How does an individual obtain EDWP Services?
Step 1: The individual contacts Area Agency on Aging (AAA) for an EDWP assessment for Tradional/ Enhanced care. The individual with active full Medicaid can contact the AAA for assessment.
Step 2: If the individual is eligible for EDWP, the care coordinator and the member/ representative collaborate to determine which services the applicant needs.
- Functional impairment caused by physical limitations NOTE: Alzheimer's and dementia are physical conditions.
- Unmet need for care
- Approval of an intermediate level of care (LOC) certification for nursing home placement
- Approval of care plan by client's physician
- Medicaid eligible or potentially eligible after admission to EDWP
- Client chooses community-based, rather than institutional services
- Services fall within the average annual cost of Medicaid-reimbursed care provided in a nursing facility. Health and safety needs can be met by EDWP
- Participation in one waiver program at a time
- Medicare home health services or hospice (Medicare or Medicaid) does not meet consumer needs for services
- Home Delivered Meals is not the only service need
- The home environment is free of illegal behavior and threats of bodily harm to other persons
Who is eligible for EDWP?