Multipurpose Senior Services Program (MSSP) Waiver
Provider Type
- Physicians
- Participating Physician Groups (PPG)
- Hospitals
- Ancillary
The Multipurpose Senior Services Program (MSSP) provides social and health care case management services for members ages 65 and older who wish to remain in their homes and communities. The goal of the program is to use available community services to prevent or delay institutionalization. The services must be provided at a cost lower than that of a skilled nursing facility (SNF). MSSP services include, but are not limited to:
- environmental accessibility adaptations
- personal emergency response systems (PERSs) and communication devices
- care management
- personal care services (bathing, dressing, grooming)
- respite care (in- and out-of-home)
- adult day care, support center and health care
- housing assistance and minor home repair
- chore services
- income maintenance counseling
- mental health services
- transportation services
- protective supervision
- meal services
- communication services (translation or interpreter)
MSSP is provided by licensed MSSP sites. MSSP is not a managed care benefit.
To qualify for the Multipurpose Senior Services Program (MSSP), Medi-Cal members must meet all of the following criteria:
- Be age 65 or older.
- Certifiable for placement in a skilled nursing facility (SNF).
- Live in a county with an MSSP site and be within the site's service area.
- Be appropriate for care management services.
- Able to be served within MSSP's cost limitations.
MSSP is provided by licensed MSSP sites. MSSP is not a managed care benefit.
If a participating provider disagrees with the Multipurpose Senior Services Program (MSSP) decision or recommendation concerning the provision of MSSP services, Health Net's public programs administrators can assist with resolution.
Members who are potentially eligible for the Multipurpose Senior Services Program (MSSP) may be identified through a variety of sources, including the member's primary care physician (PCP) or specialist, community-based organizations, inpatient admissions (concurrent review), or claims and encounter data. Members may also apply for MSSP directly by calling the Department of Public Services (DPSS) in Los Angeles County, the Aging and Independence Services (AIS) office in San Diego County, or the Health Net Public Programs Department.
MSSP is provided by licensed MSSP sites. MSSP is not a managed care benefit.
With the member's consent, Health Net provides case management information required by the MSSP. A team of health and social service professionals determine the member's eligibility for MSSP participation. The team's assessment determines the member's medical diagnosis, physical disabilities, functional abilities, psychological status, and social and physical environment. Health Net case managers continue to provide needed care coordination with the member's PCP and other community agencies pending MSSP waitlist activity.
Health Net's PCPs and other providers continue to render medically necessary care while the member participates in the MSSP.