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CHAPTER 4 Functional Assessments for Long-Term Services ...

CHAPTER 4 Functional Assessments for Long-Term Services and Supports June 201668 CHAPTER 4: Functional Assessments for Long-Term Services and SupportsFunctional Assessments for Long-Term Services and Supports Key Points Functional assessment tools are sets of questions about an applicant s health conditions and Functional needs that state Medicaid programs use to determine Functional eligibility for Long-Term Services and supports (LTSS) and to create specific care plans for eligible individuals. The federal government does not require states to use a particular assessment tool to determine eligibility or to develop a care plan.

Functional Eligibility Criteria: Variation by Eligibility Pathway Individuals must meet functional eligibility criteria to receive Medicaid coverage for LTSS, whether in an institution or the community. These functional criteria vary by eligibility pathway and by state, and the type of pathways that are

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Transcription of CHAPTER 4 Functional Assessments for Long-Term Services ...

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Medicaid Home- and Community-Based Services ...

www.macpac.gov

High-cost users are defined as HCBS users with expenditures in the top 3 percent of our analytic sample, by state. We also excluded high-cost HCBS users who (a) lived fewer than three months of the year and (b) were outliers based on spending.

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www.macpac.gov

State Experiences with Managed Long-Term Services and Supports ... • Wisconsin’s Managed Long Term Care Program • Supporting the IDD population in MLTSS • Long Term Care Quality Strategy ... • In 2000, 49% of WI long term care population was in the community. In 2015, 80.2% live in the community.

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www.macpac.gov

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www.macpac.gov

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Medicaid Coverage of Non-Emergency Medical …

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  Medical, Emergency, Transportation, Non emergency medical transportation, Of non emergency medical

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www.macpac.gov

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www.macpac.gov

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faculty.washington.edu

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