|
|
| |
| Bureau of Long Term Care |
| Evelyn H. Silas, Bureau Director |
e-mail: lmehs@medicaid.state.ms.us |
EXECUTIVE SUMMARY - Comprehensive Review of Long Term Care Services |
The Bureau of Long Term Care provides services for Medicaid beneficiaries through
its Home and Community Based Services (HCBS) waiver programs and the Hospice program;
and in the institutional setting for nursing homes, intermediate care facilities
for the mentally retarded, and those in the institutional setting that elect Hospice
services. It is the mission of the Division of Medicaid to provide the most appropriate
services to its beneficiaries as funding allows.
The Divisions in the Bureau of Long Term Care are: |
|
Click here to download LTC Staff Responsibilities
|
Division of Medicaid Long Term Care Pre-Admission Screening |
|
To enter a Long Term Care program (except Hospice and ICF/MR), an eligible Beneficiary
must have a Pre-Admission Screening Application completed by a health care professional
and certified by a physician. A score
of 50 or above is required threshold to be considered for entry into the Long Term
Care programs of Nursing Homes; Elderly and Disabled, IL and TBI/SCI;
and Assisted Living Waiver program.
Any exceptions are noted in the Provider Policy Manual for Pre-Admission Screening,
Section 64.0. |
1)
Pre-Admission Screening Long Term Care Application
Pre-Admission Screening Instruction Manual
Electronic Submission: https://msmedicaid.acs-inc.com/msenvision
2) Pre-Admission Screening Scoring Algorithm
3) Informed Choice Form
For more information contact: 601-359-6141
|
Nursing Homes and Case Mix
Intermediate Care Facilities for the Mentally Retarded (ICF/MR) |
The Case Mix/Institutional Long Term Care Division
is responsible for monitoring the Licensure and Certification Branch of the State
Department of Health. Licensure and Certification (L&C) surveys nursing facilities
and Intermediate Care Facilities for the Mentally Retarded (ICF/MR). DOM imposes
recommendations from L&C on nursing facilities and ICF/MRs that are out of compliance
with the federal regulations. The agency Division has the discretion of imposing
civil and monetary penalties and other remedies when recommended.
The Institutional Long Term Care Division is responsible for the development, monitoring
and enforcement of policy for nursing facilities and intermediate care facilities
for the mentally retarded approved by Medicaid and federal certification requirements
established by the Centers for Medicare and Medicaid.
Staff are also responsible for the Case Mix program which ensures accuracy of nursing
facility resident assessment data used to establish resident classification and
subsequent reimbursement payment rates for nursing facilities.
For Minimum Data Set (MDS) questions only, call the case mix help line at 601-359-5191
or 601-359-5251.
For Nursing Facility or ICF/MR questions, call 601-359-5191.
Please refer to the Nursing Facility Provider Manual and Intermediate Care Facility
for the Mentally Retarded provider Manual for additional information.
|
|
Hospice |
Hospice Benefit is a State Plan service for terminally ill individuals at the end
of their life cycle and having certification from a physician with a life expectancy
of six (6) months or less. Hospice provides palliative treatment such as nursing
care, medical social services, physician services, counseling short term patient
care, medical appliances and supplies, drugs related to terminal condition, home
health aide or homemaker, or non-restorative therapies.
For Mississippi Medicaid purposes, palliative is defined as the relief of severe
pain or other physical symptoms and supportive care to meet the special needs arising
from physical, psychological, spiritual social and economic stress which are experienced
during the final stages of illness and during dying and bereavement. Through this
emphasis on palliative rather than curative services, individuals have a choice
whenever conventional approaches for medical treatment may no longer be appropriate.
For more information call (601) 359-6141.
|
Bureau of Long Term Care
HCBS Waiver Programs
|
Elderly and Disabled Waiver
Independent
Living Waiver
Assisted Living Waiver
Traumatic Brain
Injury/Spinal Cord Injury
|
Assisted Living Waiver
|
The Assisted Living Waiver provides services to individuals who, but for the provision
of home and community-based services, would require placement in a nursing facility.
Assisted living services can be provided in licensed personal care homes,
community residential care facilities, or in a congregate housing services program.
These facilities must be licensed as an Assisted Living Facility by the State
Department of Health.
Individuals in this waiver program must be 21 years of age
or older and must score
50 or above on the Medicaid Long Term Care Pre-Admission Screening (PAS) instrument.
Beneficiaries of this waiver
can have income up to 300% of the SSI Federal benefit rate which is the same income
level for individuals residing in a nursing facility that are eligible for Medicaid.
The following services are available to eligible beneficiaries: Case management,
personal care, homemaker services, chore services, attendant care, medication oversight,
medication administration, therapeutic social and recreational programming,
intermittent skilled nursing services, transportation and attendant call system.
Please refer to the HCBS Assisted Living Waiver Provider Manual for additional information.
Click here to download an Assisted Living Waiver Program Informational Pamphlet
|
Elderly and Disabled Waiver
|
The Elderly and Disabled Waiver program provides home and community-based services
to individuals 21 and over who, but for the provision of such services,
would require the level of care provided in a nursing facility. Beneficiaries
of this waiver must qualify for Medicaid as Supplemental Security Income (SSI) beneficiaries
or meet the income and resource eligibility requirements for income level up to
300% of the SSI Federal Benefit Rate and meet medical criteria of the program.
The Elderly and Disabled Waiver program is administered directly by the Home and
Community Based Services Division (HCBS). Case Management services are provided
by the Planning and Development Districts. The case management team is composed
of a registered nurse and a licensed social worker who are responsible for identifying,
screening and completing an assessment on individuals in need of at-home services.
Upon approval of the HCBS, the case managers can refer qualified individuals to
the following services: adult day health care, home-delivered meals, homemaker services,
escorted transportation, institutional respite services, in-home respite, and expanded
home health visits.
Please refer to the
Home and Community-Based Services Provider Manual located on this Web site.
Click here to download an Elderly and Disabled Waiver Program
Informational Pamphlet
|
Independent Living Waiver
|
The Independent Living Waiver program was created to assist severely orthopedically
and/or neurologically impaired individuals who, for the provision of personal care
attendant services, would require the level of care provided in a nursing
facility. Individuals in this waiver must be capable of directing their own care
and possess rehabilitative potential. Beneficiaries of this waiver must be
Medicaid eligible as SSI recipients or meet the requirement of the handicapped coverage
group which allows an income level up to 300 percent of the SSI Federal benefit
rate.
This is a Medicaid Home and Community Based Services waiver that is operated
jointly with the MS Department of Rehabilitation Services. It is operated statewide.
The Department of Rehabilitation Services, in addition to administering the waiver
program, also provides case management services with registered nurses and rehabilitation
counselors who provide the necessary support for individuals in this waiver.
The case managers are also responsible for coordinating and monitoring personal
care attendant services.
Please refer to the
Home and Community-Based Services Provider Manual located on this web site.
Click here to download an Independent LIving Waiver Program Informational Pamphlet
|
Traumatic Brain Injury/Spinal Cord Injury Waiver (TBI/SCI)
|
The TBI/SCI Waiver program was created to assist individuals who have a traumatic
brain or spinal cord injury, who, but for the provisions of such services, would
require the level of care provided in a nursing facility. Individuals
in this waiver must have a diagnosis of traumatic (defined as an insult to the skull,
brain, or its covering resulting from external trauma) brain injury which produces
an altered state of consciousness or anatomic, motor, sensory, or cognitive/behavioral
deficit OR a spinal cord injury (defined as a traumatic injury to the spinal cord
or cauda equina) with evidence of motor deficit, sensory deficit, and/or bowel
and bladder dysfunction. The lesions must have significant involvement with
two of the above three. In addition, individuals served must be certified as medically
stable by their primary care physician. Medical stability is defined as the absence
of any of the following: An active, life threatening condition, IV drip to control
or support blood pressure, or intercranial pressure or arterial monitoring. Beneficiaries
in this program must qualify for one of the following eligibility Medicaid categories:
SSI, TANF, Disabled Child Living at Home, or income up to 300% of the SSI Federal
Benefit Rate.
The TBI/SCI Waiver is administered by the Department of Rehabilitation Services
. After being assessed
by the DRS and approved by the Division of Medicaid, services available under this
waiver program include: Case Management, In-Home Nursing Respite, In-Home Companion
Respite, Institutional Respite, Attendant Care Services, Environmental Accessibility
Adaptations, and Specialized Medical Equipment and Supplies.
Referrals may be
made to DRS.
Please refer to the HCBS Traumatic Brain Injury/Spinal Cord Injury Provider Manual
for additional information.
Click here to download a TBI/SCI Waiver Program Informational Pamphlet
|
Top
|
|