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Statewide Medicaid Managed Care Long-Term Care Program - Screening

Screening

The first step in getting services through the Statewide Medicaid Managed Care (SMMC) Long-Term Care (LTC) program is getting screened by an Aging and Disability Resource Center (ADRC).  A list of the ADRCs is on the Florida Department of Elder Affairs (DOEA) website or persons may call the statewide toll-free Elder Helpline at 1-800-96-ELDER (1-800-963-5337).  The screening is done over the phone with the person and/or caregiver and takes about 45 minutes to an hour to finish.  The screening yields a priority score and rank used for placement on the wait list to receive long-term care services.

When the screening process is finished, the ADRC will notify the person, or his or her authorized representative*, of their wait list placement.

*Authorized Representative is defined in 409.962 Florida Statutes and means an individual who has the legal authority to make decisions on behalf of a Medicaid recipient or potential Medicaid recipient in matters related to the managed care plan or the screening or eligibility process.

Rescreening
Persons, or their authorized representative,* may contact the Aging and Disability Resource Center (ADRC) to ask for screening to be done again if they have a significant change as defined in section 409.962(17), Florida Statutes.  A significant change is when any of the following happens:
  • A change in a person’s health status after an accident or illness;
  • An actual or expected change in an individual’s living situation;
  • A change in the caregiver relationship;
  • Loss or damage to the person’s home or decline of his or her home environment; or
  • Loss of the person’s spouse or caregiver.

*Authorized Representative is defined in 409.962 Florida Statutes and means an individual who has the legal authority to make decisions on behalf of a Medicaid recipient or potential Medicaid recipient in matters related to the managed care plan or the screening or eligibility process.

Screening Exceptions

Current Florida Medicaid recipients who meet certain requirements do not have to be screened for the Statewide Medicaid Managed Care (SMMC) Long-Term Care (LTC) program; these recipients include:

Persons who are receiving Florida Medicaid services, and:

  • Meet LTC program eligibility requirements and are currently eligible for the Institutional Care Program and have lived in a nursing facility for at least 60 days; these individuals can be enrolled in the SMMC LTC program with help from their Managed Medical Assistance (MMA) plan.
  • Are a child under age 18 already enrolled in Medicaid and living in a nursing facility; six (6) months prior to the child’s 18th birthday, the child’s MMA plan will submit a referral to the Comprehensive Assessment and Review for Long-Term Care Services (CARES) Program at the Department of Elder Affairs (DOEA) to help transition the child to the SMMC LTC program.
  • Are a child under age 21 already enrolled in Medicaid and getting private duty nursing services; six (6) months before the child’s 21st birthday, the child’s MMA plan sends a referral to CARES to help transition the child to the SMMC LTC program.
  • Are an adult with Cystic Fibrosis; persons, their caregivers, or providers should contact DOEA for more information by Email: MedWaiver@ElderAffairs.org
    Phone: (866) 232-3733, or Fax: (850) 354-5095.  Individuals and their caregivers can also contact their local Aging and Disability Resource Center (ADRC) for referral.
Persons referred to the ADRC by Adult Protective Services at the Department of Children and Families (DCF):
  • Persons  found to be high-risk and in urgent need of services; these referrals will be managed with the Aging and Disability Resources Centers.
  • High-risk persons determined to need placement in an assisted living facility for immediate care; funding for temporary placement is provided by DCF.

Next: Get a Copy of Your Screening Results
Back: Who Can Recieve LTC Services

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