Agency for Health Care Administration, Medicaid

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Medicaid

Developmental Disabilities Individual Budgeting Transition Plan for Implementing the Home and Community-Based Settings Rule Requirements and the Developmental Disabilities Individual Budgeting Waiver Amendment Request

The Agency for Health Care Administration (Agency) is submitting to the Centers for Medicare and Medicaid Services (CMS) a transition plan as specified in 42 CFR 441.301(c)4 for the Developmental Disabilities Individual Budgeting (iBudget) Waiver, which will be included in the waiver amendment request. The iBudget Transition Plan, the waiver amendment request and the public process used to solicit public input are described in this notice.

Description of the iBudget Transition Plan

The Agency is submitting to CMS a transition plan for the iBudget Waiver in compliance with the Home and Community-Based (HCB) Settings Rule CMS 2249-F. The draft transition plan is designed to ensure that individuals receiving home and community-based services in the iBudget Waiver are integrated in, and have access to, supports in the community, including opportunities to seek employment, work in competitive integrated settings, engage in community life, control personal resources and maintain the rights of privacy, dignity, respect and freedom. The draft transition plan describes how the State will assess, determine compliance, remediate and monitor the waiver’s continued compliance with the HCB settings requirements. This draft transition plan outlines the State’s process with time frames that will be used to ensure compliance with the HCB Settings Rule.

The HCB Settings Rule requires public notice and a 30-day public comment period to solicit meaningful public input for consideration in the development of the transition plan prior to submission to CMS. The Agency is providing public notice on the draft transition plan to solicit meaningful public input from recipients, providers and all stakeholders prior to submission of the transition plan to CMS. The Agency will post the draft transition plan on its website for public comment beginning February 3, 2015 and ending March 5, 2015. The draft transition plan can be viewed on the Agency’s website at the following link: http://ahca.myflorida.com/Medicaid/hcbs_waivers/index.shtml.

When submitting written comments by postal service or e-mail, please have ‘iBudget Transition Plan’ contained in the subject line. Mail comments and suggestions to: Agency for Health Care Administration, Attention: HCBS Waivers, 2727 Mahan Drive, MS 20, Tallahassee, Florida 32308. Email your comments and suggestions to: [e-mail].

For more information, you may contact: Nicholas Warner at [phone] or email: [e-mail]. If you are hearing or speech impaired, please contact us using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

Description of iBudget Waiver and Amendment Request

The iBudget Waiver serves individuals with developmental disabilities who are three years of age or older, meet the level of care criteria for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) and meet Medicaid financial eligibility requirements. The services provided under this waiver are: residential habilitation, respite, support coordination, adult dental services, occupational therapy, physical therapy, private duty nursing, respiratory therapy, skilled nursing, specialized medical equipment and supplies, specialized mental health counseling, speech therapy, transportation, behavior analysis services, behavior assistant services, dietitian services, environmental accessibility adaptations, family and guardian training, life skills development, personal emergency response system, personal supports, residential nursing, special medical home care and supported living coaching.

The Agency will submit to CMS a request to amend the iBudget Waiver that operates under the authority specified in Section 1915(c) of the Social Security Act. The waiver amendment request is being submitted to: (1) update quality performance measures, (2) revise estimated frequency of service utilization (J-Table estimates), (3) amend provider requirements, (4) amend provider enrollment process, (5) update title of Quality Improvement Organization to contracted vendor, (6) request an increase in the unduplicated number of participants, (7) delete family and guardian training service, (8) revise the name of ‘transportation day service’ to ‘transportation month service,’ (9) update mandatory spousal impoverishment information, and (10) update Medicaid agency contact person, (11) add language regarding rulemaking, (12) technical edits to correct reference to Down Syndrome and intellectual disability, (13) revise language regarding selection of entrants to the waiver, (14) add supported living coaching to services provided in the facility, (15) provide information about safeguards and State oversight regarding the use of seclusion, (16) update the public notice process and (17) include the transition plan in compliance with the HCB Settings Rule. Prior to submission to CMS, the Agency is providing public notice of the waiver amendment request as described below and in accordance with 42 CFR 441.304(f).

The Agency is providing public notice as specified in 42 CFR 441.304(f) to solicit meaningful public input from recipients, providers and all stakeholders on the waiver amendment request 30 days prior to submission to CMS. The Agency will post the waiver amendment request with a description of the changes on its website in conjunction with the draft transition plan. The waiver amendment request document can be viewed at the following link: http://ahca.myflorida.com/Medicaid/hcbs_waivers/index.shtml.

When submitting written comments by postal service or email, please have ‘iBudget Waiver Amendment Request’ contained in the subject line. Mail comments and suggestions to: Agency for Health Care Administration, Attention: HCBS Waivers, 2727 Mahan Drive, MS 20, Tallahassee, Florida 32308. Email your comments and suggestions to: [e-mail].

For more information, you may contact: Nicholas Warner at [phone] or email: [e-mail]. If you are hearing or speech impaired, please contact us using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).