What is MSSP?

MSSP, or the Multipurpose Senior Services Program, is an essential Medi-Cal funded program that provides intensive case management, care coordination, and other services and supports to help older adults stay in their homes as an alternative to nursing facilities.

MSSP services can be received in conjunction with services from other Medi-Cal HCBS programs, including In-Home Supportive Services and the Community-Based Adult Services (CBAS) program, as long as services are not duplicative. By filling service gaps, MSSP is essential to preventing unnecessary institutionalization.

Who Does MSSP Serve?

MSSP is available statewide for older adults in the Medi-Cal program who are sixty years or older and require nursing facility level of care. The goal of the MSSP program is to prevent or delay institutional placement. Eligibility does not require additional diagnostic or functional needs criteria beyond the need for nursing facility care.

MSSP Participants

10,259 total participants
92% are dual eligible
75% are women
48% of participants are non-English speakers
36% are over 85 years old
27% Spanish

*Data from DHCS, LTSS Data Dashboard (2023). Race and Ethnicity data is not available for this year.

What Services does MSSP Provide?

MSSP teams of social workers and registered nurses work with participants to create an individualized care plan to address gaps that put the participant at risk of institutional placement. MSSP is uniquely flexible in its ability to address unmet needs through purchasing individualized services and is not limited by a set package of benefits.

The services that MSSP can purchase include:

  • Care management
  • Adult day care
  • Minor home repair/maintenance
  • Specialized non-medical equipment
  • Supplemental in-home chore, personal care, and protective supervision services
  • Respite services
  • Transportation services
  • Counseling and therapeutic services
  • Meal services
  • Communication services
  • Consultative clinical services

MSSP Works with Other Programs to Fill Gaps

MSSP and IHSS keep me in my home and out of the home for the aged. I wouldn’t survive there. I am used to living alone. But I am 90 years old and I don’t venture outside by myself. I live on the 2nd floor—I am afraid to go by myself. For me it is very dangerous to fall, but with my caregiver, Robbie, I can go grocery shopping. And once a week we go out to lunch—it’s something that I look forward to. And during the week I reheat TV dinners because I can’t cook by myself anymore, but every Sunday Robbie comes over and we cook together. Well, she does everything and I supervise.

Laurel

To help address unmet needs, MSSP social workers identify available community resources, help participants access them, and, when necessary, purchase additional services to fill the gaps. Community resources can include other Medi-Cal HCBS programs so long as services are not duplicative. Many MSSP participants receive services from one or more HCBS programs—in 2023, approximately 90% of MSSP participants received IHSS concurrently and use MSSP to address additional unmet needs that put them at risk of institutional placement.

Laurel’s Story

Laurel is a 90-year-old Holocaust survivor. She lives alone in her Section 8 apartment in Los Angeles, with the support of MSSP and the help of her In-Home Supportive Services (IHSS) caregiver. Staying engaged is very important to Laurel—she enjoyed free adult education courses at the community college nearby, walks, and cooking for herself and her neighbors.

Fainting spells and falls make her cautious about going outside, cooking, and even taking baths when her IHSS caregiver is not there. When she enrolled in MSSP, her social worker, Linda, arranged for a Lifeline emergency response system, which she uses after a recent fall. Linda also found a synagogue where Laurel could celebrate holidays and attend services. Linda calls Laurel frequently to make sure that her complex medical conditions are stable, and to see if she needs more supports. When reading became too difficult, Linda arranged for a stand-alone lighted magnifying glass so Laurel could continue reading. When cooking and cleaning became too difficult, Linda arranged for another caregiver to come help on Laurel’s IHSS caregiver’s day off.

MSSP’s Resilience through Periods of Change

The MSSP program began as a demonstration in 1977, and has been a waiver program since 1983. Over the nearly 50 years of its existence, the program has faced challenges and changes. Most notably, in 2020, the state proposed to eliminate the program, and there have been repeated efforts to transition the program into managed care health plans, risking the robustness of support MSSP provides to participants. These proposals did not move forward in part due to stakeholders uplifting the critical role that MSSP plays in supporting older adults’ ability to age in place. In 2023, the MSSP was expanded and is now available statewide.

Lawmakers can support older Californian’s desire to age at home and in their communities, avoid costly institutionalization, and advance equity by continuing to fully fund MSSP so it can serve any older adult who needs it to remain in their home.

Sources