ASAP Organizational Structure, Functions and Responsibilities

(1) An ASAP may be operated by one or more nonprofit agencies, one or more home care providers as defined in M.G.L. c.19A, § 4, a combination of said home care corporations acting jointly,or astate agency. (2) An ASAP shall not provide direct services to Elders (i.e. Community Based Long Term Care Services), except for ASAP Services as defined in651 CMR2.01 et seq. The Secretary may grant a waiver of this restriction upona findingthat public necessityand convenience require such a waiver. (3) An ASAP shall not have a direct or indirectfinancialownership interest inanentity that provides institutional or communitylong-termcare services on a compensated basis. The Secretary may grant a waiver ofthis restrictionupon a finding that public necessity and convenience require such a waiver. (4) An ASAP shall not be a vendor to another ASAP for the purpose of providing direct services. (5) ASAPs are organized to plan, develop, implement, and coordinate the delivery of Community- Based Long Term Care Services. (6) ASAPs are designated by Elder Affairs and under contract with Elder Affairs to carry out activities related to clinical screening, service authorization activities and case managementforCommunityBased Long Term Care Services, and carry out activities related to Protective Services designation. (7) ASAPs shall administer the Home Care Program in compliance with 651 CMR 3.00 and all contract requirements. (8) ASAPs shall administer the Home and Community Based Waiver Program in compliance with all contract requirements (9) ASAPs shall conduct screening functions in compliance with an interagency service agreement between Elder Affairs and DMA, Medicaid regulations, procedures issued by Elder Affairs and contract requirements. (10) ASAPs shall administer the Protective Services Program in accordance with M.G.L. c. 19A, §§ 14 through 26 and regulations at 651 CMR 5.00. (11) ASAPs shall provide the following services: (a) Information and Referral Services are activities related to the maintenance of current information regarding benefits, services and programs available to elders in Massachusetts. Determinations of the type of assistance needed by an elder requesting information, referrals to appropriate services, and follow-up is provided to determine if needed services were received. Information and Referral services may be conducted by mail, telephone, or in person without regard to income. Referrals for terminally ill elders, with their consent, shall include referral to a licensed and certified hospice for determination of eligibility,appropriateness andconsumerinterest in the service. (b) Interdisciplinary Case Management Services are provided by registered nurses and case managers employed by ASAPs working in consultation with physicians, nurses and therapists from home health agencies, hospice providers, nutritionists, housing managers, mental health professionals, and other home and health care professionals in compliance with Interdisciplinary Case Management Standards issued by Elder Affairs. It includes: 1. conducting intake and comprehensive needs assessments, including pre-admission screening and clinical eligibility determinations for elders seeking institutional and community care services from Medicaid or the Home Care Program; 2. developing and implementing service plans based on the needs of the elder; provided that a medical plan of care for an elder be developed by a licensed or certified health provider; 3. arranging for, coordinating, authorizing, and purchasing community long term care services called for in the comprehensive service plan; 4. reassessing and monitoring the outcomes of the services, and making periodic adjustments to the service plan, in consultation with service and health care providers, formal and informal supports and the Client and/or family; 5. working cooperatively, coordinating service plans and maintaining ongoing communication with the elder, family members, informal supports and formal supports as necessary. (c) Protective Services means services provided in accordance with M.G.L. c. 19A, §§ 14 through 26 and regulationsat 651 CMR 5.00, which are necessary to prevent, eliminate or remedy the effects of abuse to an Elder. Subject to appropriation, these services shall include, but not be limited to: capacity to respond to an emergency or a Rapid Response situation; Protective Services Casework; counseling; the capacity to provide or arrange for Home Care and other services; petitioning the Court for guardianship, conservatorship, protective orders through the court; and legal assistance. (d) Screening. A determination of an individual’s clinical eligibility for Community-Based Long Term Care Services or nursing facility services. These determinations are carried out by Registered Nurses working for ASAPs and in compliance with Division of Medicaid Assistance regulations and contract requirements.