Information Letter 14-38 outlines the Role of STAR+PLUS Acute Care Service Coordinator in Long-term Support Services Planning.
In accordance with the provisions of Senate Bill 7, 83rd Texas Legislature, Regular Session, 2013, certain individuals residing in an Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Condition (ICF/IID) or receiving long-term services and support (LTSS) through the Home and Community-based Services (HCS), Texas Home Living (TxHmL), Community Living Assistance and Support Service (CLASS), or Deaf Blind with Multiple Disabilities (DBMD) waiver program will receive acute care services through a STAR+PLUS managed care organization (MCO) beginning September 1, 2014. Acute care services are typically provided in a primary care physician’s office, a specialty physician’s office, a hospital, clinic or emergency room, as treatment for an isolated event or part of routine health maintenance. The service delivery model through which the individual is currently receiving ICF/IID, HCS, TxHmL, CLASS, or DBMD LTSS will remain the same.
MCOs will provide service coordination activities for these individuals with responsibility only for acute care services. Every individual will receive an assigned MCO service coordinator (SC). The number of required visits and level of service coordination received from the MCO SC will vary by medical acuity (level or severity of medical needs) and the individual’s or their legally authorized representative’s (LAR’s) personal preference. The person(s) currently responsible for development and implementation of a LTSS service plan and monitoring of service delivery for an individual’s LTSS program will continue to have this responsibility. However, effective September 1, 2014, DADS will require this person(s) also coordinate service delivery with the MCO SC in the provision of acute care services.
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