LTC Amendment Guide A
Waiver Amendment Changes not including the Performance Measures Revisions
Appendix
Item # and Page #
Item 1 E, Page 1
Description of Change
Requesting effective date of 10/1/15 for amendment.
Purposes of Amendment
1)
Revise case management qualifications to allow for up to one
year's experience through a practicum, internship or clinical rotation
to substitute for one year of the experience requirements for case
managers with a master's degree in social work, sociology,
psychology, gerontology or a related social services field;
2)
Remove Structured Family Caregiving from the waiver service
menu due to lack of utilization of this service since approval, effective
on May 1, 2015. If in the future managed care plans are Interested in
offering this service to an enrollee wishing to transition from a
nursing facility, it may be offered as a downward substitution service
or “in lieu of” the more costly institutional care;
Main
Application
Item 2, Page 1
3)
Revise Performance Measures in Appendices A-J to: (A)
update based upon CMS guidance titled "Modifications to Quality
Measures and Reporting in §1915(c) Home and Community-Based
Waivers" issued on March 12, 2014, (B) to correct text in the
approved performance measure such as deleting monthly and
inserting quarterly, and (C) to update the remediation language that
no longer reflects the current process;
4)
Update the spousal impoverishment policy as directed by the
Centers for Medicare and Medicaid Services;
5) Update the physical therapy providers by adding physical
therapists employed by Nursing Facilities based upon requests from
LTC plans so they can assure access adequate physical therapists in
all regions of the state; and
6) Update the unduplicated recipient count and related Appendix J
tables' estimates based upon program enrollment and service
utilization data.
Item 3A, Page 1
Additional Needed
Information (Optional),
Page 16
Appendix
B
List of Waiver application sections amend.
Summary of comments from stakeholders will be placed in this
section after the comment period is ended.
Item B-3 a and b, Page
33
Increase the unduplicated count of recipients served at any one
time for year 3 of the waiver period
Item 5-B a, Page 37
Update the spousal impoverishment policy per CMS guidance
1
LTC Amendment Guide A
Waiver Amendment Changes not including the Performance Measures Revisions
Appendix
Item # and Page #
C-1a, Page 49
Appendix
C
C-1/C-3, Pages 54-56
C-1/C-3, Page 86
Appendix
J
J-2, Pages 206-212
Description of Change
Structured Family Caregiving service has been removed from
waiver service menu.
Case Management qualifications have been revised to allow
case managers with master’s degrees in social work,
gerontology or a related social services field to substitute up to
one year of the two year experience requirement through a
combination of experience through a practicum, internship or
clinical rotation.
Physical therapists employed by Nursing Facilities may provide
physical therapy services to LTC waiver recipients
Demonstration of Cost Neutrality for Years 1-3 reflects the
deletion of Structured Family caregiving service meu for those
years.
Years 1-3 Tables also reflect the deletion of the Structured
Family caregiving service as well as the increased unduplicated
count for case management services for Waiver year 3.
2