NOTICES
Availability of Amendments to the Office of Long-Term Living's OBRA Waiver; Additional Amendments to the Aging and Attendant Care Waivers; Renewal of the Community Care (CommCare) Waiver and Independence Waiver; and Accompanying Home and Community-Based Settings Transition Plans for the CommCare and OBRA Waivers
[44 Pa.B. 7966]
[Saturday, December 20, 2014]The Department of Human Services (Department) is making available for public review and comment the Office of Long-Term Living's proposed OBRA waiver amendments; proposed amendments to the Aging and Attendant Care waivers, which are additional amendments to the amendments in the notice published at 44 Pa.B. 7492 (November 29, 2014); the proposed CommCare and Independence waiver renewals; and accompanying transition plans for the CommCare and OBRA waivers.
Aging, Attendant Care and OBRA Waiver Amendments
Whenever there is a change that affects an element of the approved waiver, the Department must submit an amendment to the Centers for Medicare and Medicaid Services (CMS) for approval. The Department proposes to amend the service definitions in the Aging and OBRA waivers as follows: language will be added to clarify allowable settings for Adult Daily Living Services, as well as adding a 1/2 day unit to Enhanced Adult Daily Living Services and defining this unit; Accessibility Adaptations, Equipment, Technology and Medical Supplies will be separated into four separate service definitions; and standardized language will be added and the unit of service will be changed for Non-Medical Transportation Services.
The Department also proposes to amend the Prevocational Services, Structured Day Habilitation Services and Residential Habilitation Services in the OBRA waiver to clarify allowable settings.
In addition, the Department proposes to revise the Quality Improvement Strategy in the Aging, Attendant Care and OBRA waivers to meet the revised quality guidelines, Modifications to Quality Measures and Reporting in § 1915(c) Home and Community-Based Waivers, issued by CMS on March 12, 2014.
CommCare and Independence Waiver Renewals
Under 42 CFR 430.25(h)(2)(i) (relating to waivers of State plan requirements) to continue receiving Federal matching funds for Home and Community-Based Services (HCBS) waiver services, CMS requires that existing HCBS waivers be renewed every 5 years. The CommCare and Independence waivers were last renewed by CMS effective July 1, 2010; the proposed waiver renewals are to be submitted to CMS no later than March 17, 2015.
Transition Plans
CMS published a final rule for HCBS at 79 FR 2948 (January 16, 2014), with an effective date of March 17, 2014. This final rule amends the Medicaid regulation for HCBS waivers under section 1915(c) of the Social Security Act (42 U.S.C.A. § 1396n(c)) to provide requirements regarding characteristics of settings that are home and community-based as well as settings that may not be home and community-based. See 42 CFR Parts 430, 431, 435, 436, 440, 441 and 447. These requirements reflect CMS' intent that individuals receiving services and supports through Medicaid waivers receive services in settings that are integrated in and support full access to the greater community. For more details about the HCBS Final Rule, refer to the CMS HCBS webpage at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html.
The final rule requires that a waiver-specific transition plan be submitted with each waiver amendment or waiver renewal. The proposed transition plans for the CommCare and OBRA waivers include the steps that the Department anticipates taking to achieve compliance in the following areas: Assessment, Remediation Strategiesand Outreach and Engagement of Stakeholders. The transition plans for the Aging, Attendant Care and Independence waivers were published at 44 Pa.B. 7492.
The proposed OBRA waiver amendments, proposed additional amendments to the Aging and Attendant Care waivers, the proposed CommCare and Independence waiver renewals, accompanying transition plans and a summary of all revisions are available at http://www.dhs.state.pa.us/dpworganization/officeoflongtermliving/index.htm or by contacting the Department of Human Services, Office of Long-Term Living, (717) 783-8412.
Fiscal Impact
The amendments to the service definitions in the Aging and OBRA waivers are anticipated to be budget neutral; therefore, there is no anticipated fiscal impact.
The renewal and accompanying transition plans of the CommCare and Independence waivers are also anticipated to be budget neutral; therefore, there is no anticipated fiscal impact.
Public Comment
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Jennifer Hale, P. O. Box 8025, Harrisburg, PA 17105-8025, RA-waiverstandard@pa.gov. Comments received within 45 days will be reviewed and considered for revisions to the proposed waiver amendments, waiver renewals and the transition plans.
In addition, the Department will hold two webinars to receive comments on the proposed waiver amendments, waiver renewals and transition plans for the Aging, Attendant Care, OBRA, Independence and CommCare waivers.
Dates, Times and Information to Participate in the Webinars
Tuesday, January 6, 2015
10 a.m.—12 p.m.Thursday, January 8, 2015
1 p.m.—3 p.m.Dial in information for the webinars is available at http://www.dhs.state.pa.us/dpworganization/officeof longtermliving/index.htm or by contacting the Department of Human Services, Office of Long-Term Living, (717) 783-8412.
To assist the Department in accurately capturing verbal comments, individuals are asked to submit a written copy of their comments to the Department at RA-waiverstandard@pa.gov or mail comments to the address provided previously.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
BEVERLY D. MACKERETH,
SecretaryFiscal Note: 14-NOT-921. No fiscal impact. (8) recommends adoption.
[Pa.B. Doc. No. 14-2639. Filed for public inspection December 19, 2014, 9:00 a.m.]
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