Functional Assessment Processes for Medicaid Personal Care Services
This policy brief focuses on components of states’ Medicaid functional assessment processes with an eye toward how these processes could potentially inform the development of regulations for CLASS. We explore how states handle the assessment process and determine who performs the assessment and where it is performed.Date Updated: 04/06/2011
Each state develops its own unique set of criteria, policies, infrastructure and procedures specific to its Medicaid program, including detailed processes for state plan personal care services and/or home- and community-based waiver programs. Understanding how functional assessments are performed is critical to appropriately determining the need for and level of personal care services (PCS) and home- and community-based services (HCBS) for Medicaid-eligible individuals. Clearer insight into all these facets of a state’s process can potentially inform the development of CLASS regulations…
Download the publication for all visuals and complete references.
This policy brief provides background on the historical development of benefit eligibility triggers in the private long-term care insurance market. Understanding how these triggers came into being can provide important information to those charged with implementing the CLASS Plan.
This policy brief provides information about how long-term care insurers implement benefit eligibility triggers in the private insurance market. The way in which companies have operationalized benefit eligibility triggers can inform the development of regulations for the CLASS Plan.
This policy brief provides information on the benefit eligibility assessment process in the private long-term care insurance industry. It focuses on how long-term care insurers use the information in the adjudication process, who is involved in the process, and how activities of daily living and cognition are assessed.