Waiver Renewal for the Mechanical Ventilator Dependent Waiver and Waiver Specific Transition Plan
The South Carolina Department of Health and Human Services (SCDHHS) intends to file waiver renewal with the Centers for Medicare and Medicaid Services (CMS) for the Mechanical Ventilator Dependent (SC.40181) Home and Community-based (HCB) Waiver operated through the Community Long Term Care (CLTC) program. The effective date for the proposed waiver renewal changes is Dec. 1, 2017 or upon CMS approval.
The following is a summary of changes included in the proposed waiver renewal:
1. Addressed the CMS 1915(i) State Plan HCBS, 5-Year Period for Waivers, Provider Payment Reassignment, Setting Requirements for Community First Choice and 1915(c) HCBS Waivers (Final Rule).
a. All HCB settings where services are provided must meet the final rule setting 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 renewal and posted on the SCDHHS website, https://scdhhs.gov , for review and comments.
2. Person-centered planning process and service plan requirements.
a. Service planning for participants in Medicaid HCBS programs must be developed through a person-centered planning process that addresses health and long-term services and support needs in a manner that reflects individual preferences and goals.
3. Incorporated CMS’s required quality improvement project.
a. 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.
4. Clarified the definition of specialized medical equipment and supplies.
a. This service was defined more clearly to identify the other medical equipment and supplies that are available to the participants in this waiver.
5. Clarified the service package for pest control.
a. The waiver service package was updated to include the enhanced pest control service (bed bug treatment).
b. Clarified the limitations on the amount, duration and frequency of this service.
6. Removed the limitation on the amount and frequency of private duty nursing.
a. This service was limited to 60 hours per week. Nursing services are based on the participant’s assessed need, allowing for more hours if necessary.
7. Removed the extra prescription drugs benefit from this waiver.
a. Effective July 1, 2017, the state plan will no longer limit the benefit for prescription medications to four prescriptions, making this service redundant.
Although these are substantial changes, waiver participants will not be adversely impacted.
These changes to the waiver renewal were shared during the monthly Indian Health Services conference call on June 28, 2017, and will be presented to the Medical Care Advisory Committee (MCAC) meeting Aug. 29, 2017, at 10 a.m. at 1801 Main Street, Columbia, SC.
Additionally, communication on the proposed waiver renewal and the waiver specific transition plan will be shared at the following webinar:
Webinar: Mechanical Ventilator Dependent Waiver Webinar
Wednesday, Aug. 9, 2017, 1:30 p.m.
A copy of this notice and the PCSC draft waiver application are available at the following locations:
1. Electronic Access: www.scdhhs.gov (under the “Public Notice” and “Waiver” sections)
a. SCDHHS lobby at 1801 Main Street, Columbia, S.C.
b. SCDHHS CLTC Regional Offices
620 North Main Street, Suite 300
Greenville, SC 29601
945 East Main Street, Suite 3
Spartanburg, SC 29302
617 South Main Street
Greenwood, SC 29646
Rock Hill CLTC
454 South Anderson, Suite 10
Rock Hill, SC 29730
7499 Parklane Road, Suite 164
Columbia, SC 29223
191 Regional Parkway, Bldg. A
Orangeburg, SC 29118
30 Westmark Court
Sumter, SC 29150
201 Dozier Boulevard
Florence, SC 29501
1201 Creel Street
Conway, SC 29526
4130 Faber Place Drive, Suite 303
North Charleston, SC 29405
3215 Martin Luther King Jr. Blvd., Suite H
Anderson, SC 29625
6170 Woodside Executive Court
Aiken, SC 29803
10175 South Jacob Smart Blvd.
Ridgeland, SC 29936
Public Comments and Responses
If you have a question or comment, please send it to the following email or mailing address before Aug. 29, 2017:
Mail: Community Long Term Care
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.