Tenncare Plans to Take Cases from Senior Services

Tenncare may take over home and community based services for hundreds of elderly and disabled Tennesseans.

Currently, Senior Services of Shelby County and ADAPT, a program operated by Senior Services, provides care for 550 Medicaid enrollees in Nashville, Knoxville, Chattanooga and Memphis. Senior Services operates under its own Medicaid waiver, separate from Tenncare.

Early this year, the state asked the Centers for Medicare and Medicaid Services for approval to expand home-based care across the state. But Tenncare’s Deputy Commissioner, Darin Gordon, says the request was turned down and the state was given two options: terminate the Senior Services programs altogether or fold them into a statewide program.

“This wasn’t actually a route that we were prepared to go down, and if you look at all the correspondence with CMS for over the last year, we’d actually proposed adding services to the Senior Services and ADAPT waivers. CMS basically took that opportunity to say that they disapprove of how Senior Services is operating and believe that they were not operating in compliance with federal law.”

Gordon says the problem raised by CMS is that Senior Services provides both case managers to evaluate clients’ needs and the services that address those needs, essentially referring patients to itself.

The state has proposed to transfer Senior Service’s patients to Tenncare as part of a larger expansion of home-based care. Senior Services would still be eligible to contract with the state on a limited basis.

CMS is expected to make its decision on the proposal by the end of October.