Wednesday, April 16, 2008

Long Term Care Community Diversion Program

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Have you heard about the Long Term Care Community Diversion Program? The Diversion Program is designed to provide community-based services to people who would qualify for Medicaid nursing home placement. Services include long term care services, and Medicaid-covered medical services.

The way it works is that managed care organizations and other qualified providers contract with the State and receive a capitated payment to provide, manage and coordinate the enrollee's full continuum of care. The objective is to provide frail elders with safe, appropriate community based care alternatives in lieu of nursing home placement at a cost less than Medicaid nursing home care.

Qualifying terms include:
1. Age 65 or older
2. Dual eligibility for Medicaid & Medicare Part A and B
3. Live in the authorized program area
4. Be determined to be at nursing home level of care and meet one or more
established critical criteria by the Comprehensive Assessment Review and
Evaluation for Long Term Care Services (CARES)unit at the Department of Elder
Affairs.

For more information, contact your local CARES office.

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