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> <strong>Services</strong> <strong>and</strong> <strong>Assisted</strong> <strong>Living</strong> <strong>for</strong> <strong>the</strong> <strong>Elderly</strong> <strong>Waiver</strong> <strong>Services</strong><br />
Coverage <strong>and</strong> Limitations H<strong>and</strong>book<br />
Provider Qualifications <strong>and</strong> Responsibilities, continued<br />
Vendor<br />
Qualifications<br />
If an ALF purchases services from a vendor, <strong>the</strong> vendor <strong>and</strong> staff must meet<br />
all m<strong>and</strong>atory educational, licensing, <strong>and</strong> certification requirements <strong>for</strong> <strong>the</strong><br />
specific area of service furnished.<br />
Referral Agreement<br />
To be reimbursed by Medicaid <strong>for</strong> ALE waiver services, <strong>and</strong> prior to <strong>the</strong><br />
provision of services, each ALF <strong>and</strong> case management agency must have on<br />
file with <strong>the</strong> AAA, a completed, signed <strong>and</strong> dated <strong>Assisted</strong> <strong>Living</strong> Medicaid<br />
<strong>Waiver</strong> Referral Agreement. Referral agreements are available from <strong>the</strong><br />
Medicaid <strong>Waiver</strong> Specialists in each DOEA Planning <strong>and</strong> <strong>Services</strong> Area<br />
(PSA).<br />
Case Management<br />
Case managers begin <strong>the</strong> assessment process <strong>for</strong> applicants <strong>for</strong> entry into <strong>the</strong><br />
ALE waiver program <strong>and</strong> provide ongoing case management oversight of<br />
recipient’s care in ALFs.<br />
There can only be one case manager <strong>for</strong> an ALE recipient. If a recipient has<br />
a Department of Children <strong>and</strong> Families placement worker, <strong>the</strong> ALE case<br />
manager must be designated as <strong>the</strong> sole case manager when <strong>the</strong> recipient<br />
becomes an ALE waiver recipient. However, <strong>the</strong> DCF placement worker<br />
will continue to process Optional State Supplementation (OSS), reviews,<br />
placement, <strong>and</strong> o<strong>the</strong>r associated OSS responsibilities.<br />
July 2001 4-5