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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. MACPAC s analysis of states Functional assessment tools shows that there are at least 124 tools currently in use.

LTSS HCBS waiver SSI-related Yes Yes Yes Adults ≥ 65: None; Adults 18–64: Blindness or permanent, medically determinable impairment that results in the inability to do any substantial gainful activity Yes NF: Yes; All other institutions at state option At state option Children < 18: Permanent, medically determinable impairment that results

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