Long-Term Care Community Diversion Program

The Long-term Care Community Diversion Program is Medicaid waiver program designed to provide community-based services to people who would otherwise qualify for Medicaid nursing home placement. The services provided by the Diversion Program include a variety of long-term care services and Medicaid-covered medical services. The objective of the Diversion Program is to provide frail elders with safe, appropriate community-based care alternatives in lieu of nursing home placement, at a cost less than Medicaid nursing home care.

MANAGED CARE ORGANIZATIONS

Managed care organizations and other qualified providers enter into a contract with the State and receive a capitated payment to provide, manage and coordinate a qualified enrollee's full continuum of care. Generally speaking, the managed care organizations provide care through contracted providers, which can include home health agencies and assisted living facilities.

RESIDENT QUALIFICATIONS

Individuals that meet the following criteria are eligible to receive services under the Diversion Program:

• Be 65 years of age or older
• Reside in a Diversion Project service area
• Be a Florida resident
• Be a U.S. citizen or qualified noncitizen
• File for any other benefits to which they may be entitled
• Disclose any rights to third party liability (i.e., health insurance)
• Have Medicare part A and part B
• Meet nursing facility level of care criteria and additional clinical criteria as determined by the Department of Elder Affairs' CARES Unit
• Meet the income limit of $1911 for an individual or $3822 for a couple
• Meet the asset limit of $2000 for an individual or $3000 for an eligible couple

FACILITY QUALIFICATIONS

Any licensed assisted living facility in Florida may contract with a managed care organization to provide care under the Diversion Program. For a list of managed care organizations, please contact the Department of Elder Affairs' Diversion Program at telephone number (850) 414-2000.

ADDITIONAL INFORMATION