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Revision 26-1; Effective Feb. 20, 2026
Long-term services and supports (LTSS) offered through the STAR+PLUS program include:
- Community First Choice (CFC) - Available to members who receive Supplemental Security Income (SSI) or receive SSI-related Medicaid. CFC is not available for medical assistance only (MAO) members. Members with CFC meet an institutional level of care (LOC) for a hospital, nursing facility (NF), intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID) or psychiatric hospital, also called an institution for mental disease. CFC services are provided in a community-based setting. Community-based settings do not include:
- hospitals;
- NFs;
- institutions for mental disease (IMD);
- ICF/IID; and
- any setting with the characteristics of an institution.
- CFC services include:
- Emergency Response Services (ERS), which are backup systems and supports, including electronic devices with a backup support plan to ensure continuity of services and supports;
- habilitation services, which provide acquisition, maintenance, and enhancement of skills necessary for the individual to accomplish activities of daily living (ADLs), instrumental activities of daily living (IADLs) and health-related tasks;
- personal assistance services (PAS), which help with ADLs, IADLs and health-related tasks through hands-on assistance, supervision or cueing, including nurse-delegated tasks; and
- support management, which is training provided to members or authorized representatives (ARs) on how to manage and dismiss their attendants.
- Day Activity and Health Services (DAHS) — All members of a STAR+PLUS managed care organization (MCO) may receive medically and functionally necessary DAHS. DAHS includes nursing and PAS, therapy extension services, nutrition services, transportation services and other supportive services. These services are provided at facilities licensed by the state.
- Nursing facilities (NFs) — Institutional care for members whose physician certified that the member has a medical condition that requires 24-hour nursing care that meets medical necessity (MN) requirements. The need for custodial care solely does not constitute MN for an NF placement. Institutional care includes coverage for the medical, social and psychological needs of each resident, including room and board (R&B) charges, social services, medications not covered by Medicare Part B or D, medical supplies and equipment, rehabilitative services and personal needs items.
- PAS, formerly known as Primary Home Care (PHC) PAS — All members may receive medically and functionally necessary PAS. PAS includes helping the member perform ADLs and household chores necessary to keep the home in a clean, sanitary and safe environment. The level of help given is determined by the member's need and the plan of care (POC). To be eligible for Medicaid state plan PAS, the MCO must assess applicants in a face-to-face visit. Members are assessed using Form H2060, Needs Assessment Questionnaire and Task/Hour Guide, or Form H6516, Community First Choice Assessment. To be eligible for PAS through programs other than CFC or the STAR+PLUS Home and Community Based Services (HCBS) program, members must score at least 24 on Form H2060. PAS includes three service delivery options:
- Agency Option (AO);
- Consumer Directed Services Option (CDS); and
- Service Responsibility Option (SRO).
STAR+PLUS HCBS program — This is for those members who qualify for such services. The state also provides an enriched array of services to members who would otherwise qualify for NF care through the STAR+PLUS HCBS program. The MCO must also provide medically necessary services that are available to members who meet the functional and financial eligibility for the STAR+PLUS HCBS program.