Health and Functional Assessment - Child and Adult
The goal of QUEST Integration (QI) is to provide improved access and enhanced quality healthcare services to eligible QI members for medically necessary healthcare services. All members meeting the following criteria will be included in the service coordination program and have an HFA completed.
- Eligible for Long-Term Services and Supports (LTSS),
- Eligible for At-Risk services, or
- Identified as having Special Health Care Needs (SHCN)
For members identified with SHCN, the service coordinator may be a licensed nurse, social worker, or other healthcare professional. For members receiving LTSS, the service coordinator and consult will be a nurse and social worker team. The service coordinator for individuals living in a Community Care Foster Family Home (CCFFH), Expanded-Adult Residential Care Home (E-ARCH), or Assisted Living Facility (ALF) may be the case manager from the Community Care Management Agency (CCMA). As of this 2017 edition of the HFA, there is only one HFA. Regardless of setting, eligibility, or status of reassessment, all members will be assessed with the same HFA.
The HFA serves as a starting point in the development of the service plan. This process requires input from all primary participants of the member’s healthcare team including the member (or authorized representative), caregivers, PCP, and service providers