For Florida residents considering Medicaid to assist with the costs of nursing homes or home and community-based services, understanding the medical eligibility process is crucial. This is where the Comprehensive Assessment and Review for Long-Term Care Services (CARES) program comes into play. The CARES program utilizes a specific assessment tool to determine medical eligibility for these vital long-term care services.
CARES assessment tool in Florida evaluates the needs of seniors for long-term care services, including nursing homes and home care.
What is the CARES Program and its Assessment?
The CARES program is a Florida initiative designed to evaluate an individual’s medical needs to determine if they meet the medical eligibility requirements for Medicaid long-term care. This assessment is a critical step in accessing Medicaid benefits for both nursing facilities and home and community-based care waivers.
Trained professionals, including registered nurses and CARES assessors, conduct these evaluations. These assessments are provided at no cost to the applicant and are focused on identifying long-term care needs. The goal is to recommend the most suitable and least restrictive care setting for each individual based on their assessed needs. Following the assessment, a CARES physician or registered nurse reviews the application and assessment to officially determine the appropriate level of care.
Administration and Reach of the CARES Program
The Florida Department of Elder Affairs, in partnership with the Agency for Health Care Administration, oversees the CARES program. This partnership ensures the program’s effective operation and alignment with state healthcare guidelines. To provide statewide coverage, CARES operates through 17 field offices located across Florida.
The CARES program is staffed by a diverse team of professionals. This includes physicians and registered nurses who make medical eligibility determinations, assessors who conduct the initial evaluations, administrative support staff, office supervisors, and regional program supervisors. A central headquarters team is also in place to manage program and policy development, ensuring the CARES program remains effective and responsive to the evolving needs of Florida’s senior population.
Services and Eligibility Determination
The Cares Assessment Tool plays a key role in determining medical eligibility for several critical services:
- Medicaid Institutional Care Program (ICP): CARES assessments determine medical eligibility for individuals requiring care in a nursing facility setting.
- Medicaid Waivers for Home and Community-Based Services: For those who can receive care at home or in a community setting, CARES assessments are essential for accessing Medicaid waivers that support these services.
- Medical Assessments for Nursing Facilities in Receivership: CARES also conducts medical assessments for residents in nursing facilities that are under court-ordered receivership, ensuring continuity of care and appropriate medical oversight.
It is important to note that while CARES handles medical eligibility, financial eligibility for Medicaid long-term care is determined separately by the Florida Department of Children and Families or the Social Security Administration. Therefore, applicants must meet both medical and financial criteria to qualify for Medicaid long-term care assistance.
For individuals seeking more detailed information about Long-Term Care eligibility and the application process, resources are available through the Agency for Health Care Administration website: https://ahca.myflorida.com/medicaid/statewide_mc/smmc_ltc.shtml.
