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Notification for Waiver Renewal for the Community Choices (CC) and HIV/AIDS Waivers and Waiver Amendment for the Mechanical Ventilator Dependent Waiver

The South Carolina Department of Health and Human Services (SCDHHS) intends to file waiver renewals and an amendment with the Centers for Medicare and Medicaid Services (CMS) for the three home and community-based (HCB) waivers operated through the Community Long Term Care (CLTC) program. The waiver renewals are for the Community Choices Waiver (SC.0405) and HIV/AIDS Waiver (SC.0186), and a waiver amendment for the Mechanical Ventilator Dependent Waive (SC.40181). 

Drafts of these waivers have been posted on the SCDHHS website, scdhhs.gov, for public review and comments.

The following topics are addressed in the proposed waiver renewals and amendment:

1. Community Choices (SC.0405) - Renewal

  • The CMS 1915(i) State Plan Home and Community-based Services (HCBS) five-year period for waivers, provider payment reassignment, setting requirements for Community First Choice and 1915(c) HCBS Waivers (Final Rule) requirements.
    • All HCB settings where services are provided must meet the Final Rule settings requirements, which can be found in the Community Choices Transition Plan. This transition plan will be submitted with the proposed Community Choices waiver renewal and posted on the SCDHHS website, scdhhs.gov, for review and comments.
    • Person-Centered Planning Process requirements
    • Person-Centered Service Plan documentation requirements
  • Incorporated CMS’s required Quality Improvement project.
    • To monitor the quality of services provided to waiver participants, CMS requires states to investigate any performance measure that does not meet the required rate of compliance. Systemic remediation, which is written in a Quality Improvement Project (QIP), must be conducted until the required rate of compliance is met. 
  • Revised the case management service and its billing process.
    • To simplify billing for both case management providers and SCDHHS, the case management service will be reimbursed at a monthly fixed rate rather than in 15-minute increments; adjusting the enrollment process that will allow for agency-only providers while retaining current independent case managers.
  • Removed non-utilized adult care home service.
    • This service has not been authorized in the last two years and does not have service providers available.
  • Removed nursing home transition service.
    • The Money-Follows-the-Person (Home Again) program provides the same and additional services, making this service redundant.
  • Revised the Community Choices Transition Plan.
    • The CMS requires waiver specific transition plans to reflect similar language that is in the Statewide Transition Plan. The Community Choices Waiver Transition Plan has been revised to reflect language in the March 2016 revised Statewide Transition Plan.

The effective date for proposed waiver renewal changes will be on or after Sept. 1, 2016, and upon CMS approval.

 

2. HIV/AIDS (SC.0186) – Renewal

  • The CMS 1915(i) State Plan HCBS five-year period for waivers, provider payment reassignment, setting requirements for Community First Choice and 1915(c) HCBS Waivers (Final Rule) requirements.
    • All HCB settings where services are provided must meet the Final Rule settings requirements, which can be found in the HIV/AIDS Transition Plan. This transition plan will be submitted with the proposed HIV/AIDS waiver renewal and posted on the SCDHHS website, scdhhs.gov, for review and comments.
    • Person-Centered Planning Process requirements
    • Person-Centered Service Plan documentation requirements
  • Incorporated CMS’s required Quality Improvement project.
    • To monitor the quality of services provided to waiver participants, CMS requires states to investigate any performance measure that does not meet the required rate of compliance. Systemic remediation, which is written in a Quality Improvement Project (QIP), must be conducted until the required rate of compliance is met.
  • Revised the Case Management service and its billing process.
    • To simplify billing for both case management providers and SCDHHS, the case management service will be reimbursed at a monthly fixed rate rather than in 15-minute increments; adjusting the enrollment process that will allow for agency-only providers while retaining current independent case managers.
  • Revised HIV/AIDS Transition Plan.
    • The CMS requires waiver specific transition plans to reflect similar language that is in the Statewide Transition Plan. The HIV/AIDS Waiver Transition Plan has been revised to reflect language in the March 2016 revised Statewide Transition Plan.

The effective date for proposed waiver renewal changes will be on or after Sept. 1, 2016, and upon CMS approval.

3. Mechanical Ventilator Dependent (SC.40181) – Amendment

  • The CMS 1915(i) State Plan HCBS five-year period for waivers, provider payment reassignment, setting requirements for Community First Choice and 1915(c) HCBS Waivers (Final Rule) requirements.
    • All HCB settings where services are provided must meet the Final Rule settings requirements, which can be found in the Mechanical Ventilator Dependent Transition Plan. This transition plan will be submitted with the proposed Mechanical Ventilator Dependent Waiver Amendment and posted on the SCDHHS website, scdhhs.gov, for review and comments.
    • Because the Mechanical Ventilator Dependent Waiver is up for renewal in 2017, the other Final Rule requirements (Person-Centered Planning and Person-Centered Service Plan documentation) will be addressed at that time.
  • Revised the case management service and its billing process.
    • To simplify billing for both case management providers and SCDHHS, the case management service will be reimbursed at a monthly fixed rate rather than in 15-minute increments; adjusting the enrollment process that will allow for agency-only providers while retaining current independent case managers.
  • Revised Mechanical Ventilator Dependent Transition Plan.
    • The CMS requires waiver specific transition plans to reflect similar language that is in the Statewide Transition Plan. The Mechanical Ventilator Dependent Waiver Transition Plan has been revised to reflect language in the March 2016 revised Statewide Transition Plan.

The effective date for proposed waiver amendment changes will be on or after Sept. 1, 2016, and upon CMS approval.

 

Communication:

These changes to the waiver renewals and the amendment were discussed at SCDHHS’ Medical Care Advisory Committee (MCAC) meeting Nov. 17, 2015, 10 a.m. at 1801 Main Street, Columbia, SC, and shared during the SCDHHS monthly Indian Health Services conference call on Dec. 16, 2015.

 

Additionally, communication on the proposed waiver renewals, waiver amendment and each of the waiver specific transition plans will be shared at the following public meeting and webinar:

Public Meeting: Tuesday, May 3, 2016, 11 a.m.
                                BlueCross BlueShield of South Carolina

                                                8901 Farrow Road, Building 200

                                                Columbia, SC 29203

 

Webinar:             Wednesday, May 11, 2016, 2 p.m.
Register: https://level3.cwebcast.com/Embed/EncryptedEmbedSingle?encryptedId=Pmbs8CSo9cpzVV1ssslo8w~~

The Community Choices, HIV/AIDS Waiver Renewals, and the Mechanical Ventilator Dependent Amendment including the waiver specific transition plans can be found in the following locations:

 

 

                SCDHHS (Documents are in the Lobby)

                1801 Main Street

                Columbia, SC  29202

 

                Greenville CLTC

                620 North Main Street, Suite 300

                Greenville, SC  29601

 

                Spartanburg CLTC

                945 East Main Street, Suite 3

                Spartanburg, SC 29302

 

Greenwood CLTC

                617 South Main Street

                Greenwood, SC  29646

 

                Rock Hill CLTC

                454 South Anderson, Suite 10

                Rock Hill, SC  29730

 

                Columbia CLTC

                7499 Parklane Road, Suite 164

                Columbia, SC  29223

 

                Orangeburg CLTC

                191 Regional Parkway, Bldg. A

                Orangeburg, SC  29118

 

                Sumter CLTC

                30 Westmark Court

                Sumter, SC  29150

 

                Florence CLTC

                201 Dozier Boulevard

                Florence, SC  29501

 

                Conway CLTC

                1201 Creel Street

                Conway, SC  29526

 

                Charleston CLTC

                4130 Faber Place Drive, Suite 303

                North Charleston, SC  29405

 

                Anderson CLTC

3215 Martin Luther King Jr. Blvd.,
Suite H

                Anderson, SC  29625

 

                Aiken CLTC

                6170 Woodside Executive Court

                Aiken, SC  29803

 

                Ridgeland CLTC

                10175 South Jacob Smart Blvd.

                Ridgeland, SC  29936

 

 

Questions and/or comments must be sent to the following before May 25, 2016:

                                                ATTN:  Lisa Ragland

                                                South Carolina Department of Health and Human Services

                                                Post Office Box 8206

                                                Columbia, SC  29202-8206

 

Any written comments submitted may be reviewed by the public at SCDHHS, Division of Community Long Term Care, Jefferson Square Building, 1801 Main Street, Columbia, SC, Monday through Friday between the hours of 8 a.m.-4:30 p.m.

 

 

 

 

 

 

 

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