Medically Indigent Adult in Long Term Care

Individuals who qualify for MC under aid code 53, must be:

• In an acute care hospital,
• Otherwise ineligible for MC,
• Expected to remain in long term care (LTC) for more than 30 days, and
• Ready to be transferred to an LTC facility. Refer to Medically Indigent Adults

MIA LTC - Intake

The following must occur for a Medically Indigent Adult (MIA) LTC (aid code 53) application:

1. Hospital Case Manager:
   1. Contacts Intake Information Supervisor to inquire if the client has an application pending.
2. Intake Information Supervisor:
   1. Explains that an application must be on file if one is not already pending.
   2. Requests SCD 41 and SAWS 1 from Hospital Case Manager.
   3. Explains the process will take a minimum of 24 hours before a card can be issued.
   4. Refers information to Screener.
3. Screener:
   1. Meets patient in hospital.
   2. Gathers necessary paperwork.
   3. Returns paperwork to clerical at MBA.
4. Clerical:
   1. Receives paperwork.
   2. Completes application registration in CalSAWS.
   3. Assigns case to an EW.
5. EW:
   1. Receives case assignment.
   2. Initiates Intake workflow window in CalSAWS.
   3. Runs EDBC and authorizes aid code 53.
   4. Completes SCD 1296 to initiate immediate need MC card.
   5. Submits case to supervisor for immediate review.
6. EW Supervisor:
   1. Receives and reviews case.
   2. Forwards case to clerical or returns to EW for corrections, as appropriate.
7. Clerical:
   1. Receives case.
   2. Performs all clerical functions to transfer case.
   3. Scans into IDM.

MIA LTC - Continuing

When the case has already been set up at Intake and is pending a DDSD decision from Los Angeles, the following procedures apply:

1. Hospital Case Manager:    
   1. Contacts Continuing Information Supervisor to inquire if a card may be issued.
2. Continuing Information Supervisor:
   1. Requests the Hospital Case Manager fax verification to 793 - 1875.
   2. Forwards request to BSC LTC unit.
   3. Notifies Continuing EW that an aid code 53 is going to be necessary.
3. Case Manager:
   1. Completes necessary paperwork.
   2. Makes arrangements with LTC facility to transport patient to facility and reserves bed.
   3. Faxes verification to district office.
4. Clerical:
   1. Receives fax.
   2. Forwards verification to Continuing EW.
5. Continuing EW:
   1. Receives case assignment.
   2. Verifies the client is expected to stay at least 30 days in the LTC facility.
   3. Receives verification.
   4. Updates CalSAWS.
   5. Runs EDBC and authorizes aid code 53.
   6. Completes SCD 1296 to initiate immediate need MC card.

Related Topics

HIPAA/PII

Application

Medically Indigent Adults