The Comprehensive Assessment and Review for Long-Term Care Services (CARES) Program in Florida plays a crucial role in determining who can receive Medicaid assistance for long-term care. Specifically, CARES is responsible for evaluating the medical eligibility of Florida residents who are applying for Medicaid to help cover the costs of nursing homes or home and community-based services. This assessment is a necessary step to access these vital support programs.
Elderly care at home, featuring a smiling senior woman in a wheelchair being offered water by a nurse, highlighting assistance for senior people
Core Function: Medical Eligibility Assessment
The primary function of the CARES program is to conduct thorough medical assessments. These assessments are performed by registered nurses or CARES assessors and are provided at no cost to the applicant. The goal of these assessments is to identify an individual’s long-term care needs and to recommend the most suitable and least restrictive care setting. Following the assessment, a CARES physician or registered nurse reviews the application to officially determine the appropriate level of medical care required by the applicant. This determination is key to accessing Medicaid benefits for long-term care services.
Who Runs the CARES Program?
The CARES Program is a collaborative effort between the Florida Department of Elder Affairs and the Agency for Health Care Administration. The Department of Elder Affairs takes the lead in administering the program. To effectively serve the state, CARES operates through 17 field offices located throughout Florida. The program is staffed by a diverse team of professionals including physicians, registered nurses, assessors, administrative support personnel, office supervisors, and regional program supervisors. A central headquarters staff manages program and policy development, ensuring consistent standards and practices across all field offices.
Services Provided by CARES
CARES offers several key services related to medical eligibility for long-term care:
- Medicaid Institutional Care Program (ICP) Eligibility: CARES determines the medical eligibility for individuals seeking to access the Medicaid Institutional Care Program, which assists with nursing home costs.
- Medicaid Waiver Eligibility for Home and Community-Based Services: CARES assesses medical eligibility for various Medicaid waivers that enable individuals to receive long-term care services in their homes or communities, rather than in institutions.
- Nursing Facility Assessments in Receivership: CARES conducts medical assessments for residents residing in nursing facilities that are under court-ordered receivership, ensuring appropriate care and placement.
Eligibility Determination
It is important to understand that CARES focuses specifically on medical eligibility. While CARES determines if an individual meets the State’s medical level of care requirements for long-term care Medicaid, financial eligibility is assessed separately. Financial eligibility is determined by the Florida Department of Children and Families or the Social Security Administration. Therefore, applicants must meet both medical and financial criteria to qualify for Medicaid long-term care assistance.
For more detailed information regarding Long-Term Care eligibility and the application process, please visit: https://ahca.myflorida.com/medicaid/statewide_mc/smmc_ltc.shtml
