Michelle P. Waiver (MPW) Case Management
Since 2017, CareStar has been an eligible provider in the Michelle P. Waiver Program. The program provides assistance to individuals with intellectual and developmental disabilities to help them live as independently as possible in the community. CareStar can provide case management services for eligible individuals to help them and their family develop a person-centered care plan to meet their individual needs. CareStar will act as the point person in assisting them with connecting to community and waiver services. We are their advocate to safeguard their choices among groups of providers.
Populations Served: CareStar can serve individuals with intellectual disabilities or other developmental disabilities who meet the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) and who meet other Medicaid requirements through this program.
Location: CareStar can perform services across the State of Kentucky. However, as our presence in the Program is early, our focus will be on the northern regions of the State.
Application Process: The first step is to receive financial eligibility from Medicaid. The application process is maintained through the Kentucky Department for Community Based Services and can be completed online through their portal, or by calling/visiting a DCBS Office. If you would like CareStar to assist with the process and work as your Case Manager, please call 1-800-616-3718. There is currently a waiting list for services and supports.
Supports For Community Living (SCL) Case Management
Since 2017, CareStar has been an eligible provider in the Supports for Community Living Waiver Program. The program provides a wide variety of services to enable individuals with intellectual and developmental disabilities live in the community as independently as possible. CareStar can provide case management services for eligible individuals to help them and their family develop a person-centered care plan to meet their individual needs. CareStar will act as the point person in assisting them with connecting to community and waiver services. We are their advocate to safeguard their choices among groups of providers.
Populations Served: CareStar can serve individuals with intellectual disabilities or other developmental disabilities who meet the level of care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) and who meet other Medicaid requirements through this program.
Location: CareStar can perform services across the State of Kentucky. However, as our presence in the Program is early, our focus will be on the northern regions of the State.
Application Process: The first step is to complete an application form for SCL services. You may obtain an application by calling CareStar at 1-800-616-3718, or by printing a copy from the Medicaid website at https://chfs.ky.gov/dms/forms.htm or by calling 502-564-7702. If you are already receiving services, but are interested in transitioning to a new agency, please call CareStar at 1-800-616-3718. There is currently a waiting list for services and supports.
Population Health – Health Risk Assessments (HRA)
CareStar has partnered with Managed Care Plans to complete telephonic and in-person Health Risk Assessments, Health Needs Assessments and care planning for eligible members. CareStar completes the assessments to gather updated health history and to determine if there are any identified health or social service needs. Risks identified for the individual during the assessment are reported for additional care management follow-up. CareStar is committed to helping identify an individual’s needs and providing resources when necessary.
Population Served: Members of a managed care plan or other medical insurance provider.
Location: CareStar can perform these services where members reside or telephonically.
Quality and Utilization Review
CareStar is proud to be Quality Improvement Organization-like (QIO-like) certified by the Centers for Medicare and Medicaid Services (CMS). As a leader in Case Management, Assessment, Technology and Software Development, CareStar uses this Certification to assist our customers with quality assurance, improved healthcare outcomes and reduced costs. Additionally, CareStar engages physicians in specialty areas including, but not limited to, Family Medicine, Cardiology, Pulmonology, Gastroenterology, Neurology, Vascular Surgery, Internal Medicine, and Cardiovascular and Thoracic Surgery, to expand our expertise and capabilities and ensure efficiency and accuracy of our QIO-like activities.
Administered by CMS, a QIO-like Organization is made up of a group of expert healthcare clinicians and professionals contracted to complete utilization reviews and analyze patterns of care related to medical necessity and quality review. State Medicaid Agencies and organizations contracting with CareStar for QIO-like services are eligible for an enhanced Federal match of funds up to 75 percent. The QIO-like Certification is one of CMS’s most significant programs to improve quality and efficiency of healthcare delivery. . As of March 2020, CareStar is one of 76 organizations to hold this certification nation