Medical Respite Care definition

Medical Respite Care means short-term care and case management 27 provided to individuals recovering from an acute illness or injury that generally does not necessitate 28 hospitalization, but would be exacerbated by the individuals’ living conditions (e.g., street, shelter, or 29 other unsuitable places).

Medical Respite Care means short-term housing with supportive medical services.

Medical Respite Care means care for homeless CalOptima Medi-Cal Members who have circumstances that are expected to require care beyond the maximum 90-day stay period stated in for the County/DHCS Contract and who do not meet the Medical Necessity criteria for inpatient care or skilled nursing care and are appropriate for discharge to home. Examples include, without limitation, homeless members who are in hospice or are receiving intravenous (IV) chemotherapy. Medical Respite Care does not include any services that are medical covered services under the CalOptima Medi-Cal Program. To the extent that they are not covered services under the CalOptima Medi-Cal program, Medical Respite Care may include, but are not necessarily limited to the following:

Examples of Medical Respite Care in a sentence

• Medical Respite Care does not include any services that are medical covered services under the CalOptima Medi-Cal Program.

• Post Whole-Person Care Medical Respite Care will be authorized for a maximum of ninety (90) days, which may be extended on a case-by-case basis for up to an additional ninety (90) days per request, subject to CalOptima confirmation of medical necessity; there is no limit to the number of instances in which additional time may be approved, subject to available IGT funds specifically allocated hereunder.

• In the event County refers and pays for the provision of Medical Respite Care for qualifying CalOptima Medi-Cal members, County may seek reimbursement from CalOptima for such Medical Respite Care services subject to the terms and conditions below and this Amendment.

• Reimbursement shall be available for authorized Medical Respite Care for CalOptima Members following the 90-day Whole-Person Care Recuperative Care stay, whether the Member is assigned to CalOptima Direct, to a CalOptima Shared Risk Health Network, to a CalOptima HMO Health Network, or to a CalOptima Physician-Hospital Consortium.

• Regardless of the quantity or volume of Medical Respite Care services provided by County, in no event will CalOptima's obligations exceed said remaining CalOptima IGT dollars specifically allocated for Medical Respite Care.

• CalOptima’s funding shall be limited to the unspent CalOptima Intergovernmental Transfer (“IGT”) dollars allocated for Medical Respite Care approved by the CalOptima Board of Directors.