The Florida Statewide Medicaid Managed Care Long-Term Care Program (SMMC LTC) was approved and implemented in 2013 (Agency for Health Care Administration, 2017). The main rationale for adopting this initiative was centered on the intention to diverge senior adults from nursing homes. According to this innovation, senior adults can receive healthcare services and support while residing in their homes, their neighborhoods or communities, or in assisted living. Overall, eight different providers offer these services for senior individuals across the state. Given that the state was divided into 11 regions, it is quite possible that various providers are available at different locations (Agency for Health Care Administration, 2017).
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To be able to participate in the program, the individual needs to be the legal resident of the state and be no younger than 65 years of age. If the age is younger, then the person needs to be recognized as disabled by the administration. In terms of the health condition, the person should be in the state requiring a nursing facility level of care and also be financially eligible for the service.
Adoption of the Reform
The program was adopted under the general policies of the Medicaid initiative. The similar service-specific programs were applied along with the Statewide Medicaid Managed Care contract. After the innovation was drafted, it was legally authorized by three services, such as Title 42 of the Social Security Act, Code of Federal Regulations, and Section 409 Part IV of the Florida Statutes (Agency for Health Care Administration, 2017). After that, the initiative was implemented, starting from the year 2013.
The funding structure is quite simple due to the rationale behind it, although the statistical data is quite limited. In particular, the innovation is funded by the Medicaid plan through an approach of rebalancing of the funding (Paying for Senior Care, 2020). The intention behind this strategy is to decrease the growth rate of the long-term care budget. The state strives for reaching community-based care and diverging the use of nursing home services towards community-level healthcare.
The program has an important impact on the life and well-being of senior Floridians. All eligible senior adults are provided with an opportunity to receive community-level care that is less restrictive in character, and their health needs are addressed in their habitual or close to habitual settings. The plan of care is tailored to their specific case, and the manager to which every person is assigned ensures the needs of their client are satisfied (Paying for Senior Care, 2020).
Individuals eligible for this program take a comprehensive assessment of their health and receive the services required for maintaining their health on an adequate level. Importantly, family members can participate in the process of care or provide other assistance in the process under the guidance of the trained staff (Agency for Health Care Administration, 2017). Older adults are not kept in nursing homes, which are regarded as a restrictive environment, and receive services at home, in assisted living, or other facilities that were chosen together with them or their family.
Thus, the Florida Statewide Medicaid Managed Care Long-Term Care Program initiated seven years ago is the result of an attempt for budget rebalancing. It was aimed at reducing the growth rate of long-term care budget and ensuring senior adults receive care in a less restrictive environment. Individuals eligible for participating in the program go through comprehensive assessment and then receive care in the home environment or other desired settings while their immediate family can assist in the process of healthcare provision.
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Agency for Health Care Administration. (2017). A snapshot of Florida Medicaid long-term care program. Web.
Paying for Senior Care. (2020). Florida statewide Medicaid managed care long-term care program (SMMC LTC). Web.