Download as PDF
205.217 Long-term care case management demonstration.
(1)
(2)
(3)
As used in this section, unless the context requires otherwise:
(a) "Case manager" means an employee of the area development district or
an agency under contract with the area development district who shall
assist any functionally impaired person in identifying and accessing the
long-term-care services most appropriate to the individual's social and
medical needs.
(b) "Functionally impaired person" means any person who is unable to
perform without assistance any of the activities of daily living including,
but not limited to dressing, bathing, toileting, transferring, or feeding, or
any of the instrumental activities of daily living including but not limited to
meal preparation, laundry, housecleaning, budgeting, and shopping.
There shall be established within the Cabinet for Health and Family Services a
Long-Term Care Case Management Demonstration Program to consolidate
and coordinate all services provided or funded by the cabinet with respect to
long-term care, conducted in at least three (3) area development districts. This
demonstration program shall serve as the focal point for the provision of all
services provided to functionally impaired persons to assure that services are
consistent with the following goals:
(a) That functionally impaired persons be allowed to live independently at
home or with others as long as the citizen desires without requiring
inappropriate or premature institutionalization;
(b) That services provided or funded by the cabinet promote independent
living by functionally impaired persons and prevent or minimize illness or
social isolation;
(c) That institutional services be used only as a last resort when in-home or
community-based support services are not available or are not adequate
to meet the needs of functionally impaired persons;
(d) That a single entry point for all services for functionally impaired persons
be available to all persons in need of information about or access to the
services; and
(e) That the use of informal providers of care, such as friends and relatives of
functionally impaired persons, be used as long as possible before paid
services are utilized.
The following programs and services shall be included in the Long-Term Care
Case Management Demonstration Program:
(a) Hospital-based long-term-care services including dual-licensed beds,
swing beds and physical rehabilitation services, skilled-nursing facility
services, intermediate-care-facility services, nursing-facility services,
home-health services, and home- and community-based waiver services
funded by the Kentucky Medical Assistance Program;
(b) In-home and community-based services for elderly persons funded under
the Older Americans Act (42 U.S.C. secs. 3001 et seq.) and Title XX of
the Social Security Act (42 U.S.C. secs. 1397-1397f);
(c) Services provided under the home care program pursuant to KRS
(4)
(5)
(6)
205.460; and
(d) Personal-care-home services or domiciliary care funded by supplemental
payments to persons receiving supplemental security income benefits
pursuant to KRS 205.245.
The Long-Term Care Case Management Demonstration Program shall employ
a system of case management to assure that appropriate services are provided
to all persons using or applying for the services set forth in subsection (3) of
this section, and that the services are consistent with the goals set forth in
subsection (2) of this section. All persons applying for these services shall be
assigned a case manager. The duties of the case manager shall include
preparation of a general plan of care, based on the person's need for services,
arranging placements or other needed services or equipment, coordination and
management of the applicant through the eligibility process for these services,
and reviewing each case on a periodic basis to assure the plan of care is being
followed. Case management shall not include the determination of eligibility for
Medicaid covered services, long-term-care facility preadmission reviews,
level-of-care determinations for purposes of Medicaid reimbursement, or peer
review activities. The general plan of care shall not replace a daily care plan
prescribed by a physician for treatment of a person in a hospital or
long-term-care facility or receiving home-health services. The general plan of
care shall identify the categories of services or type of placement required and
the providers of the services. Case managers shall serve as advocates for
applicants for the services set forth in subsection (3) of this section, and shall
interact with the existing administrative structure within the Cabinet for Health
and Family Services to meet the goals stated in subsection (2) of this section.
Patients discharged from a hospital to a long-term-care facility shall receive
case management services in the hospital on a timely basis or immediately
after admission to a long-term-care facility. The goal of each case plan shall be
the provision of services in the least restrictive setting designed to best meet
the individual needs of the functionally impaired person. When persons are
determined to need services to maintain independent living, but do not meet
the financial or eligibility criteria for services, case managers shall attempt to
ensure that services are provided from community resources, family member,
or volunteers.
The cabinet, through the Long-Term Care Demonstration Program, shall
provide access to information, counseling, and screening as appropriate, for
persons potentially in need of long-term-care services without regard to the
person's income, in order to assist functionally impaired persons in accessing
available services. In administering the Long-Term Care Demonstration
Program, the cabinet shall provide services to meet the needs of the minority
elderly as identified by the cabinet pursuant to KRS 205.201. The cabinet may
charge a fee for providing information, counseling, and screening services
based on the client's ability to pay.
The secretary for health and family services may promulgate administrative
regulations necessary to implement the Long-Term Care Demonstration
Program.
Effective:June 20, 2005
History: Amended 2005 Ky. Acts ch. 99, sec. 223, effective June 20, 2005. --
Amended 2000 Ky. Acts ch. 6, sec. 23, effective July 14, 2000. -- Amended
1998 Ky. Acts ch. 426, sec. 190, effective July 15, 1998. -- Amended 1992 Ky.
Acts ch. 246, sec. 4, effective July 14, 1992. -- Created 1990 Ky. Acts ch. 482,
sec. 28, effective July 13, 1990.
Disclaimer: These codes may not be the most recent version. Kentucky may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.