Example Level I Screens

CMS requires States to implement a two-level assessment process across populations seeking LTSS, involving a Level I screen and a Level II assessment. The purpose of a Level I screen is to identify those individuals who are likely to be eligible candidates for Medicaid-funded community LTSS.  The Level I screen must be available for completion by the potential applicant and/or his/her representatives in person or over the phone (by calling a 1-800 number with live support available). 

CMS also strongly recommends that States develop a self-screening tool that allows individuals to conduct a Level I screen online.  It should be as short, concise, and as simple to complete as possible, recognizing that the screening tool might be completed by the individual with support needs themselves or by family members, friends, advocates or others on behalf of the individual.  The Level I screen, for those considered likely eligible for community LTSS, provides a foundation of information or springboard for determining if a Level II assessment is appropriate.