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12/08/1999 , Dee Simpson .. CARESAGREE~Ef\Jf9P"6.WPD ,_..~ """H'~_',__,.,~,., ,',. " Page 1 Prioritization of CARES Referrals Agreements 1999-2000 " ., "'." ..... c '" - Between ~, ~ 0 ~ :::On__ P1 ...... 0,-- n '-' CARES, Alliance for Aging, United Home Care Services and Monroe County ~;1 SOceb en' ..... C=-:;:r:: ,., A, Number of Irnminent Risk Referrals ~~~ :I ~ :< :o::t: c.4 ,(") "". :> -, 0 I, Carlos Escobar from CARES estimated there would be at most 6 ~ertis ~br@ for Dade County and 1 referral a month for Monroe County. These referrals would be clients in imminent risk of nursing home placement. 2, Per DOEA, imminent risk clients referred to the lead agency are to be served and not wait-listed, Any referrals above the number negotiated can go on a waiting list and be prioritized with the other referrals made to the agency each month, CARES will not put the waiting list clients (those above the negotiated number) on their Imminent Risk Logs, The number negotiated to be served, who are referred, will appear on the logs, (The exception would be if the lead agency and CARES agreed to take more than the monthly negotiated number.) 3, CARES will send copies of the Imminent Risk Referral Logs to the lead agencies and the Alliance for Aging to review and reconcile any discrepancies prior to forwarding the logs to DOEA. 4, If the lead agency conducts an assessment and the client refuses services, the lead agency should open the case and close it the next day in CIRTS (termination code is client refused copay or client place in nursing after case management had already started, etc,) CARES will enter the client on the Referral Log; Lead agency will enter the information CARES completed on the 70lA into CIRTS. 5, If a referred client dies before an assessment is conducted by the lead agency, CARES will not place the client on the referral log and the lead agency will not enter the client in CIRTS. B, Referral Process 1, CARES will send the completed fax cover sheet which includes the name and Social Security Number of the client, Medicaid Number, the reason for the referral and service recommendations to the provider agency, 2. CARES will also indicate on the fax cover sheet if the client was referred to , Channeling or ElderCare and the approximate date of enrollment. This will flag the client as a short term client for the provider. 3, CARES will send along with the fax cover sheet to the provider agency the ! l5eeSirrips()n~CAREsAGREEMENT99:iib.Wpl5 I. . ......,.,........... '-,-"",'- ....'.',_.,-.",.........,............ _,__......,.,..........w...,.,...,.....,._,__..........,_..,.---.,.....,.,."',,,.,,~.v,..,.,__,__..,__.._.,"_._,_,_,_,_,___ ..........,..,.."......e<........................:<<...." . ~ ~ ~._.. ~_ ^ _. n..>.~ Page 2 ' "...~~,~~.""~.,..._.....-..~.,""_.w. ~ ....~~, ..~, ...~,_.,' . "" ,.~. '. following documents: the Uniform Client Assessment Instrument (UCAI), the physician form, the informed conSCDt sheet and the Risk Assessment form indicating that the client's level of cae with a note in the comment section that the client meets the Medicaid Waiva' eligibility requirements. (The UeAI may be faxed or mailed,) 4, Service providers will complete the bottom portion of the fax cover sheet and return it to CARES, The providerril indicate the date services started and what services were authorized, This is aoIy to serve as feedback to CARES; this is not to receive CARES approval. Providers will respond to CARES referrals within one (1) week. C, Service Provider Case Managers make the final care plan determination. CARES may make service recommendations at the time of the referral. D, In the same vein of mutual cooperation, CARES will accept the service providers referrals to CARES. CARES' turnaround time to staff a referral is two to three days maxImum. E. Service providers will NOT have to duplicate the assessment process. F, A high Medicaid Waiver care plan budget of$15,OOO year will be used to determine how much money is to be set aside to serve these clients, G, Slots/Funds not used for CARES referrals would be available to providers to use to meet the service needs of existing clients or reduce the waiting list. H, CARES, Service Providers and the Alliance will meet on an as needed basis to discuss outstanding issues and staff cases, Cases to be staffed include those cases that were prioritized based on imminent risk of nursing home placement as well as other cases that CARES has sent back to providers requesting additional information or where there is disagreement between the Service Provider and CARES, Only those providers who have cases to staff will be required to attend. At a minimum, attendance should include the provider's Case Manager, CARES Program Analyst and Alliance Medicaid Waiver Specialist. Staffings will be arranged by Alliance staff at the request of the Service Provider or CARES, I have read and agree with the above agreements as set forth. Any questions my agency has regarding ,the agreement or its implementation will be addressed to the Alliance for Aging for clarification and/or resolution. /V1 ~ 0 Y" // Ghe,. r I'l1 Q n... COC4r'\ 1-11 Soc..,' ./ Date: I e2 - y~ 9 ? " S-e.r V ,.ce 5 ~~ '6~~t0~~ ;NNf:A rl~N DAT;. __,_," 0/1' if L. KOLHAGE CLERK ~~. ") ---.'.---- ~ Ol;:':;Ul'l'C:" "