Section 1 modifies the long-term care consultation services section of law to allow a person being assessed for community-based living assistance to have her or his chosen provider of customized living (CL) services present during the face-to-face assessment interview. The chosen provider of CL services must be provided a copy of the long-term care consultant’s assessment, and the decision regarding the person’s need for institutional level of care.
Sections 2 through 6 amends the Medicaid waiver for elderly services section of law.
Sections 2 and 3 require the lead agency to consult with the chosen provider of CL services to ensure payments are in compliance with the parameters of authorized CL services and 24-hour CL services.
Section 4 establishes appeals and reassessment processes for waiver recipients.
Section 5 requires the elderly waiver client’s provider of services to be provided a copy of the client’s written care plan.
Section 6 applies Medical Assistance CL services benefits retroactively to the date of the long-term care assessment or reassessment. Requires managed care organizations to train and notify CL service providers on systems and policy changes to eligibility, billing ,and payment within 90 days of the change. Allows CL services-eligible persons the option to choose any CL service provider that meets federal standards. Allows CL services recipients with a spenddown to designate the CL service provider of their choice to whom they will pay their spenddown amount.