list — California Department of Aging“Professional nursing services”
  15. Community-Based Adult Services | California Department of Aging: meals — California Department of Aging“Hot meals and nutritional counseling”
  16. Community-Based Adult Services | California Department of Aging: transportation — California Department of Aging“Transportation to and from the participant’s residence”
  17. Community-Based Adult Services | California Department of Aging: who can get CBAS — California Department of Aging“Persons 18 years of age or older who meet specific medical necessity and are currently eligible for Medi-Cal under a qualifying primary Medi-Cal aid code”
  18. Community-Based Adult Services | California Department of Aging: finding a center — California Department of Aging“You can locate a CBAS center in your area by selecting your county on the”
  19. Hearing Requests | CDSS: the 90 days — California Department of Social Services, State Hearings Division“you have 90 days to request a state hearing.”
  20. Hearing Requests | CDSS: plan appeal — California Department of Social Services, State Hearings Division“You have 60 calendar days from the date of the notice of action to file an appeal with the managed care plan.”
  21. Hearing Requests | CDSS: phone — California Department of Social Services, State Hearings Division“Call the State Hearings Division toll free (800) 743-8525”