Proposed Amendments to Florida’s 1115 Managed Medical Assistance (MMA) Waiver (Project Number 11-W-00206/4), 1115 MEDS-AD Waiver (Project Number 11-W-00205/4), 1915(c) Project AIDS Care (PAC) Waiver (FL.0194), and 1915(b)/(c) Long-term Care (LTC) Waiver (FL.0962) SUMMARY DESCRIPTION OF PROPOSED AMENDMENTS: The Agency is seeking to amend Florida’s 1115 MMA Waiver and 1915(b)/(c) LTC Waiver to: • Transition individuals enrolled in the 1915(c) Adults with Cystic Fibrosis (ACF) Waiver and the 1915(c) Traumatic Brain and Spinal Cord Injury (TBI/SCI) Waiver into the 1915(b)/(c) LTC Waiver in order for them to continue to receive home and community-based services (HCBS). This change will result in no loss of Medicaid coverage or services for these populations. • Transition individuals enrolled in the 1915(c) PAC Waiver who are receiving HCBS and who meet nursing facility level of care into the 1915(b)/(c) LTC Waiver in order for them to continue to receive HCBS. This change will result in no loss of Medicaid coverage or services for the population. • Establish financial and non-financial eligibility criteria (specified in section 409.904, Florida Statues) in the 1115 MMA Waiver that will enable individuals who are diagnosed with Acquired Immune Deficiency Syndrome (AIDS) to obtain and maintain Medicaid coverage without the need for enrollment in the 1915(c) PAC Waiver. This population does not need HCBS but are at risk for institutionalization without access to necessary medical/acute care services (prescribed drugs, physician services, etc.). This change enables the population to maintain access to needed services and will result in no loss of Medicaid coverage. • Transition the federal authority to serve individuals enrolled in the 1115 MEDS-AD Waiver to the 1115 MMA Waiver. This is a technical change; the population will continue to have access to all Medicaid covered services. The vast majority of these individuals are currently enrolled in an MMA plan for receipt of their medical, behavioral health, prescribed drugs, and dental services. The proposed changes will not affect how they receive these services or the plan in which they are enrolled. Individuals who are transitioning to the 1915(b)/(c) LTC Waiver will have an opportunity to choose their LTC plan and will continue to have access to HCBS that are comparable to the services they are currently utilizing. In addition, the LTC program offers a more robust benefit package than the 1915(c) TBI/SCI, ACF, and PAC Waivers, including enhanced case management standards and expanded benefits. The LTC program also offers individuals an opportunity to receive care/services through a program with enhanced quality outcome measures. The Agency is also seeking authority from the Centers for Medicare and Medicaid Services to end the 1915(c) TBI/SCI, ACF, and PAC Waivers, and the 1115 MEDS-AD Waiver once all transitions (described above) are complete. The Agency is seeking federal approval to have all transitions completed by January 1, 2018. To view the full description of the proposed amendment requests, please see the public notice documents published on the Agency’s website at the following link: http://ahca.myflorida.com/Medicaid/Policy_and_Quality/Policy/federal_authorities/federal_waivers/index.shtml PUBLIC NOTICE AND PUBLIC COMMENT PERIOD: The Agency will conduct a 30-day public notice and comment period prior to the submission of the proposed amendment requests to Centers for Medicare and Medicaid Services (CMS). The Agency will consider all public comments received regarding the proposed amendment requests. The 30-day public notice and public comment period is from August 1, 2017 through August 30, 2017. This public notice and public comment period is being held to solicit public input from recipients, providers, and all stakeholders and interested parties on the development of the proposed changes. When submitting comments, please include “Proposed Amendment to 1115 MMA Waiver,” “Proposed Amendment to 1115 MEDS-AD Waiver,” “Proposed Amendment to 1915(b)/(c) Long-term Care Waiver,” or “Proposed Amendment to 1915(c) Project AIDS Care Waiver” in the subject line as appropriate: • Submit email comments to FLMedicaidWaivers@ahca.myflorida.com. • Submit comments by mail to Bureau of Medicaid Policy, Agency for Health Care Administration, 2727 Mahan Drive, MS 20, Tallahassee, Florida 32308.