Update to Case Management Policies for HCBS Waiver Providers, Assistance in Maintaining Updated Member Contact Information
During the initial response to the ongoing coronavirus disease 2019 (COVID-19) pandemic, the South Carolina Department of Health and Human Services (SCDHHS) announced temporary policy changes designed to ensure ongoing access to care for Healthy Connections Medicaid members enrolled in HCBS waiver programs and Healthy Connections Prime.
One of those flexibilities added an electronic method of service delivery (e.g., telephonic) allowing certain services, including case management and monthly monitoring, to be provided remotely. SCDHHS is announcing an update to the temporary policy changes it previously issued. Effective Jan. 1, 2023, case managers, care coordinators, and wrap facilitators are to resume face-to-face visits in the Healthy Connections Medicaid member’s place of residence for the following case management activities: initial, quarterly, and re-evaluation visits. SCDHHS strongly encourages case management providers to resume face-to-face visits immediately if they have not done so already. The requirement for a comprehensive face-to-face assessment to be performed for members enrolled in Healthy Connections Prime within 90 days of enrollment is also reinstated effective Jan. 1, 2023.
Prior to Jan. 1, 2023, case managers must conduct visits in the participant’s home if there is an immediate risk to the health, safety and/or welfare of the participant that indicates a need for a face-to-face visit. Providers may continue to perform the service telephonically during the PHE if the participant declines a face-to-face visit. Providers must follow recommended Centers for Disease Control and Prevention (CDC) COVID-19 home visit safety protocols at all times. This includes screening participants for COVID-19 symptoms prior to making visits; wearing face masks at all times during the visit; not sharing objects with participants such as pens, laptops, or other personal items; and, socially distancing while conducting the visit.
For waivers operated by the South Carolina Department of Disabilities and Special Needs (DDSN), guidance on case management requirements has been issued by DDSN and can be found here.
Help SCDHHS Maintain Updated Medicaid Member Contact Information
To comply with provisions of the Families First Coronavirus Response Act, SCDHHS paused the typical Medicaid eligibility annual review process effective March 2020. While the final end-date for the federal PHE remains unknown, SCDHHS is asking case management and Healthy Connections Prime providers to help ensure Healthy Connections Medicaid members’ contact information is accurate and up to date. If SCDHHS does not have accurate contact information, Healthy Connections Medicaid members may miss information on renewing and maintaining their health care coverage.
Providers can help with this process by sharing information about how a Medicaid member can update their address and other household information, which is available in the Healthy Connections Medicaid Communications Toolkit that is available on the Resources page of www.scdhhs.gov/annualreviews.
Providers should direct any questions related to this bulletin to SCDHHS program staff at MedicaidWaiver@scdhhs.gov.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.