Evaluation and Review Services (AERS)

AERS is a  Maryland program based in local health departments which provides assistance to frail, aged, or disabled adults and children by conducting a comprehensive evaluation to identify public services available to help individuals remain in the community, or in their least restrictive environment, with as much independence as possible.   Evaluations are conducted by a licensed registered nurse or social worker.  Interpretation and translation services are available.

How to make a referral

Referrals are accepted by telephone, fax, mail, or in person from potential clients, their relatives, staff from agencies, and any concerned individual. Referred clients or their representatives are contacted by AERS staff to schedule an evaluation in their home, or present location. Assessments are voluntary, free of charge, and confidential, in compliance with state and federal regulations. Referrals to other agencies are not made unless a consent form is signed.

When to make a referral

• • A referral to AERS should be considered whenever frail individuals, or their caregivers, need information and assistance in accessing community services such as Senior Care, medication assistance, Assisted Living, In-Home Aid services, and other public support programs.
  • Individuals already in a nursing facility and on medical assistance, who are seeking assistance in obtaining services to return to the community, should contact AERS for information about the Community Options Waiver or Community First Choice services.
  • An AERS evaluation is required when individuals have a positive history of mental illness, developmental disability, or both, and are seeking nursing home placement.
  • An evaluation is also required for individuals age 65 and older who are referred for admission to a state psychiatric facility.

Medical Assistance Personal Care Program

The Medical Assistance Personal Care Program has changed.
The program still helps individuals with Medicaid who have a chronic illness, medical condition, or disability remain in their homes. Services provided assist individuals with basic domestic activities of daily living.

The program has been renamed to allow for the different levels of services provided:

• • Community Options Waiver
  • Community First Choice (CFC)
  • Community Personal Assistance Services (CPAS)

These three programs work hand-in-hand to provide community services and supports. They empower older adults and people with disabilities to live in the community.  

About the Programs

What do these programs offer and who do they serve?

The programs provide assistance with activities of daily living to Medicaid recipients who have a chronic illness, medical condition or disability. Services are provided in the eligible individual’s home or community residence (waiver participants may receive services in an assisted living facility). Other services in each program vary.  Please see each program’s fact sheet for information about the specific services provided through the program.

How Do I Apply To Receive These Services?

Qualified applicants must meet both the Medicaid Program’s financial and medical requirements. An assessment completed by your Local Health Department determines medical eligibility. Financial eligibility is determined by either the local Department of Social Services or by the Maryland Department of Health.

Once you are determined eligible, each participant or his or her representative will choose an approved Supports Planning Agency to guide them through developing a plan for services.

What Services Are Provided?

Services provided in the program include assistance, or items that substitute for assistance, with the following activities of daily living:

• • Bathing
  • Toileting
  • Mobility, including transferring from place to place
  • Eating
  • Dressing

Individuals who need help with activities of daily living may also receive help with:

• • Household services related to medical needs
  • Escort services to a medical appointment
  • Personal hygiene and grooming

The Personal Care program may be helpful to you or someone you know that is:

• • Eligible for Medical Assistance
  • Chronically ill
  • Disabled and under a doctor´s care for a chronic illness or disability
  • Needs help with simple daily activities
  • Moderately at risk of institutionalization (i.e. nursing home)

Referrals are accepted at Talbot County Health Department by telephone, fax, mail, or in person.   A licensed registered nurse will complete an evaluation for services in the client’s home or place of residence.  Medical information from the client’s medical provider is required.

Senior Care

The Talbot County Senior Care Program is funded by the Maryland Department of Aging and supplemented with County support and funding.  It is administered by the Talbot County Health Department in partnership with Upper Shore Aging and the Department of Social Services.

The Senior Care program provides case management and funds for services for people 65 or older who may be at risk of nursing home placement. Senior Care allows seniors to live with dignity and in the comfort of their own homes and at a lower cost than nursing facility care. Senior Care provides a comprehensive assessment of an   individual’s needs, a case manager to secure and coordinate services, and a pool of gapfilling funds to purchase services for individuals who meet program eligibility requirements. Services may include personal care, chore service, medications, medical supplies, adult day care, respite care, home delivered meals, transportation, and emergency response systems.

Coordination of Services
The Senior Care system of coordinated services is provided through the local aging, health and social services agencies. These services consist of screening, assessment, case management, and gap-filling services. Case management is provided both in-kind and paid for with Senior Care funds.

Screening
When older persons are referred for help, they are screened to determine if they may be eligible for Senior Care and other services. Screens may be performed by all participating agencies and include information about an individual’s age, income, assets and functional abilities. If the individual appears eligible for Senior Care, a referral is made for a full evaluation of need.

Assessment
These assessments are the evaluation of need and are conducted by Talbot County Health Department licensed registered nurses and social workers.  Upon completion of the assessment, these nurses and social workers meet with the individuals, families, and caregivers to develop a plan of care that outlines services that the client is currently receiving and those that are still needed. This plan of care and the assessment information is forwarded to a case manager, who meets with the client to determine the services that the client will receive. This service plan is based on the client’s wishes as well as the availability of services and funds.

Case Management
Each Senior Care client is assigned a case manager.  The case manager is responsible for implementing the care plan. This entails seeking out and ordering services, assisting the client or the client’s family to apply for other services, client advocacy, and overseeing services that are provided.

For further information on eligibility and to access Senior Care or other senior assistance programs and services, please contact Talbot County Health Department at 410-819-5600.