Many seniors are opting for this program because it is one that allows them to stay in their own homes for as long as possible.
According the Florida Department of Elder Affairs, this program was created to keep the elderly in their homes instead of going to a nursing home.
In order to do this, community services are provided in the person's home through Medicaid and the services include long-term care and Medicaid covered medical services.
In order for an individual to participate they must be eligible for both Medicaid and for a nursing home.
On the provider side of the program, qualified professions available through managed care organizations sit down with an individual and anyone who needs to be present, and talks about what is needed.
Managed care organizations contract with the State to provide the full care for each individual.
The managed care facility receives a capitated payment for these services.
They also are responsible for management and coordination of the program.
Individual providers can also contract with the State for this purpose.
The main objective of the Florida Nursing Home Diversion program is to keep those elderly who are frail in a safe environment.
This means they will use an alternative community based care program instead of a nursing home which is more cost effective than having the individual in a nursing home.
All individuals who take part in this program must fit the following criteria: * They must be at least 65 * They must be eligible for Medicare (both parts A&B) and Medicaid * They must live in a program area that is already authorized * They must receive an assessment through CARES (Comprehensive Assessment and Review for Long-Term Care Services) that specifically determines the individual's level of care that would be needed in a nursing home.
These criteria will help the family and the managed care program help the elderly family member get the appropriate care that is needed.
Some of the programs that a person in this program can receive include case management, someone to do chores, medical supplies and respite care.
This is just a short list of what they can receive.
There is also another waiver for acute care that will provide x-rays, mental health services in the community, outpatient programs for hospital and emergency, prescribed drugs and transportation where necessary.
The medical services that are provided are done so on a medical necessity basis only, o they must be necessary for someone to live in the community instead of going to some type of institution.
For more information about forms and eligibility contact the local CARES program.
When you are in need of services for someone who is eligible for Medicaid nursing home services it can be a weight off you to know that the individual can receive care to stay at home.
This is preferable for many elderly because home is what they know and where they feel most comfortable.