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Clinical Eligibility Screens

MassHealth designates authority to determine a consumer’s clinical eligibility for various MassHealth Programs, called Clinical Assessment & Eligibility (CAE), to Aging Service Access Points (ASAP). LifePath is the ASAP for Franklin County as well as the four Worcester County towns of Athol, Petersham, Phillipston, and Royalston. LifePath’s clinical nurses make the CAE determinations for admissions to programs both in the community and in nursing homes. 

Consumers must be both financially and clinically eligible to qualify for and remain in a program. CAE determinations are performed for MassHealth members or applicants.

Community Nursing Facility Screens

Persons over age 21 seeking placement in a nursing facility are required to be screened for clinical eligibility if MassHealth will be the payment source for short-term and long-term nursing facility care. 

Adult Day Health Screens

LifePath also conducts screens for individuals seeking MassHealth coverage for adult day health.

Frail Elder Waiver (Home and Community-Based Services Waiver)

Consumers with higher incomes may still qualify under a “waivered” program in which the consumer’s income is counted separately from their spouse’s or in which the consumer is very frail. Massachusetts has “waivers” that allow persons who meet nursing facility level of care access to home and community services.

Contact us to arrange for a clinical eligibility screening.