This performance measure reflects the total number of Long Term Care (LTC) Medicaid applications which received an eligibility determination during the month.
LTC applications require a two-part eligibility determination: DAIL nurses perform a clinical determination and DVHA workers perform the financial eligibility determination.
The LTC Unit is responsible for the financial eligibility determination necessary to ensure that eligible Vermonters are able to access high quality long term supports and services. The LTC financial eligibility rules are complex. Many Vermonters hire elder law attorneys to help them with the LTC planning and application process. The LTC applications have gotten increasingly detailed and complex over time. LTC financial eligibility rules require a five year look back period of the applicant’s financial documents.
The above trend line reflects the number of LTC applications that are processed in a given month. An application is considered “processed” after both the DAIL LTC clinical eligibility and the DVHA LTC financial eligibility determinations are completed. The number includes both LTC application approvals and denials.
The new electronic asset verification system (eAVS) was launched in January 2018. While we get many of the eAVS financial results within the Vermont standard of 10 days, we continue to get many later than that. For all applications where we do not get eAVS results for known bank accounts within 10 days, the LTC staff must send paper forms to banks requesting copies of the applicants bank statements. In many cases, the staff will get ultimately get responses from both eAVS and copies of bank statements from the banks. This process creates more work for eligibility staff.
Due to updated information from LTC staff about the April LTC application processing, the final summary report for April compiled on May 8 is slightly higher than what was reported about April on May 1. (On May 1, LTC reported 316 LTC applications processed and 692 applications in process.)
Last updated: 10/15/2020