Long Term and Personal Care Assessment Services

If you or someone in your family needs nursing facility care or personal care in the home and cannot afford the cost, you may be eligible to have this service covered by Medicaid. You do need to be enrolled in Medicaid for this service. You can apply for Medicaid online or with the Richmond Department of Social Services.

Prescreening

Prescreening is the preauthorization of Medicaid payment for covered LTSS through the CCC Plus Waiver/Uniform Assessment Instrument (UAI). The prescreening can be completed by a hospital screening committee, if the person is acutely hospitalized at the time the placement is needed, or by community-based team by client request. A community-based team typically consists of a nurse from the local Health Department and an adult service worker from Social Services. The team visits the patient at home to assess the functional needs, medical/nursing needs, and risk of needing a higher level of care within the next 30 days. This information is given to a provider at the local health department to evaluate the clients care needs based on criteria established by the Department of Medical Assistance Services (DMAS) Individuals approved for services have , in addition to placement in a nursing facility.

Children’s Screenings

Children are eligible to receive services under the CCC Plus waiver. Children screened are evaluated by the same qualifications as all other individuals, with activities of daily living (ADLs) being evaluated with the child and caregiver as one unit for children under the age of 5.

Medicaid Provider

If approved, the nursing facility or personal care provider must be a Medicaid provider to be covered by this program. If the individual is in a nursing home, he or she must be in a Medicaid certified bed. Please contact your Managed Care Organization (MCO) on your Medicaid card for a list of available options.

Steps in the Screening Process

  1. Request a prescreening for nursing home, personal care, adult day care, etc. by calling Service Intake at 804-501-7346. For children requesting screenings, please call 804-205-3718.
  2. For adult screenings, a Richmond City DSS social worker will coordinate an appointment time with a nurse from the Health Department. The social worker will contact the family to confirm the appointment time to visit and complete the screening. For children screenings, a nurse from the Health Department will call to coordinate a time to screen.
  3. It is helpful to have a family member or caregiver present during the screening visit due to volume of information needed for waiver eligibility
  4. After the screening and the visit are completed, the original screening forms will be entered into the Medicaid MES system for final approval or denial by a Health Department provider.
  5. If approved:
    1. You will receive a copy of your UAI and approval.
    2. You do have to have Medicaid for this program. If you do not have Medicaid, contact a Medicaid Benefits Worker at the local Department of Social Services to apply. Clients who have Medicare still need to apply for Medicaid.
    3. Contact your MCO to identify a care provider to determine who can best meet your needs. The care provider will then discuss whether or not an aide is available, how many hours they can provide, and other necessary details.
  6. If denied:
    1. You will receive a copy of your UAI and denial.
    2. Clients have the right to appeal that decision. How to appeal is written on the decision letter.
  7. If a client need a copy of the original UAI, please contact the health department at 804-205-3718.

連結

聯絡方式

Request a prescreening for nursing home, personal care, adult day care, etc. by calling Service Intake at 804-501-7346.

For children requesting screenings, please call 804-205-3718.