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Posted January 4, 2016

 

Public Notice for Waiver Amendments


PUBLIC NOTICE

Comprehensive Waiver Amendment

Supports Waiver Amendment

Acquired Brain Injury Waiver Amendment

 

Public notice is hereby given that the Wyoming Department of Health (Department) is submitting three (3) amendments to the Centers for Medicaid and Medicare Services (CMS), one for the Wyoming Medicaid Home and Community Based Services Comprehensive Waiver, Supports Waiver, and Acquired Brain Injury Waiver.

The amendments specifies changes to caps on Respite and Companion services, a change to Adult Day Services, a change to the High Level of Care Service of Community Integration, and changes to Appendix J to correct service unit types. For the Supports Waiver, eligibility is being extended to people with a qualifying acquired brain injury.

 

Summary of Changes in the Amendments

Comprehensive Waiver

1. Added a transition plan to the Main section:

Participants on the current Acquired Brain Injury (ABI) Waiver will be given notice with 30 days of the effective date of this amendment that the ABI waiver will end on September 30, 2016. Those ABI participants will be offered the choice to transfer to the Supports Waiver or Comprehensive Waiver, if they choose to continue with waiver services. The Participants will be given notice of how to transition according to their plan of care start date, with a final transition deadline of September 1, 2016 to turn in a plan of care for the Comprehensive Waiver so that it can be approved and active on 10/1/2016 to avoid any disruption in services.

2. Specified changes to the eligibility criteria:

The Comprehensive Waiver will add the criteria for an Acquired Brain Injury to the eligibility section. The acquired brain injury must meet medical eligibility as determined by a licensed physician and registered nurse who reviews the medical documentation submitted by the applicant and verifies that this documentation meets the definition of acquired brain injury with verification on a neuropsychological examination that confirms the person meets any of the following functional criteria:

o Mayo Portland Adaptability Inventory (MPAI) score of 42 or more

o California Verbal Learning Test II Trials 1-5 T score of 40 or less

o Supervision Rating Scale score of 4 or more

o Inventory for Client and Agency Planning (ICAP) service score of 70 or less (ICAP
administered by a contracted agency)

3. Added to the number of people served by the waiver for the Acquired Brain Injury waiver participants.

4. Changed to the “Selection of Entrants to the Waiver” section to add the ABI waiver participants and update the process for entering the Comprehensive waiver by adding that a person must have a level of service need score of 4 or higher to qualify.

5. Changed to specific service definitions in Appendix C:

* Community Integration services require 50% of the time to be in the community or planning activities in the community over the course of each month (changing from "each week"). Community options offered, places visited and the people who were visited must be documented in the service documentation. We are also removing the employment procedure requirement for providers for this service and the employment training qualification for providers, which stated "Within one year of being certified in this service, 1 staff person working at least 50% of their time as a service supervisor must be certified in a nationally recognized supported employment curriculum and demonstrate that a portion of their time each month is spent training direct care staff on exploring employment interests, working on job readiness skills, or other employment related activities with participants."

* Cognitive retraining was added as a service for the ABI population.

6. Changed a performance measure data source in Appendix D QIS section for "type, scope, amount, frequency, and duration".

7. Updated the rate methodology in Appendix I due to legislative requirements for rate increases in Year 2 and 3 and Department of Labor Requirements that increase rates for special family habilitation home and daily respite for years 2 through 5.

8. Updated to Appendix J to add the ABI waiver to "D" and adjust the service unit types and rates based on recent data from COLD reports. Services listed in Appendix J of the waiver application will have new rates for year 2 and year 3 due to the legislative increase for 1 year for levels 4, 5, and 6. The average cost reflects the higher rate for those years.

Supports Waiver

Summary of waiver changes for this amendment

1. Change numbers served in Year 1 and 2 in B

2. Changed to specific service definitions in Appendix C:

* Community Integration services require 50% of the time to be in the community or planning activities in the community over the course of each month (changing from "each week"). Community options offered, places visited and the people who were visited must be documented in the service documentation. We are also removing the employment procedure requirement for providers for this service and the employment training qualification for providers, which stated "Within one year of being certified in this service, 1 staff person working at least 50% of their time as a service supervisor must be certified in a nationally recognized supported employment curriculum and demonstrate that a portion of their time each month is spent training direct care staff on exploring employment interests, working on job readiness skills, or other employment related activities with participants."

3. Changed a performance measure data source in Appendix D QIS section for "type, scope, amount, frequency, and duration".

4. Updated the rate methodology in Appendix I due to legislative requirements for rate increases in Year 2 and 3 and Department of Labor Requirements that increase rates for daily respite for years 2 through 5.

5. Updated to Appendix J to adjust the number served and adjust the service unit types and rates based on recent data from COLD reports. The rate for Daily respite is higher in years 2-5 due to the DOL requirement. Services listed in Appendix J of the waiver application will have new rates for year 2 and year 3 due to the legislative increase for 1 year for levels 4, 5, and 6. The average cost reflects the higher rate for those years.

Acquired Brain Injury Waiver

The ABI waiver will be ending on September 30, 2016. Please note the transition plan in Attachment 1 of the Main section of the waiver application located before Appendix A.

Summary of waiver changes for this amendment:

1. Transition plan to end the waiver in the Main section.

2. Changed to specific service definitions in Appendix C:

*  Community Integration services require 50% of the time to be in the community or planning activities in the community over the course of each month (changing from "each week"). Community options offered, places visited and the people who were visited must be documented in the service documentation. We are also removing the employment procedure requirement for providers for this service and the employment training qualification for providers, which stated "Within one year of being certified in this service, 1 staff person working at least 50% of their time as a service supervisor must be certified in a nationally recognized supported employment curriculum and demonstrate that a portion of their time each month is spent training direct care staff on exploring employment interests, working on job readiness skills, or other employment related activities with participants."

3. Changed a performance measure data source in Appendix D QIS section for "type, scope, amount, frequency, and duration".

4. Updated the rate methodology in Appendix I due to Department of Labor Requirements that increase rates for daily respite for years 2 through 5.

5. Updated to Appendix J to add the ABI waiver to "D" and adjust the service unit types and rates based on recent data from COLD reports. The daily respite rate is increased due to DOL requirements in years 2 - 5.


Public Comment

This notice is in the two main Wyoming newspapers. The amendments are in draft on the Department’s website (http://health.wyo.gov/ddd/index.html) and will be submitted to CMS after the Public Comment period. Public comment on this plan will close on January 30, 2016. A conference call (1-877-278-2734 Access Code 252484) will be held on January 25,
2016 at 2 pm to review the amendments and listen to public input.

Comments can be sent via email to bhdmail@wyo.gov or calling 307-777-6494.


Written comments may be sent to:

Wyoming Department of Health – Behavioral Health Division

Attention: Janet Altum

6101 Yellowstone Road Suite 259A

Cheyenne, Wyoming 82009


2016 Public Notice for ABI, Supports, and Comprehensive Waiver Amendments - Posted 1/4/2016


NEW - Rights Restriction Process Flow Chart - posted 1/22/2016

NEW - What are Rights Restrictions? - posted 1/22/2016

NEW - What Does CMS Say About Rights Restrictions? - posted 1/22/2016

 

Rate Rebasement Study by Navigant Consulting - posted 12-7-2015

Clarification on HCB Standards and FAQ's - reposted 12-3-2015

 

Important Notices: The SIS Pilot project and the Variance Reporting Requirement for providers have been cancelled -announced 11.30.2015 - Providers do not need to continue implementing the variance reporting process.

 

Popular Division Page Links

Link to Comprehensive and Supports Waivers Web Page

Link to YouTube Waiver Trainings and Supplemental Materials

Link to Case Manager Forms

Link to Waiver Tool Kit & Resources

Link to Register for MAT Student and Trainer Classes

Link to Register Your MAT Classes with the Division

 

HCB Setting Information and Transition plans

Waiver Transition Plans

· ALF HCBS Transition Plan PDF posted 4-8-2015

·  Wyoming Statewide Transition Plan PDF posted 4-1-2015

· Supports Waiver Transition PlanPDF posted 4-1-2015

· Comprehensive Waiver Transition PlanPDF posted 4-1-2015

· ABI Waiver HCB Transition Plan submitted to CMS PDF posted 4-1-2015

Additional HCB Setting Documents

· HCBS Setting Compliance Report SAMPLE (completed by providers) - PDF posted 1-21-2015

· Public Comment Summary and state responses PDF posted 11-21-14

· Summary of HCBS Setting Standards and Transition plan approach

· Children's Mental Health Waiver Compliance Summary (not a transition plan)

· Long Term Care Waiver Compliance Summary (reposted 10-14-14 - not a transition plan)

  

Clinical Review Team (CRT)

   ·         Clinical Review Team (CRT) Membership and Experience Summary Posted 6-16-14

   ·         Link to Page for Clinical Review Team (CRT) Policy and Form


Conflict Free Case Management Model 

          ·     Conflict Free Case Management Model revised 5-12-2014


Understanding Your IBA for the Comprehensive Waiver

 

·         Explanation on IBA Methodology Posted 5-16-2014

·         Recorded Training "Understanding Your New IBA for the Comprehensive Waiver" Posted 4-3-14


 

Legislation on Waiver Redesign

2013 Senate Enrolled Act No. 0082 Medicaid Reform (Legislation requiring the Division to develop and redesign waiver program.)

 

Need to Contact Us?

Send an email to bhdmail@wyo.gov