36-2999.02

36-2999.02. Program; program contractors; interdisciplinary teams

A. The comprehensive care for the elderly program is established to provide managed care benefits to members of the Arizona long-term care system through a comprehensive medical and social service delivery system that uses interdisciplinary teams in a center where primary and other services are provided. A program contractor may offer the comprehensive care for the elderly program as an alternative model to the Arizona long-term care system service delivery model. The comprehensive care for the elderly program shall provide services to participants pursuant to this article and all state and federal requirements that govern the Arizona long-term care system.

B. A comprehensive care for the elderly organization must establish an interdisciplinary team at each comprehensive care for the elderly center to comprehensively assess and meet the individual needs of each participant. The organization must assign each participant to an interdisciplinary team functioning at the comprehensive care for the elderly center that the participant attends. The interdisciplinary team, in coordination with the participant, shall create a mutually agreed upon care plan that meets the medical, health, social and behavioral health needs of the participant. The interdisciplinary team shall provide and coordinate services that include, at a minimum, primary care services and all applicable long-term care services pursuant to section 36-2939.

C. The administration and its program contractors shall cooperate in the development of the comprehensive care for the elderly program.

D. A program contractor shall make a prospective monthly payment, based on the capitation rate, to the comprehensive care for the elderly organization for each participant.