The state of Florida provides essential support for its elderly residents through various programs, and one crucial aspect is accessing Medicaid for long-term care services. For Florida residents considering home and community-based services or nursing home care covered by Medicaid, understanding the medical eligibility process is key. This is where the Comprehensive Assessment and Review for Long-Term Care Services (CARES) Program plays a vital role. CARES is responsible for determining medical eligibility, often referred to as the level of care determination, for individuals seeking to access both home and community-based Medicaid waiver programs and Medicaid-funded nursing home services.
What is the CARES Program and How Does It Work?
The CARES program in Florida is designed to streamline the process for individuals needing long-term care to access the necessary Medicaid benefits. A significant part of this process involves a comprehensive medical assessment. This assessment is conducted by a CARES registered nurse or a CARES assessor, and it is provided at no cost to the applicant. The purpose of this assessment is to thoroughly identify the individual’s long-term care needs and to recommend the least restrictive, yet most appropriate care setting. Following the assessment, a CARES physician or registered nurse reviews the application and the assessment findings to officially determine the most suitable level of care required by the applicant. This ensures that individuals receive the right type of care in the most appropriate environment, whether that be at home, in the community, or in a nursing facility.
Elderly woman receiving care. CARES program assessment ensures appropriate care for seniors in Florida.
Who Administers the Florida CARES Program?
The administration of the CARES Program is a collaborative effort in Florida. The lead agency responsible for overseeing the program is the Florida Department of Elder Affairs. They work in close partnership with the Agency for Health Care Administration to ensure the program operates effectively and efficiently across the state. To provide localized support and access, there are 17 CARES field offices strategically located throughout Florida. The CARES program is staffed by a multidisciplinary team of professionals, including physicians, registered nurses, assessors, administrative support personnel, office supervisors, and regional program supervisors. Furthermore, a central headquarters staff is dedicated to program and policy development, ensuring the CARES program remains responsive to the evolving needs of Florida’s senior population and adheres to best practices in long-term care assessment and eligibility determination.
Services Provided by the CARES Program
The CARES Program offers several critical services aimed at facilitating access to long-term care for eligible Florida residents. These services include:
- Medical Eligibility Determination for the Medicaid Institutional Care Program (ICP): CARES assesses individuals to determine if they meet the medical criteria for receiving care under the Medicaid ICP, which often covers nursing facility services.
- Medical Eligibility Determination for Medicaid Waivers for Home and Community-Based Services: For those who prefer to receive care in their homes or within community settings, CARES determines medical eligibility for relevant Medicaid waivers that support these types of services.
- Medical Assessments for Nursing Facility Residents in Court-Ordered Receivership: In situations where nursing facilities enter court-ordered receivership, CARES conducts medical assessments for residents to ensure continuity of appropriate care during transitions.
CARES Program Eligibility Requirements
To be eligible for long-term care services through Medicaid in Florida, and consequently for assessment by the CARES program, Florida residents must meet specific criteria. Eligibility is divided into two main categories: medical eligibility and financial eligibility. The CARES Program specifically focuses on determining medical eligibility. This involves a comprehensive assessment to ascertain whether an individual meets the State’s defined medical level of care requirements for long-term care services. It is important to note that while CARES handles medical eligibility assessments, financial eligibility is evaluated separately by the Florida Department of Children and Families or the Social Security Administration. For those seeking more detailed information regarding Long-Term Care eligibility criteria and the application process, the Agency for Health Care Administration provides comprehensive resources online: https://ahca.myflorida.com/medicaid/statewide_mc/smmc_ltc.shtml. Understanding the CARES program is a crucial first step for Florida residents navigating the complexities of long-term care and Medicaid access.
