Community Elderly Sample Clauses
The 'Community Elderly' clause establishes provisions specifically addressing the needs, rights, or services related to elderly individuals within a community. Typically, this clause outlines eligibility criteria for elderly residents, details the types of support or accommodations provided—such as access to healthcare, social activities, or housing modifications—and may set forth responsibilities for both the community and the elderly members. Its core practical function is to ensure that elderly individuals are adequately supported and protected within the community, addressing their unique needs and promoting their well-being.
Community Elderly. Waiver (Community EW) Rate Cell.
(a) The Community EW Rate Cell will be assigned to Enrollees who, at capitation for MSC+, are coded in MMIS to be in a community living arrangement and are enrolled in the Elderly Waiver for the 1st of the following month.
(b) EW services must be delivered to Enrollees who meet the EW Level of Care criteria based on demonstrated need, and are eligible for payment of LTC services. MCOs are responsible for delivery of EW services even if the EW Rate Cell component was not paid in a given month.
Community Elderly. Waiver (Community EW) means Enrollees who, at capitation for MSHO or MSC+ are coded in MMIS to be in a community living arrangement and are enrolled in the Elderly Waiver for the first of the following month.
Community Elderly. Waiver (Rate Cell Category “B”):
(1) The Community EW Rate Cell Category will be assigned to those Recipients who, at the time of enrollment in the MCO, are coded in MMIS to be in a community living arrangement and are enrolled in the Elderly Waiver for the 1st of the following month.
(2) For changes in MSHO Rate Cell Categories after initial enrollment, the Community EW Rate Cell Category will be assigned after the MCO:
(a) Notifies the STATE that an Enrollee is living in a community setting; and has indicated that the enrollee has received a Long Term Care Consultation and has been identified to be in need of Elderly Waiver services; and
(b) Enters into MMIS the Screening Document (DHS-3247) completed for that Enrollee.
(3) The Community EW Rate Cell Category will be assigned to those Recipients, who, at capitation, have an open EW span for the next available month.
(4) EW services must be delivered to Enrollees who meet the EW Level of Care criteria based on demonstrated need, and are eligible for payment of LTC services. MCOs are responsible for delivery of EW services even if the EW Rate Cell component was not paid in a given month.