The Waiver supplements, rather than replaces, the formal and informal services and supports already available to an approved Beneficiary. Services are intended for situations where no household member, relative, caregiver, landlord, community agency, volunteer agency, or third-party payer is able or willing to meet the assessed and required medical, psychosocial, and functional needs of the approved CAP Beneficiary. Services provided under the Waiver are:
A full list of conditions that are considered when assessing a beneficiary for nursing facility level of care can be found in Clinical Coverage Policy 3K-2 here:
You can expect to receive a service request packet in the mail within 2 business days from the date of referral, from Acentra. They are the independent assessing contractor for Medicaid. Three forms are included with the service request packet that must be returned to Acentra for review of eligibility for CAP services. These three forms are:
Instructions are included in the packet on how to return the three required forms.
IMPORTANT: These forms are required to be returned within 7 days from date of receipt in order to be considered for the program.