Learning Center
Plans & pricing Sign in
Sign Out

RE Revised AHCA MedServ Process Pilot Project Dear


									                          RE: Revised AHCA MedServ-3008 Process Pilot Project

                          Dear Nursing Facility /Hospital Administrator:

                          The purpose of this letter is to provide information about a pilot project between
                          the Department of Children and Families (DCF), Automated Community Connection to
                          Economic Self Sufficiency (ACCESS) Florida staff and the Department of Elder Affairs (DOEA)
                          Comprehensive Assessment and Review for Long-Term Care Services (CARES) staff.

                          The pilot began in May 2008 in the Florida panhandle and has continued to be
                          expanded throughout the state since this time. Beginning June 29, 2009, all 19 CARES
                          program offices statewide will participate in the revised AHCA MedServ-3008 Process.

                          The goal of this pilot project is to expedite the Level of Care process between ACCESS
                          Florida staff and CARES staff to ensure timely Medicaid eligibility determinations for
                          nursing facility placement.
                          Summary of Changes:
                               • The Patient Transfer and Continuity of Care (CF-MED 3008) form has been
                                   revised and renamed the Medical Certification for Nursing Facility/Home and Community
                                   Based Services form (AHCA MedServ-3008 form). This form and the instructions are
                                   located for your convenience at the following link:
                          From this link you may download
                                   the form, complete as appropriate for each individual, save the portable
                                   document format (.PDF) file as needed before printing, signing and returning to CARES.
                               • The Informed Consent form (CF-ES 2040) form has been revised. The revised
                                   form is now the Informed Consent form (AHCA MedServ-2040).
                               • The 3008 and 2040 forms will no longer be required to be routed through ACCESS Florida
                                   staff to CARES in the pilot areas.
E. DOUGLAS BEACH, PH.D.        • If the 3008 and 2040 forms are received by ACCESS Florida staff, they will
                                   forward to CARES.
                               • Completed 3008s should be forwarded to the local CARES office with the AHCA
                                   MedServ-3008 Referral Cover Sheet, indicating the 10-digit DCF ACCESS Confirmation
                                   number provided at the time application is made online at
                               • CARES will be responsible for ensuring the 3008 is completed correctly. CARES will
                                   complete the Request for Additional Medical Information form DOEA-CARES form 617 and
                                   return the incomplete 3008 form to appropriate facility with Instructions for AHCA MedServ-
                                   3008 form, and CARES contact information.
                          If the 3008 and 2040 forms are not received by ACCESS Florida staff, they will place the case in a
                          pending status and request the client submit the 3008 and 2040 to the appropriate CARES office,
                          using the manual pending letter. CARES will notify the DCF/ACCESS unit if the request for
                          additional information is not received within 30 days of the ACCESS Florida request.
                          Attached are the documents needed for the pilot project:
                          • Medical Certification for Nursing Facility/Home and Community Based Services form
                               (AHCA MedServ-3008 form)
                          • Instructions for completing the AHCA MedServ-3008 form
                          • AHCA Med-Serv 3008 Referral Cover Sheet
                          • CARES Request for Additional Medical Information Form (DOEA-CARES form 617)

                          Thank you in advance for your participation in this pilot project. If you have any questions regarding
                          this pilot project, please feel free to contact me at


To top