Notification to Amend Medicaid Home and Community-Based Waivers:

PUBLIC NOTICE: 
SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

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THIS IS A CORRECTION TO THE AUGUST 28, 2014 PUBLIC NOTICE

The South Carolina Department of Health and Human Services (SCDHHS) intends to file amendments with the Centers for Medicare and Medicaid Services (CMS) to two (2) of its home and community based waiver programs operated through the Community Long Term Care (CLTC) Program. These waivers are:

1. SC.0405 Community Choices Waiver and 2. SC.40181 Mechanical Ventilator Dependent Waiver These waivers will be amended to address the following topics.

1. Changes to the Community Choices Waiver

The number of participants served in this waiver has grown faster than was projected when the five year estimates were made (this waiver began its fourth year of the current approval July 1, 2014). In order to be in compliance with federal requirements, an amendment must be requested which will increase the number of people allowed to be served in the waiver program. The census increase is a count of the census for the entire waiver year so this amendment will allow the agency to continue to add participants at all points during the year and will have a proposed effective date of July 1, 2014.

The Community Choices waiver will also be amended to add Adult Day Health Care Nursing as a waiver service. Persons attending adult day health care centers often have skilled medical needs. This service reimburses the facility for providing certain skilled nursing services (ostomy care, urinary catheter care, wound care, tracheostomy care, tube feedings and nebulizer treatments that require medication). This service was a part of the waiver program for a number of years but was removed as a cost saving measure during 2011. The effective date for this service is upon CMS approval and not prior to May 1, 2015.

Finally, during the amendment process, SCDHHS will review current language and make necessary modifications to reflect technical changes to the flow of billing and filing of claims, organizational structure changes, and other minor language clarifications that may be necessary. Examples include: updating previous references to Care Call and Phoenix, changing the name of internal SCDHHS bureaus and divisions, and similar items. These language updates, do not affect participant services or substantive aspects of the waiver.

Language changes will be implemented along with the July 1, 2014 effective date of the census increase.

2. Changes to the Mechanical Ventilator Dependent Waiver

Presently, case management for Mechanical Ventilator Dependent waiver participants is performed as an administrative service by nurse consultants who are SCDHHS employees. This was done because of the extensive medical needs of this population. However, these nurses have many other duties and many aspects of case management do not fully utilize their medical training. This amendment will make case management a new waiver service that will be provided by provider case managers (usually licensed social workers). Waiver providers will be reimbursed for these services and SCDHHS nurse consultants will be able to commit more time to their many other responsibilities, such as completing initial waiver assessments to determine waiver medical eligibility and enrollment. The SCDHHS nurse consultants will also be available to consult with case managers when necessary.

Another change for this waiver is to add the service of home delivered meals. Many persons on ventilators are able to spend some time during the day off of the ventilator. This service meets the nutritional needs of participants in the CC and HIV/AIDS waivers. This will make the service available for all three waiver programs.

Finally, during the amendment process, SCDHHS will review current language and make necessary modifications to reflect technical changes to the flow of billing and filing of claims, organizational structure changes, and other minor language clarifications that may be necessary. Examples include: updating previous references to Care Call and Phoenix, changing the name of internal SCDHHS bureaus and divisions, and similar items. These language updates do not affect participant services or substantive aspects of the waiver.

The effective date for all changes is upon CMS approval and not prior to May 1, 2015.

Questions and Comments

These amendments will be discussed at SCDHHS’ Medical Care Advisory Committee meeting on November 12, 2014 at 10:00 a.m. at 1801 Main Street, Columbia, S.C. Additionally, information on these amendments will be shared during four regional public meetings and one live online webinar. See schedule below for the public meetings:

FIRST PUBLIC MEETING

Time:
6:00 - 7:30 PM

Date:
November 13, 2014

Location:
The Cottage at Francis Marion University, Hendrick Room
4822 E. Palmetto Street
Florence, SC

SECOND PUBLIC MEETING

Time:
6:00 - 7:30 PM

Date:
November 18, 2014

Location:
Kroc Center
424 Westfield Street
Greenville, SC 29601

THIRD PUBLIC MEETING

Time:
2:30 - 4:00 PM

Date:
November 19, 2014

Location:
Online Webinar
Link: https://www3.gotomeeting.com/register/941405902

FOURTH PUBLIC MEETING

Time:
6:00 - 7:30 PM

Date:
December 2, 2014

Location:
The College Center at the Complex for Economic Development of Trident
Technical College, Salons A-C
7000 Rivers Ave, Building 920
North Charleston, SC 29406

FIFTH PUBLIC MEETING

Time:
6:00 - 7:30 PM

Date:
December 4, 2014

Location:
Babcock Center
2725 Banny Jones Avenue
West Columbia, SC 29170
 

*Please refer to: https://msp.scdhhs.gov/hcbs/Events to confirm public meetings locations and dates.

Questions or comments must be addressed to comments @scdhhs.gov by December 12, 2014.

Written comments on these waiver amendments may be sent to:
Community Long Term Care 

ATTN: Belinda Adams
South Carolina Department Health and Human Services
Post Office Box 8206
Columbia, South Carolina 29202-8206
Comments may also be submitted to Comments@scdhhs.gov.
Comments must be received by December 12, 2014.

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