February, 5 2005 to August, 26 2005
State of Arizona – ALTCS
Arizona Long Term Care Service
Department of Member Services
Financial Eligibility Specialist I
Responsibilities include: Informing the Client
And Authorized Rep. what ALTCS is, how
The application process is. I have to explain
The client has to be in need of Nursing home
Level of care such – more... as, not being able to dress, bath,
Feed; get into or out of bed, and they are not able to get up and
Use the restroom
Interviewing clients or their Authorized Representative
I would have to determine if the client meets the eligibility requirements
If the client appears to be financially eligible at the present time
The client cannot receive over $1737.00 a month earned or unearned Income or have over $2,000 in Resources.
PAS Pre assessment Screening for the medical
I have client sign and date all Required/Mandatory Forms
ALTCS Application DE-112-Authorized Representative This form lets us know who the client authorizes to be their representative DE-113-Customer’s Rights and Responsibilities Rights: they cannot be discriminated against in any way, because of beliefs, race, color, religion etc. Responsibilities: Must maintain any information needed to determine the clients eligibility such as, their income, resources, and medically.DE-805 – Share of Cost Estimate that the Customer Must Pay towards Share of Cost while the client is in a nursing facility.
We take their total Gross income and subtract a PNA Personal
Needs Allowance and any other expenses they might have such
As, rent utilities, and if they have a spouse or dependents at home,
After subtracting the total expenses and if any money left is what they will pay to the nursing facility while they are there.
If client or their Authorized Representative do not show for the Financial and Medical Interview the client who applied will be denied ALTCS benefits.
Be denied for ALTCS Benefits. They can re-apply as many times as they want.
Aged, Blind, or Disabled by Social Security Administration They have to PAS the Medical Assessment requirements WE use ACE, a computer program along with PMMIS We can tell if client is disabled, blind, or aged by a form called a (WTPY) that is issued from SSA. This shows us how Much Social Security someone is receiving by the SS claim # and if it is their spouses or their own claim number, and if a Client is SSI Cash and how much they are receiving.
How much and what claim number receiving the amount. I have to verify all the clients’ resources such as, checking accounts, Life insurances and trusts. Property owned. Grazing Permits, trust, or if they have transferred any money, homes, etc. Income has to be verified also if it is earned or not and how often they are Paid, and how much. Apply for Potential benefits, such as VA, Retirement pension.
Living arrangements have to be verified this is where the client resides. If living in a Nursing Facility the client may have to pay a SOC for their Care, while they are in the Nursing Facility. If client at home no SOC.
Have to Verify the Fiscal County because this determines what program
Provider is responsible for providing benefits that Program Contractor provider is responsible for setting up a specific care plan for the client.
They will be assigned to a Case Manager from that provider.
ACES, PMMIS, are two computer interfaces that allow communication between the State and Federal Government. – less