Community Programs HealthChoices (CHC) is a new mandatory Medicaid managed care program in Pennsylvania. Please join CARIE’s CHC Advocates Alliance to advocate, educate and empower older adults and their caregivers through educational Resources, Community Engagement, and Advocacy. CARIE’s CHC Advocates Alliance will provide advocates with a collaborative network to share resources to improve knowledge about CHC, listen to stakeholder concerns, and work together to improve CHC though systemic change. Members of CARIE’s Advocates Alliance will receive the CHC Grapevine with updates, advocacy tips, and new resources from CARIE including fact sheets and webinar tutorials.
Need help or have questions? Want to schedule a CHC presentation? Call a CARIE advocate for free at 1-800-356-3606 or submit an online request through Get Help.
Resources
An Advocate’s Guide to Community HealthChoices (CHC) provides a comprehensive overview of CHC along with advocacy tips and resource information. The purpose of the guide is to help advocates and others understand and navigate CHC.
The Guide will be periodically updated, and the most up-to-date version will always be posted here at www.carie.org/education-outreach/chc/. There is an “Edition Changes Log” immediately following the cover page highlighting what changes have been made. (Last update – December 2020)
If you have any feedback about the Guide or any of our resources, please let us know! Contact Kathy at [email protected] with any thoughts, suggestions, or requests.
Sign-up for CARIE’s CHC Grapevine.
Fact Sheets
Consumer CHC Fact Sheet – English
Nursing Home CHC Fact Sheet – English
Consumer CHC Fact Sheet – Spanish/Español
Consumer CHC Fact Sheet – Simplified Chinese/简体中文
Consumer CHC Fact Sheet – Russian/русский язык
Consumer CHC Fact Sheet – Korean/한국어
Consumer CHC Fact Sheet – Vietnamese/tiếng Việt
Transportation Roadmap
The complexities of transportation can prevent CHC consumers from getting to important places, whether for medical or non-medical needs. CARIE created a guide to help identify different transportation options under CHC and other programs, along with troubleshooting tips.
CHC Transportation Roadmap
CHC Transportation Roadmap (Booklet View)
You may contact CARIE at 1-800-356-3606 or [email protected] for free copies of this booklet. Please let us know if you have any feedback.
Participant Advisory Committee (PAC) Toolkit
All CHC plans must have a PAC in each of the 5 zones throughout Pennsylvania. CARIE created the CHC PAC Toolkit to help participants advocate for their needs and support PAC participation.
PAC Overview Fact Sheet
Participant Advisory Committees (PACs) and self-advocacy (1:42)
Fact sheets about each CHC plan’s PACs, such as how to apply and who to contact:
Keystone First and Amerihealth Caritas PA CHC PAC Fact Sheet
PA Health & Wellness PAC Fact Sheet
UPMC CHC PAC Fact Sheet
Advocacy Journal helps all CHC participants or their caregivers keep their health and CHC plan and provider information in one place. Advocacy logs track experiences and help with advocacy. The journal may be downloaded, used and saved offline or printed. You may also call CARIE at 215-545-5728 to request a free copy.
Parts of the Advocacy Journal for easy printing:
Your Health Plan Information and Contacts
Advocacy Log – Good Experience
Advocacy Log
Please rate our toolkit and share any feedback! An updated version will be released in 2021.
Webinars and Videos
Introduction to Community HealthChoices (5:51)
Consumer rights (1:13)
If you have Medicare and Medicaid (1:51)
Where to turn for help (1:43)
Participant Advisory Committees (PACs) and self-advocacy (1:42)
PA Senior Medicare Patrol (SMP) Webinar (33:58)
PAC Training (55:23)
2020 Webinar Series – PA’s Medicaid LTSS Application and Redetermination Processes
What You Need to Know About Medicaid Financial Eligibility for CHC LTSS (1:05:51) (.pdf of presentation slides)
Understanding Functional Eligibility Determinations in Medicaid LTSS Application and Redetermination (1:27:29) Presentation Slides and FED Tool Sample and FED Matrix
What Advocates Need to Know about CHC’s LTSS Grievance and Appeals Process (2:00:47) Presentation Slides and How to Appeal a Service Denial in CHC and PAS Appeal Guide
Other Resources
Pennsylvania’s Community HealthChoices website for consumers
Pennsylvania’s Community HealthChoices website for providers and professionals
Pennsylvania’s Independent Enrollment Broker (IEB) – CHC consumer information and enrollment
Community HealthChoices Three Plans:
- AmeriHealth Caritas – called Keystone First Community HealthChoices in Southeastern Pennsylvania – Call 1-855-235-5115, (TTY: 1-855-235-5112)
- PA Health & Wellness (known as Centene nationwide) – Call 1-844-626-6813, (TTY: 1-844-349-8916)
- UPMC Community HealthChoices – Call 1-844-833-0523, (TTY: 1-866-407-8762)
LIFE managed care program – an alternative for some who are age 55 and over
Behavioral HealthChoices – all CHC participants eligible for these benefits and services
Community Engagement
Sign-up here to be part of CARIE’s CHC Advocates Alliance and receive the CHC Grapevine newsletter.
CHC Forum Summary Notes:
Center in the Park, 11/29/2018
Philadelphia Senior Center, 5/8/2019
Inglis House, 11/19/2019
Town Hall Webinar, 12/17/20
Resources from the Commonwealth of Pennsylvania’s Department of Human Services
Sign-up here to get CHC updates from Pennsylvania’s Office of Long Term Living (OLTL).
Pennsylvania’s CHC Advisory Committee, the Managed Long-Term Services and Supports (MLTSS) subcommittee of the Medical Assistance Advisory Committee (MAAC) – The MLTSS SubMAAC holds monthly meetings and the public can attend or participate by webinar.
The Office of Long-Term Living (OLTL) maintains a CHC mailbox at [email protected] that stakeholders can use to ask questions or make comments about CHC.
Advocacy
CHC Ombudsman Issue Brief – an issue brief describing why Pennsylvania needs a CHC ombudsman.
CARIE wishes to acknowledge and thank our funders who support CARIE’s CHC advocacy, education and consumer engagement including Impact100 Philadelphia, The Pew Charitable Trusts, the Independence Foundation, Philadelphia Health Partnership, the Samuel S. Fels Fund, and our individual donors.
