DSD eList announcement
Date: March 15, 2018
To: Lead agency staff and other interested stakeholders
From: DHS Disability Services Division
Purpose: To announce federal approval of a waiver amendment package that affects the BI, CAC, CADI and DD waivers
Effective date: Varies by service
Contact: DSD.ResponseCenter@state.mn.us
Waiver amendments approved by CMS
The Centers for Medicare & Medicaid Services (CMS) approved DHS’ waiver amendment package March 8, 2018. The amendment package affects the following waivers:
Summary
The following summarizes the policy changes and clarifications included in this waiver amendment package. The DHS Disability Services Division will send eList announcements as it updates the Community-Based Services Manual (CBSM) and MMIS to implement these federally approved amendments.
Fiscal
CDCS budget methodology | Updates language to reflect additional criteria for when DHS may approve an exception to a CDCS budget. |
Rate determination | Clarifies which payment rates are associated with each of the new services included in the amendment package. Removes respite (daily) from the Disability Waiver Rate System (DWRS) framework and allows it to be authorized as a market-rate service. Cost of living adjustmentIn the review of this waiver amendment, CMS notified the state that the DWRS rate methodology cannot include both after-model rate adjustments and automatic inflationary adjustments. As required by CMS in the approval process of this amendment, DHS adjusted waiver plans to reflect the clarification that previous after-model cost-of-living adjustments are removed from DWRS rate calculations upon implementation of the automatic inflationary adjustments. The implementation of this adjustment will occur July 1, 2018. Seventh year bandingIn the review of this waiver amendment, CMS expressed concern over the legislated request for a seventh year of banding. This additional year would extend banding throughout calendar year 2020. The state agreed to remove this request from the current waiver amendment and will re-submit the request to CMS after this amendment has been processed. |
Employment services
Employment exploration services | Establishes a new employment service that supports people to make informed choices about working in competitively paid jobs in their community. |
Employment development services | Establishes a new employment service that supports people in: |
Employment support services | Establishes employment support services as individualized services that support people to maintain paid employment in the community whether in individual jobs, group employment, self-employment or microenterprise businesses. |
Day training and habilitation (DT&H) | Separates community-based employment services from DT&H services Establishes June 30, 2019, as the date when community-based employment services must not be authorized or provided under DT&H and instead must be authorized and provided under employment exploration services, employment development services or employment support services (depending on the services and supports being provided). |
Supported employment | Repeals supported employment effective June 30, 2019 and replaces it with: |
Consumer directed community supports (CDCS)
Changes to financial management services (FMS) provider type | Changes fiscal support entity (FSE) to financial management services (FMS). Removes co-employment as an option since FMS providers will not offer agency services. Changes the term “rate” to “fee.” |
FMS qualifications and enrollment | Changes FMS provider qualifications. Changes FMS enrollment criteria. Changes eligibility for enrollment (i.e., successfully complete a readiness review before enrollment). Clarifies that DHS will not use governmental entities as FMS providers. Deletes certified FSE’s and adds enrolled FMS providers. |
FMS monitoring | Updates FMS oversight. Changes frequency of verification to performance reviews every three years. |
Other CDCS changes | Changes certification to include only support planners. Clarifies CDCS eligibility when living in licensed settings to align with the rest of the waiver plan. |
Services and standards
Respite | Adds residential hospice facilities as a new licensed facility type and expands the size limitation for these types of facilities. Expands options for respite provided in unlicensed settings. Adds camps as a provider type. Revises language in CAC and DD waivers to be consistent with BI and CADI waivers. |
Transitional services | Aligns the settings where a person can be living in order to receive transitional services with the settings listed in housing access coordination services. Corrects statutory references. Revises the language in CADI, BI and CAC to be consistent with DD. |
Specialist services | Clarifies that specialist services can provide mental health-symptom support and management of harmful conduct that could endanger self and others. |
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