64-prog_z01

64-prog_z01 - prog Programs Overview This section explains...

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prog Programs Overview 1 This section explains basic qualifying information about health care services administered to eligible California residents by the Department of Health Care Services (DHCS). Programs that are offered through Medi-Cal are identified in the description. Refer to eligibility sections in the Part 1 manual or policy and billing sections in the appropriate Part 2 manual for additional program information. An asterisk (*) indicates programs that have no correlating Part 1 or Part 2 manual section with additional information. Adult Day Health Adult Day Health Care (ADHC) centers offer a package of health, Care (ADHC) Centers therapeutic and social services in a community-based day care program. Services are provided according to a six-month plan of care for each recipient by the center’s multidisciplinary team. The services are designed to prevent premature and unnecessary institutionalization and keep recipients as independent as possible in the community. For policy information, refer to the Part 2 manual, Outpatient Services for Adult Day Health Care (ADHC) Centers . AIDS Waiver Program The Department of Health Care Services Office of AIDS has received a federal waiver of certain Medicaid requirements, enabling the Medi-Cal program to provide home and community-based services to persons with a written diagnosis from his/her attending physician of HIV Disease or AIDS with current symptoms related to HIV Disease, AIDS or HIV Disease/AIDS treatment in lieu of placement in a nursing facility or hospital. The AIDS Waiver Program is approved by the Centers for Medicare & Medicaid Services (CMS) and must continue to be cost effective for the state to receive federal matching funds. The Office of AIDS enters into agreements with agencies throughout California to administer the waiver program and provide case management services. These waiver agencies subcontract with, or employ (requires prior written authorization by the Office of AIDS), appropriately licensed providers to render direct care services. To participate in the waiver program, a waiver agency must be one of the following: A Home and Health Agency licensed and certified by DHCS The outpatient department of a hospital licensed and certified by DHCS A county health department A community-based organization that meets certain DHCS Office of AIDS standards and requirements Agencies that have demonstrated organizational, administrative and financial capabilities through the AIDS Case Management Program (CMP) are eligible to become a waiver agency. 1 – Programs Overview October 2009
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prog 2 Enrollment Procedures Providers submit a letter to the Office of AIDS that includes a request to become a waiver agency, the counties to be served and a statement that becoming a waiver agency will be cost and administratively feasible. DHCS Office of AIDS:
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64-prog_z01 - prog Programs Overview This section explains...

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