Questions and Answers / 11-28-16
Agenda
· DD Waiver Rules and Public Comment
· Administrator Announcement
· 3.3% Rate Increase
· ABI Waiver Transition
· ECHO
· HCBS Transition Deadlines
· Bulletin: Change to Subsequent Assessments and Goods and Services Reminder
· Self Direction Connection
· Biofeedback and other disallowed services
· Transition from Residential Services to Support Living Policy
Topics
Developmental Disability Waiver Rules
The Chapter 44, 45, and 46 proposed rules, as well as many repealed rules, are out for public comment. They can be found on the Secretary of State website athttps://rules.wyo.gov/. Once you are on that website, simply click on Proposed Rules, and then go to Health.
The proposed repealed rules for Adult DD, Contested Cases, and ISC can be found under Adult Developmentally Disabled Programs and Services (0001), Developmental Disabilities - Contested Cases (0019), and Developmental Disabilities - Individually selected (0021). Chapters 41 - 46 can be found under Medicaid. If you can't find the rules, you can email Shirley Pratt nd she will provide you a copy.
Public Comment will be accepted untilDecember 29, 2016.
Administrator Announcement
We arepleased to announce that Lee Grossman has accepted the Developmental Disabilities Section Administrator position. Lee currently serves as the Waivers and Home Care Services Coordinator in the Division of Healthcare Financing, and has worked closely with Joe and his team over the past several years. Lee has a Master's degree in Public Administration from the University of Wyoming and an undergraduate degree in Political Science from the University of Nebraska.
Lee will be starting his new position onJanuary 3!
3.3% Rate Increase
The Behavioral Health Division has submitted a Retroactive Waiver Amendment to CMS with the following proposed changes across the Comprehensive, Supports and ABI waiver. It has been requested that these rates be retroactive to July 1, 2016.
1)Rate Increase: The Behavioral Health Division (BHD) proposes an across the board rate increase of 3.3% and an accompanying 3.3% increase to Individual Budget Amounts (IBA).
2)The Department of Labor (DOL) promulgated rule (78 FR 60454-85) addresses definition changes in the Fair Labor Standard Act, 29 U.S.C. § 201 et seq. that affect a governmental unit’s status as an employer. As a result, it prohibits employers other than the individual or their families or households from claiming the companionship services exemption from overtime.Three services have been identified which required additional rate increases to meet DOL overtime requirements. These rate increases replace the 3.3% increase for the specified services.
a. The Respite (individual) daily rate will increase to $190.15 per day.
b. The Special Family Habilitation Home rate and the Residential Habilitation Home rate will increase to $188.21 per day.
At this time, the Division has not received approval from CMS for this amendment.
ABI Waiver Transition
The Division will be updating providers and case managers, as we get closer to amending our waivers to end the ABI Adult Waiver. We are hopeful that the waiver will end sometime before summer of 2017. More to come!
ECHO
In an effort to respond to questions regarding the changes in the 1915(c) Medicaid Waiver Services, and to provide you with ongoing support, the Wyoming Department of Health, Divisions of Health Care Financing and Behavioral Health, in collaboration with the University of Wyoming’s Institute for Disabilities is setting up a series of weekly video conferences. These weekly sessions will assist providers, prescribers, agencies, and other professionals to understand the core elements of the 1915c Waiver Programs, including the recent changes. The Project ECHO® model will be used for these interactive sessions. Each UW ECHO session will include a 30-minute training along with a waiver service case study. All attendees will be awarded continuing education credit for their participation in the live sessions which are scheduled to start in the fall of 2016.
HCBS Transition Update and Deadlines
The Division is working hard on the HCBS Transitioning of providers into compliance of the new Home and Community Based Settings rule that was implemented in 2014. The State of Wyoming has until March 17, 2019 to come into complete compliance with this new rule. CMS has deemed that states must show compliance with the new rule by documenting how providers are transitioning to meet the new rules. By December 2, 2016, all providers who are being asked to transition should have received a Compliance Report that outlines what areas they are in compliance with or not in compliance with. The next step for providers will be to turn in a Transition Plan on how they plan to come into compliance with the new rule. All Transition Plans are due to the Division by January 3, 2017. Please submit all transition plans via email to your provider support specialist.
If a Transition plan is not received by the Division, the Division has no documentation to support that a provider is transitioning into the new rule. Without this evidence and documentation, the Division will have to move for decertification of the provider by March 17, 2019.
The Self-Direction Connection
Updates:
· The deadline for participants, Employers of Record and Direct Service Professional to get all missing or incomplete enrollment items to ACES$ is 12/31/2016. If there any incomplete records after 12/31/2016, they will be inactivated and put on hold and timesheets will not be processed. To prevent a delay in payments, participants, Employers of Record, and Direct Service Professionals need to turn in all missing items. Most of the missing items are:
o Unreadable documents (ex. Driver license which was scanned and too dark to read)
o Missing signatures/initials
o Signatures in the wrong place
o Missing certificates
If you have any questions, please contact ACES$ at 844.500.3815 to find out if any items are still outstanding.
Change to Subsequent Assessments and Goods and Services Bulletin
The Division released a bulletin on 11/3/2016 regarding changes to Subsequent Assessments and Goods and Services. You can find this bulletin on our website at: https://health.wyo.gov/behavioralhealth/dd/commwaiver/providers/
Biofeedback and Other Disallowed Services
The Division has been approving biofeedback therapies and equipment. This service and any associated equipment is specifically excluded per Chapter 16 of the Medicaid Handbook and Wyoming Medicaid Rules, Chapter 26 Section 6.
If you know of any plans where this has been an approved service, please contact your PSS. Those service lines need to be immediately modified to the units used.
Transition from Residential Services to Support Living Policy
It was discovered following the Case Manager training that a typo was made on the slide regarding the Transition Policy. According to the Division Policy on these transitions, the slide should have read: "5. During the last 6 months of the transition, ensures participant has begun receiving Supported Living and begin transitioning to less supervision and more independence. In certain circumstances, the last 6 months may remain at the current residentialhabilitationrate, if necessary. By the end of the year, it is expected that all participants will transition to Supported Living rates."
We apologize for any confusion that slide may have created and appreciate this discrepancy being brought to our attention.
Next call is on January 30, 2017