Multipurpose Senior Services Program (MSSP)

Program Code

The Multipurpose Senior Services Program (MSSP) program code is 3910100.

Program Description

MSSP provides both social and health care management services to assist frail individuals aged 65 or older to remain in their own homes and communities. To be eligible for MSSP, these individuals must be Medi-Cal eligible and meet the criteria for skilled nursing facility care. The Program’s goal is to prevent or delay institutionalization through ongoing care management, using available community services and resources, and purchasing needed services when they are not already available. The total annual combined cost of care management and other services must be lower than the cost of receiving skilled nursing facility care.

MSSP operates under a Medicaid (Medi-Cal in California) 1915(c) Home and Community-Based Services (HCBS) waiver that has been approved by the federal Centers for Medicare & Medicaid Services. The current waiver extends from July 1, 2014 through June 30, 2019. The California Department of Aging (CDA) administers MSSP under an interagency agreement with the Department of Health Care Services. CDA’s MSSP Branch oversees the programmatic, fiscal, and service components of local MSSP site operations.

Under California’s Coordinated Care Initiative (CCI), most Medi-Cal beneficiaries in CCI counties must be enrolled in a participating Medi-Cal managed care health plan to receive their Medi-Cal benefits, including MSSP. MSSP sites that provide waiver services in a CCI county have entered into agreements with participating managed care health plans to deliver MSSP waiver services to eligible plan members. MSSP sites serving non-CCI counties deliver MSSP services as a Medi-Cal fee-for-service benefit.

In six of the seven CCI counties (Los Angeles, Orange, Riverside, San Bernardino, San Diego, and Santa Clara), MSSP continues to be a 1915(c) HCBS waiver benefit until it transitions to be a fully integrated managed care health plan benefit that is administered and authorized by the plan. In San Mateo County, this transition occurred on October 31, 2015. Full transition of MSSP into Medi-Cal managed care in the remaining six CCI counties must occur no sooner than December 31, 2020 and will affect 12 MSSP sites and approximately 4,856 participants.

The Governor’s Budget evaluation of CCI determined that it would no longer be cost-effective. Therefore, pursuant to the provisions of current law, the program was discontinued in 2017-18. Based on the lessons learned from the CCI demonstration project, the Budget extended the Cal MediConnect program and the mandatory enrollment of dual eligibles and integrating of long-term services and support, such as MSSP, into managed care.

Program Benefits

While most of the program participants also receive In-Home Supportive Services, MSSP provides on-going care coordination, links participants to other needed community services and resources, coordinates with health care providers, and purchases needed services that are not otherwise available in an effort to prevent or delay institutionalization. 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. A team of health and social service professionals provides each MSSP participant with a complete health and psychosocial assessment to determine needed services. The team then works with the MSSP participant, their physician, family, and others to develop an individualized care plan.

Services include, but are not limited to: care management; adult day care; housing assistance; supplemental in-home chore and supplemental personal care services; respite services; transportation services; supplemental protective services; meal services; and special communication assistance.

Program Eligibility

Eligibility Criteria Eligibility Requirement
Age

Individuals age 65 or older on Medicare

Income

Currently eligible for Medi-Cal under a qualifying primary Medi-Cal aid code

Other
  • Medi-Cal beneficiaries certified or certifiable for placement in a skilled nursing facility
  • Medi-Cal beneficiaries residing in a CCI demonstration county must be enrolled in a participating Medi-Cal managed care health plan, unless the individual lives outside the managed care health plan’s covered service area, is awaiting enrollment into a managed care health plan, or is exempt from managed care health plan enrollment

Program Funding

Funding Type Funding Information
Source
  • Social Security Act Title XIX Medicaid federal funds
  • State General Fund (GF)
Allocation Formula

Not applicable

Match Requirements

50 percent State General Fund

Other

Not applicable

Cycle

July 1 - June 30

Program Fact Sheets - Statewide

Available Content:

Program Fact Sheets - Local Level