1/10/08

Medical Qualification

A pre-admission screening test, called the PAS, is administered to every candidate for the program. The PAS assesses whether a person can maintain herself in the community or whether she needs custodial or skilled nursing care. The PAS is largely based upon assessing the applicant's ability to perform activities of daily living (ADL's), like eating, walking, toileting, bathing, and dressing. Though it is possible that a person can perform all the ADL's and still be at significant risk for institutionalization due to cognitive impairments.

Its important to focus on what your loved one CAN'T DO as apposed to focus on the positive. Also It's important to be at this medical meeting if you have a loved one who is ashamed to admit what limitations they have.

1/9/08

Basic Qualifications For ALTCS

How does a person qualify for the ALTCS program? Here's a quick list of basic qualifications and I will follow up on each with another post.

Basic Qualifications
  • Be a United States Citizen or a lawful resident alien
  • Be a resident of the State of Arizona
  • Be at significant risk for institutionalization (medically qualify for services)
  • Be at or below the income limit
  • Be at or below the resource limit

1/8/08

What Is Assisted Living?

Having a loved one spend the rest of their life in a nursing facility is not the only option. Here is some information on assisted living:

Assisted living residences or assisted living facilities (ALFs) provide supervision or assistance with activities of daily living (ADLs); coordination of services by outside health care providers; and monitoring of resident activities to help to ensure their health, safety, and well-being. Assistance may include the administration or supervision of medication, or personal care services provided by a trained staff person. Assisted living as it exists today emerged in the 1990’s as an alternative on the continuum of care for people who cannot live independently in a private residence, but who do not need the 24 hour medical care provided by a nursing home. Assisted living is a philosophy of care and services promoting independence and dignity.

There is no nationally recognized definition of assisted living. Assisted Living facilities are regulated and licensed at the state level. More than two-thirds of the states use the licensure term “assisted living.” Other licensure terms used for this philosophy of care include Residential Care Home, Assisted Care Living Facilities, and Personal Care Homes. Each state licensing agency has its own definition of the term it uses to describe assisted living.

In Arizona, ALTCS will pay for Assisted Living Homes (4 to 10 residents) and Assisted Living Centers (11 or more residents).

1/7/08

Can I Keep My Old Doctor On ALTCS?

This is one of those questions that has an answer of maybe. You get to choose a Program Contractor (basically a third party company the state pays for) that provides an approved listing of physicians and specialist. If your doctor is already on this list then no problem but if your doctor isn't you may have to change doctors or use another form of payment like a medicare supplement or pay cash.

Make sure you pick your Program Contractor very carefully, when we originally chose Mercy Care our PCP wasn't covered but thankfully I had insurance through AARP which covered our main doctor who we had already established a relationship with. I tried to get Mercy Care to pick up the cost of the co-pay but I was told if the physician is non-contracted they would not provide anything.

1/6/08

What Services Does ALTCS Provide?

The Arizona Long Term Care Program provides the following services for approved members:
  • AHCCCS Acute Care Services, which include: doctors, hospitalization, prescriptions, lab work, x-rays, tests, and specialists treatments.
  • Nursing facility care, a freestanding hospice, or a psychiatric hospital for persons age 65 or older.
  • Home and Community-based Services (HCBS) provided in your home. These in-home services are intended to help you to remain in your own home.

HCBS services include, but are not limited to:

  • Home Health Nursing
  • Habitation
  • Adult Day Care
  • Personal Care Medical Transportation
  • Mental Health Services
  • Homemaker Services
  • Attendant Care Respite Care
  • Home Health Aids
  • Home Delivered Meals
  • Hospice
  • Home and Community-based Services (HCBS) may also be provided in a supervised alternative residential setting, such as an Assisted Living Home or Assisted Living Community

1/4/08

What Is ALTCS?

The Arizona Longer Term Care System (ALTCS) program is the state of Arizona's medicaid system for aged (65 and over), blind, or disabled individuals who need ongoing services at a nursing facility level of care.

This doesn't mean you have to be living in a nursing home. Many people on ALTCS live in their own homes or at an assisted living facility and receive needed in-home services. ALTCS participants are also covered for medical care, including doctor's office visits, hospitalization, prescriptions, lab work and behavioral health services.

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