(1) An ASAP may be operated by one or more
nonprofit agencies, one or more home care providers as defined in M.G.L. c.19A,
§ 4, a combination of said home care corporations acting jointly, or a
state agency.
(2) An ASAP shall not
provide direct services to Elders (i.e. Community Based Long
Term Care Services), except for ASAP Services as defined in 651 CMR
2.01et seq. The Secretary may grant a waiver of this
restriction upon a finding that public necessity and convenience require such a
waiver.
(3) An ASAP shall not have
a direct or indirect financial ownership interest in an entity that provides
institutional or community long-term care services on a compensated basis. The
Secretary may grant a waiver of this restriction upon a finding that public
necessity and convenience require such a waiver.
(4) An ASAP shall not be a vendor to another
ASAP for the purpose of providing direct services.
(5) ASAPs are organized to plan, develop,
implement, and coordinate the delivery of Community-Based Long Term Care
Services.
(6) ASAPs are designated
by Elder Affairs and under contract with Elder Affairs to carry out activities
related to clinical screening, service authorization activities and case
management for Community Based Long Term Care Services, and carry out
activities related to Protective Services designation.
(7) ASAPs shall administer the Home Care
Program in compliance with
651
CMR 3.00 and all contract requirements.
(8) ASAPs shall administer the Home and
Community Based Waiver Program in compliance with all contract
requirements
(9) ASAPs shall
conduct screening functions in compliance with an interagency service agreement
between Elder Affairs and DMA, Medicaid regulations, procedures issued by Elder
Affairs and contract requirements.
(10) ASAPs shall administer the Protective
Services Program in accordance with M.G.L. c. 19A, §§ 14 through 26
and regulations at
651 CMR 5.00.
(11) ASAPs shall provide the following
services:
(a)
Information and
Referral Services are activities related to the maintenance of
current information regarding benefits, services and programs available to
elders in Massachusetts. Determinations of the type of assistance needed by an
elder requesting information, referrals to appropriate services, and follow-up
is provided to determine if needed services were received. Information and
Referral services may be conducted by mail, telephone, or in person without
regard to income. Referrals for terminally ill elders, with their consent,
shall include referral to a licensed and certified hospice for determination of
eligibility, appropriateness and consumer interest in the service.
(b)
Interdisciplinary Case
Management Services are provided by registered nurses and case
managers employed by ASAPs working in consultation with physicians, nurses and
therapists from home health agencies, hospice providers, nutritionists, housing
managers, mental health professionals, and other home and health care
professionals in compliance with Interdisciplinary Case Management Standards
issued by Elder Affairs. It includes:
1.
conducting intake and comprehensive needs assessments, including preadmission
screening and clinical eligibility determinations for elders seeking
institutional and community care services from Medicaid or the Home Care
Program;
2. developing and
implementing service plans based on the needs of the elder; provided that a
medical plan of care for an elder be developed by a licensed or certified
health provider;
3. arranging for,
coordinating, authorizing, and purchasing community long term care services
called for in the comprehensive service plan;
4. reassessing and monitoring the outcomes of
the services, and making periodic adjustments to the service plan, in
consultation with service and health care providers, formal and informal
supports and the Client and/or family;
5. working cooperatively, coordinating
service plans and maintaining ongoing communication with the elder, family
members, informal supports and formal supports as necessary.
(c)
Protective
Services means services provided in accordance with M.G.L. c. 19A,
§§ 14 through 26 and regulations at
651 CMR 5.00, which are
necessary to prevent, eliminate or remedy the effects of abuse to an Elder.
Subject to appropriation, these services shall include, but not be limited to:
capacity to respond to an emergency or a Rapid Response situation; Protective
Services Casework; counseling; the capacity to provide or arrange for Home Care
and other services; petitioning the Court for guardianship, conservatorship,
protective orders through the court; and legal assistance.
(d)
Screening. A
determination of an individual's clinical eligibility for Community-Based Long
Term Care Services or nursing facility services. These determinations are
carried out by Registered Nurses working for ASAPs and in compliance with
Division of Medicaid Assistance regulations and contract
requirements.
