Long-Term Care Managed Care Program
The Long-Term Care Managed Care Program has managed care plans under contract with the Agency for Health Care Administration. The state is divided into 11 regions, each of which has its own long-term care plans. Limited enrollment slots for this program are available, meaning some eligible applicants may be placed on a wait list until services open up. Coverage may vary across plans, but all plans must provide core services including:
- Assisted living
- Attendant nursing care
- Care coordination and case management
- Hospice
- Intermittent and skilled nursing services
- Medication administration
- Medical equipment and supplies
- Personal care
- Personal Emergency Response System
- Physical, speech and occupational therapy
To be eligible for this program, applicants must be at least 65 years old or have a disability. They must also meet medical and financial eligibility criteria.
Enrolling in this waiver has a three-step process. First, applicants are screened for services by an Aging and Disability Resource Center. This screening can take place in person or over the phone and takes about 45 minutes. Through this screening, the ADRC generates a priority score, which affects the individual’s placement on the wait list for services. Once the individual is released from the wait list, they undergo a CARES Assessment of Long-Term Care Needs. Finally, they pick a long-term care plan.