Navigating long-term care options can be complex, especially when seeking Medicaid assistance in Florida. For residents requiring home and community-based services or nursing home care, understanding the Comprehensive Assessment and Review for Long-Term Care Services (CARES) Program is crucial. This program plays a vital role in determining medical eligibility for these essential services.
The CARES program is Florida’s system for evaluating the medical needs of individuals applying for Medicaid long-term care services. Administered by the Florida Department of Elder Affairs in partnership with the Agency for Health Care Administration, CARES ensures that individuals receive the most appropriate care in the least restrictive setting. It’s a critical step in accessing both home and community-based Medicaid waiver programs and Medicaid nursing home care.
Who are the professionals behind the CARES Program? A network of dedicated individuals across Florida makes CARES function effectively. CARES assessments are conducted by registered nurses or CARES assessors, all at no cost to the applicant. These professionals identify an individual’s long-term care needs and recommend the most suitable care setting. To ensure accurate and appropriate care level determinations, each assessment is further reviewed by a CARES physician or registered nurse. The CARES team also includes administrative support staff, office supervisors, regional program supervisors, and headquarters staff focused on program and policy development, operating from 17 field offices throughout the state.
Nurse assisting elderly woman in wheelchair, providing water at a retirement home, highlighting senior care and support
What specific services does the CARES Program provide? CARES is responsible for several key activities:
- Medical Eligibility for Medicaid Institutional Care Program (ICP): CARES determines if individuals meet the medical requirements for the ICP, which covers nursing facility care.
- Medical Eligibility for Medicaid Waivers: The program assesses medical eligibility for Medicaid waivers that enable home and community-based services, allowing individuals to receive care outside of institutional settings.
- Medical Assessments for Nursing Facilities in Receivership: CARES conducts medical evaluations for residents in nursing facilities that are under court-ordered receivership, ensuring continuity of appropriate care.
It’s important to note that while CARES determines medical eligibility, financial eligibility for Medicaid long-term care is assessed separately by the Florida Department of Children and Families or the Social Security Administration. To qualify for Medicaid long-term care services in Florida, both medical and financial criteria must be met.
For those seeking more detailed information about Long-Term Care eligibility and the application process, further resources are available at the Agency for Health Care Administration website: https://ahca.myflorida.com/medicaid/statewide_mc/smmc_ltc.shtml.
