Broome County CASA began operations in 1983. “If CASA is to manage effectively, it is essential that potential long term care clients be promptly identified; that those for who community based care appears a viable option be thoroughly assessed; and that CASA ensure that, wherever possible, the long term care system is accessed at the appropriate points. None of these functions can adequately be performed at a distance. In short, each CASA will need to become that partnership between government and providers envisioned  by the New York State Long Term Care Systems Development Project; and each of the CASAs will need to intervene, directly and indirectly, in the long term care system to ensure the availability, accessibility and delivery of long term care services in the most appropriate and cost efficient manner possible.” (CASA Operations Notebook, NYS DSS 1983.)

 

·        CASA receives 200 new referrals every month. In 2008, CASA received 2,530 referrals for people in need of long term care.

 

·        CASA is the gatekeeper for those in need of long term care. CASA assesses  clients to determine their level of care and makes referrals to the appropriate programs and services.

 

 

1.                 Pre-Admission Program Assessments

2.                 Medical Eligibility (level and locus of care determination)

3.                 Case Management

4.                 Data Systems

5.                 Long Term Care Systems Planning and Development

 

·        Because of our planning function, CASA has developed innovative programs and services. Broome County CASA began operating a Nursing Home to Community program in 1996 and the In-Home Mental Health program in 2001.

 

·        During the 1990’s we were mandated by New York State to create new methods of service delivery to include new populations needing care, primarily children and young disabled adults. We accomplished this with no new staffing.

 

 

 

 

 

 

CASA operates AND/OR authorizes Medicaid payment for the following programs, which are MANDATED by the state of New York.

This program operates under three models: traditional Personal Care, Consumer Directed Personal Assistance Program, and Shared Aide. Between these three models, Personal Care serves 490 clients on a monthly average.

 

·        The Personal Care Program represents the largest Medicaid home care program
in the state, as well as in the United States.

 

·        In New York State, personal care is a billion-dollar program.

 

·        CASA assesses every person receiving personal care on a bi-annual basis.

 

·        CASA develops a care plan for every person in the program on a bi-annual basis.

 

·        CASA authorizes the Medicaid payment and coordinates the care with the
assistance of seven contracted licensed nursing agencies and the Southern
Tier Independence Center (STIC).

 

·        47% of the people receiving this service on a monthly basis are less than
60 years old.

 

·        Beginning in the early 1990’s, the Personal Care Program became available to developmentally disabled children and adults via the Home and Community Based Waiver programs and the Traumatic Brain Injury program.

 

 

This program is referred to as the “Nursing Home Without Walls Program.” It provides a higher level of nursing case management and assessment than the Personal Care Program. There are two providers in Broome County that service approximately 175 clients on a monthly basis. CASA assesses and authorizes the Medicaid services for these clients and is the number one referral source for both programs.

There are four providers of these residential care programs in Broome County with a total of 105 beds, approximately one-third are Medicaid recipients. CASA assesses all clients, private pay or Medicaid, who want to access the program and authorizes payment for Medicaid residents. Assisted Living supports seniors in need of long term care, but not infirmed enough for skilled nursing care.

 

Susquehanna Nursing Center operates the only Medical Day Care Program in Broome County.  CASA assesses and authorizes the care for all Medicaid clients served by the program.

 

CASA assesses and authorizes all Medicaid private duty nursing cases in Broome County for an average of 20 clients per month. People in receipt of this care are mainly children with high tech nursing and intense nursing management needs.

 

 

CASA provides assessment and Medicaid payment authorization to this program designed to serve children.

 

 

The goal of every CASA assessment is to develop the best care plan, at the least cost for all payers, whether private pay or Medicaid.   Combined with the referrals we receive on a monthly basis, CASA staff manages approximately 1,100 clients per

 

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