D12-016 – Information

October 2, 2012
TO: / Regional Administrators
Field Services Administrators
Field Services Staff
FROM: / Linda Rolfe, Director, Division of Developmental Disabilities
SUBJECT: /
Home and Community Based Services (HCBS) Waiver Renewal and Implementation of Changes
Purpose: / This bulletin is to inform regional staff of changes to the DDD HCBS Waiver programs and the CMS approval of the Basic Plus, Core, Community Protection (CP) and Children’s Intensive In-Home Behavior Supports (CIIBS) waivers effective September 1, 2012.
Background: / DDD submitted to CMS the renewal of the Basic Plus, Core, CP, and CIIBS waivers on June 5, 2012, with changes to the waiver programs and services. DDD requested that the Basic Plus, Core, CP and CIIBS waivers be renewed effective September 1, 2012. The Basic waiver program was not renewed and will end September 28, 2012. Current Basic waiver clients were provided written notification on August 24, 2012, regarding changes to their HCBS waiver program (see attached letter).
Training and information sharing occurred with field staff in July, August, and September of 2012 regarding changes described below (see link for presentations).
What’s new, changed, or Clarified / The Basic Plus, CP, Core and CIIBS waiver programs have been renewed and are effective with a new waiver year from September 1, 2012 through August 31, 2017.
The Basic waiver program will end September 28, 2012. All current Basic waiver clients will be moved to the Basic Plus waiver with an effective date of September 29, 2012. This will occur through CARE changes that will run the evening of October 12, 2012.
HCBS waiver renewals included the following changes:
·  Addition of Adult Dental Services to the Basic Plus, Core, and CP waivers;
·  Addition of Individualized Technical Assistance (ITA) to the Basic Plus, Core, and CP waivers;
·  Addition of Behavioral Health Stabilization services to the CIIBS waiver;
·  Change in the name of Mental Health Stabilization services to Behavioral Health Stabilization services in all HCBS Waivers;
·  Change in the name of Behavior Management and Consultation services to Behavior Support and Consultation services in all HCBS Waivers;
·  Elimination of Person to Person services in the Basic Plus, Core, and CP waivers;
·  Elimination of Employment and Day annual dollar limits and replacement with Supported Employment acuity and monthly employment service hourly limits in the Basic Plus, Core, and CP waivers (see emergency rule); and
·  Elimination of Employment and Day annual dollar limits and replacement with Community Access acuity and monthly Community Access service hourly limits in the Basic Plus and Core waivers (see emergency rule).
On October 12, 2012, the following CARE changes will automatically occur:
·  Add Adult Dental (age 21 and older) as a service option in the treatment screen, ISP and PAN.
·  Add Dental Provider type to treatment screen.
·  Change all CSAs with Basic waiver and Basic waiver proviso funds source to reflect Basic Plus waiver fund source.
·  Eliminate Basic and Basic waiver with personal care as program options.
·  End all Basic waiver database requests and replace with a Basic Plus database request.
·  End all currently open Basic waiver records with an effective date of September 28, 2012.
·  Open a Basic Plus waiver record for all clients previously on the Basic waiver with an effective date of September 29, 2012.
·  Withdraw all pending Basic waiver requests with an effective date of September 28, 2012 (these requests will not be replaced).
On October 13, 2012, a Social Services Payment System (SSPS) transaction generator will run to:
·  End all open Basic waiver SSPS authorized services and open Basic Plus waiver authorizations with the appropriate corresponding SSPS code to replace them:
o  Basic waiver service codes will have an end date of September 30, 2012, and
o  Basic Plus waiver service codes will have a begin date of October 1, 2012.
·  Basic waiver SSPS codes will no longer be available after October31, 2012.
Action: / 1. Case Resource Managers (CRM) must check in all client assessments at the end of the business day on Friday, October12, 2012 to prepare for the CARE changes.
2. The CRM will implement any changes at the next annual assessment or sooner if change is occurring to services identified below.
3. For authorizations with an end date of September 30, 2012, the CRM will need to update them manually, as appropriate, to reflect Basic Plus waiver program. The SSPS transaction generator will not change any authorization with an end date of September 30, 2012. An Excel spreadsheet will be forwarded to the Regions with authorizations that were not caught so that the CRM can take appropriate actions.
4. The CRM will implement changes to the Employment Program Services and Day Program Services at the client’s next annual assessment or sooner if a change is occurring in this service:
o  Use the DDD assessment, acuity and current rule to determine the amount of service for which each individual is eligible for;
o  Use information to develop and document in the ISP the amount of service the individual can expect to receive; and
o  Use available information to communicate changes in the Employment and Day Program Services to clients.
5. CRM will complete following activities to transition clients to the Basic Plus waiver at client’s annual assessment or sooner if any changes are needed to modify CARE assessment:
o  For assessments due in October, it is recommended to leave assessment in pending until after electronic Care change occurs to allow for all planning under the Basic Plus waiver program.
o  At client’s next annual assessment, CRM will complete steps identified below to develop an ISP to reflect Basic Plus waiver program:
1)  Add Basic Plus waiver or Basic Plus Waiver with personal care to the “Programs Client On” field on the Support Assessment “Programs and Services” panel;
2)  Develop ISP with Basic Plus waiver services;
3)  Obtain client signature on a new DSHS 10-424, Voluntary Participation Statement; and
4)  Use the updated Waiver Fact and Information Sheets during assessments (see Attachments section below).
o  If the CRM needs to modify the CARE assessment in any way prior to the annual assessment, including an ISP amendment, then steps 1 and 2 will need to occur. Step 3 may occur at the planned annual assessment.
6. The CRM will begin to plan for Adult Dental Services after October 12, 2012 at the client’s next annual assessment:
o  Use the Care Treatment screen to document Adult Dental (Age 21 and older) service needs.
o  Use the ISP to document Adult Dental (Age 21 and older) services with a dental provider from collateral contacts.
o  Cite Chapter 182-535 WAC for Adult Dental services in PAN.
Related REFERENCES: / ·  WAC 388-828-4165, 4420, 4440, 9300 and 9310 Community Access (emergency rule effective September 1, 2012)
·  WAC 388-828-9325, 9339, 9335, 9340, 9345, 9350, 9355 and 9360 Employment Support Program (emergency rule effective September1, 2012)
·  Chapter 388-845 WAC DDD home and community based services waivers (emergency rule effective September 1, 2012)
·  HCBS Waiver Renewal information presentations
ATTACHMENT(S): /


CONTACT(S): / Kris Pederson, HCBS Waiver Program Manager

360-725-3445
Christie Seligman, CIIBS Waiver Program Manager

360-725-3448
Branda Matson, Employment and Day Program Manager

360-725-3405

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