NEWS Trial on Medicaid Unwind Wraps Up

NEWS Trial on Medicaid Unwind Wraps Up

Florida’s Medicaid Long-Term Care – Home and Community Based Services (HCBS): Navigating the Program

 

This video is a summary of the Advocate’s Guide to the Florida Long-Term Care Medicaid Waiver, which is published on the Florida Health Justice Project website.

Portal Resource Materials

00 min 00 sec | Medicaid HCBS

An overview for the purpose of the video, an outline of the general topics that will be covered, the background information for the Medicaid HCBS program and an explanation of the corresponding resource materials in the toolkit.

Abbreviations

04 min 00 sec | Apply

Details about the initial call to learn about the Program, the types of screening and assessment questions asked during the call and the next steps that occur after the call.

Alzheimer’s Disease Initiative (ADI)
Community Care for the Elderly (CCE) Program
​Home Care for the Elderly (HCE) Program
​The Road to Medicare-Covered Home Health Care
Priority Score and Rank
Post-Screening Notices: Sample Letters (prior to May 2021 and new rule development)​
Post-Screening Notices: Current template as of May 2021
​Post Screening Notice

08 min 46 sec | Waitlist – Eligibility

Explanation of the Waitlist Release procedures and protocols as well as the Clinical and Financial Eligibility requirements for the Program.

ADRC Waitlist Release Letter Templates
Post Waitlist Release Eligibility Determination: Process and Timeline

12 min 02 sec | Medicaid Managed Care

Tips for picking a plan, the available options for Miami-Dade County and steps for changing your Managed Care Organization.

Picking a Managed Care Organization (“Plan”)
Changing Managed Care Organization (“Plan”)

13 min 15 sec | Program Services

Description of the types of Program services, the specifics entailed in the Plan of Care and a list of ensured rights.

Long-Term Care (LTC) Home & Community Based Care Services
Plan of Care
​Personal-Centered Care Plan Sample Form
Member Handbook
​Supplemental Assessment
​Protections Against Gaps in Long-Term Care (LTC) Services
​Participant Directed Services

17 min 36 sec | Addressing Problems

Steps for addressing complaints with the Program and an explanation of the grievance and appeal process.

How to File a Complaint
Adverse Benefit Determination (ABD)
Grievances, Appeals and Fair Hearings

20 min 00 sec | Resources For Help

Entities to contact to help assist with resolving problems experienced with the Program.

Where to go for Questions or Help

20 min 49 sec | Share Your Story

The importance of sharing your personal experience of navigating the system and your thoughts on the services provided by the Program.

Florida Health STORIES
Florida Health STORIES | Long-Term Care

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