Assistive Care Services and Assisted Living for the Elderly Waiver
Assistive Care Services and Assisted Living for the Elderly Waiver
Assistive Care Services and Assisted Living for the Elderly Waiver
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<strong>Assistive</strong> <strong>Care</strong> Service <strong>and</strong> <strong>Assisted</strong> <strong>Living</strong> <strong>for</strong> <strong>the</strong> <strong>Elderly</strong> Wavier <strong>Services</strong><br />
Coverage <strong>and</strong> Limitations H<strong>and</strong>book<br />
Requirements to Receive <strong>Services</strong>, continued<br />
Medicaid<br />
Application<br />
Responsibilities<br />
If an individual has not applied <strong>for</strong> <strong>and</strong> been determined eligible <strong>for</strong> Medicaid<br />
at <strong>the</strong> time <strong>Assistive</strong> <strong>Care</strong> <strong>Services</strong> (ACS) are needed, <strong>the</strong> individual must<br />
submit a Request <strong>for</strong> Assistance (RFA) to <strong>the</strong> local service center of <strong>the</strong><br />
Department of Children <strong>and</strong> Families. Providers should assist individuals with<br />
this process.<br />
Note: See Appendix C of <strong>the</strong> Medicaid Provider Reimbursement<br />
H<strong>and</strong>book, HCFA-1500 <strong>and</strong> Child Health Check-Up 221 <strong>for</strong> a list of <strong>the</strong><br />
DCF district offices. A map of district offices is available on <strong>the</strong> Internet at<br />
www.MyFlorida.com. Click on Directory, <strong>and</strong> <strong>the</strong>n click on Children <strong>and</strong><br />
Families, <strong>the</strong>n click on Economic <strong>Services</strong>, <strong>and</strong> <strong>the</strong>n click on Service Center<br />
of desired county.<br />
Who Can Receive<br />
ACS <strong>Services</strong><br />
To receive assistive care services, recipients in this program must be at least<br />
18 years of age or older <strong>and</strong> meet <strong>the</strong> following requirements:<br />
1. Be Medicaid eligible;<br />
2. Have a health assessment completed by a physician or o<strong>the</strong>r licensed<br />
practitioner of <strong>the</strong> healing arts acting within <strong>the</strong> scope of <strong>the</strong>ir practice<br />
under state law which indicates <strong>the</strong> medical necessity of assistive care<br />
services;<br />
3. Be determined to need at least two service components of <strong>the</strong><br />
assistive care service;<br />
4. Reside in an ACS-enrolled ALF, RTF, or AFCH; <strong>and</strong><br />
5. Not participate in any Medicaid managed care program such as <strong>the</strong><br />
Eldercare HMO, or <strong>the</strong> Long-Term <strong>Care</strong> Community Pilot Project<br />
where <strong>the</strong> capitated payment is designed to cover all Medicaid<br />
services.<br />
<strong>Assisted</strong> <strong>Living</strong> <strong>for</strong> <strong>the</strong> <strong>Elderly</strong> (ALE) waiver recipients can receive ASC<br />
services provided <strong>the</strong> waiver <strong>and</strong> ACS component services are not<br />
duplicative <strong>and</strong> appear on <strong>the</strong> ALE service plans.<br />
Note: See Part II of this h<strong>and</strong>book <strong>for</strong> in<strong>for</strong>mation on <strong>the</strong> ALE waiver<br />
program requirements.<br />
July 2001 2-2