(a) To address the need of this state to develop for the future the framework and infrastructure for a comprehensive long-term care system that makes an appropriate place for both institutional care and a broad array of home-based and community-based services (HBCS), this section establishes a program that is intended to provide information, referral and assistance on a wide variety of quality, cost-effective and affordable long-term care choices and that should be designed to provide data collection and individual assessment and referral to community-based services and appropriate placement in long-term care facilities.
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Terms Used In Tennessee Code 71-5-1418

  • Commissioner: means the commissioner of finance and administration or the commissioner's designee. See Tennessee Code 71-5-1403
  • Contract: A legal written agreement that becomes binding when signed.
  • Cost-effective: means that the total cost of services provided to an eligible elderly or physically disabled adult in the home or other community-based setting does not exceed the cost of reimbursement for institutional care in a nursing facility. See Tennessee Code 71-5-1403
  • Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
  • Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
(b) As used in this section, unless the context otherwise requires:

(1) “Area agency on aging” means the agency defined in § 71-2-103;
(2) “Assessment services” means prescreening and evaluation of an individual’s health and functional status to estimate the need for long-term care services and to identify appropriate service options that meet these needs;
(3) “Director” means the executive director of the commission on aging and disability;
(4) “Hospital” has the meaning ascribed to such term under § 68-11-201; and
(5) “Nursing home” has the meaning ascribed to such term under § 68-11-201.
(c)

(1) There is established a long-term care client information, referral and assistance program, which shall be administered by the director and shall be implemented by area agencies on aging in accordance with this section.
(2) Individuals in the community seeking long-term care services for the elderly and disabled may obtain information about the available services and receive assistance in accessing needed services from the appropriate area agency on aging. Individuals who are initially prescreened by the area agency on aging will be referred to the local health department if determination of eligibility for medicaid-funded programs is needed. Area agency on aging staff may assist the individual to ensure that appropriate documentation is collected and available when the individual is referred to the local health or human services department for medical and financial eligibility determination.
(3)[See the Compiler’s Notes.] With the consent of the consumer or the consumer’s representative, a copy of the data gathered by the information, referral and assistance provider during the screening process will be provided to the health department to facilitate the preadmission evaluation assessment process and to the department of human services for use in beginning the financial eligibility determination process. Staff from the health department and the department of human services will contact the applicant to collect information for assessment.
(4) For those individuals already residing in nursing facilities or awaiting nursing facility placement following hospital discharge or directly seeking nursing home services, the preadmission evaluation (PAE) application will continue to be completed by the nursing facility, hospital staff or the individual’s physician and submitted to the division of long-term care of the bureau of TennCare for medical criteria determination.
(5)[See the Compiler’s Notes.] For those determined to be medically or financially ineligible for medicaid/TennCare funded services, the area agency on aging information, referral and assistance agency will:

(A) Conduct a more in-depth assessment of the person‘s needs;
(B) Identify appropriate community services to meet those needs, including eligibility requirements;
(C) Identify providers, including government agencies, private non-profit agencies, and for-profit agencies based upon rules and regulations adopted by the commission on aging and disability;
(D) Provide information on “How to Select a Provider”; and
(E) Offer tracking and follow-up to assure the client has received services.
(6) Any entity that provides client screening and assessment services pursuant to this section shall not also directly provide long-term care services.
(d)[See the Compiler’s Notes.] Prior to January 1, 2000, the commissioner of health in consultation with the director and the commissioner of human services, shall adopt by rule, promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, a long-term care client assessment and referral data entry form. The purpose of this form is for data collection and referral services only, not to determine eligibility for services. Such form shall be concise and questions shall be limited to those necessary to carry out the stated purposes. The long-term care client assessment and referral data entry form shall be used by all information, referral and assistance providers.
(e)[See the Compiler’s Notes.] The director and the area agencies on aging shall cooperate in compiling results of all assessment services conducted under this section. Area agencies on aging may provide assessment services under this section to assist persons seeking or needing long-term care. In providing such services, the staff of the area agencies on aging shall provide assessment and referral services.
(f) The director, after consultation with the commissioner of health, shall assure that each area agency on aging shall compile comprehensive resource information for use by individuals and agencies related to long-term care resources, including offices of the department of health, the department of human services and county health departments. This information shall include, but not be limited to, resources available to assist persons in selecting among all available long-term care options, including both institutional and non-institutional care, and such information shall be accurate and balanced.
(g)[See the Compiler’s Notes.] Area agencies on aging shall provide to all individuals, or caregivers of individuals in need of long-term care services, comprehensive information on the range of long-term care services that are appropriate for that individual and that are available in that individual’s community.
(h) On and after July 1, 2000, the area agencies on aging will operate or contract for a home care ombudsman program supervised by the commission on aging and disability, office of the state long-term care ombudsman. The home care ombudsman will investigate consumer/family member complaints regarding the quality of care, and assist in the resolution of problems between the consumer/family and a case manager or service provider.
(i) The director shall adopt rules to govern such matters, as the director deems necessary for the administration of this program. Such rules shall be promulgated in accordance with the Uniform Administrative Procedures Act.
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