Assistive Care Services and Assisted Living for the Elderly Waiver

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Assistive Care Services and Assisted Living for the Elderly Waiver Services Coverage and Limitations Handbook Provider Qualifications and Responsibilities, continued Vendor Qualifications If an ALF purchases services from a vendor, the vendor and staff must meet all mandatory educational, licensing, and certification requirements for the specific area of service furnished. Referral Agreement To be reimbursed by Medicaid for ALE waiver services, and prior to the provision of services, each ALF and case management agency must have on file with the AAA, a completed, signed and dated Assisted Living Medicaid Waiver Referral Agreement. Referral agreements are available from the Medicaid Waiver Specialists in each DOEA Planning and Services Area (PSA). Case Management Case managers begin the assessment process for applicants for entry into the ALE waiver program and provide ongoing case management oversight of recipient’s care in ALFs. There can only be one case manager for an ALE recipient. If a recipient has a Department of Children and Families placement worker, the ALE case manager must be designated as the sole case manager when the recipient becomes an ALE waiver recipient. However, the DCF placement worker will continue to process Optional State Supplementation (OSS), reviews, placement, and other associated OSS responsibilities. July 2001 4-5
Assistive Care Services and Assisted Living for the Elderly Waiver Services Coverage and Limitations Handbook Case Management Agency Qualifications Case management ALE waiver providers must be a designated Community Care for the Elderly lead agency in accordance with Chapter 430, F.S. or meet the following standards: • Employ case management staff with skills, knowledge, education, and experience to link consumers to community-based services and resources appropriate to meet their needs; • Have personnel policies which meet or exceed federal, state, DOEA, AHCA, and AAA and local requirements for licensure, certification, or other special education and training qualifications for specific personnel functions; • Have case managers trained and certified on relevant DOEA forms. A minimum score of 80% on the assessment training is required. July 2001 4-6
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Assistive Care Services and Assisted Living for the Elderly Waiver

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