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HCBS Waiver

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The Role of HCBS Waiver Services in Supporting Families
April 4, 2024
1:00 pm – 2:30 pm (CT)
Register Now

Due to unforeseen circumstances that are beyond their control, the Best Practice Series scheduled for March will now be in April.

Note: If you already registered before the date change, you do not need to register again. You will be sent a separate email with the updated zoom link for the new date.

 The Best Practice Series introduces and elevates best practices related to supporting families. Each session will feature a panel of individuals or organizations who will address key recommendations from the National Agenda through their lens of:

  • Grassroots Advocacy
  • “Practice Level” Implementation
  • States Service System
  • Federal Policies
  • Research

In this session, they will focus on Recommendation 4: The redesign of waiver services and supports to focus on quality-of-life outcomes, increase flexibilities, improve access and navigation, and ensure self-determination and self- direction (while also balancing the need to support the family).

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Background
In administering the Office of Long-Term Living (OLTL) Home and Community-Based Services (HCBS) Waivers, OLTL requires service coordinators to monitor that waiver participants receive all HCBS services authorized in their service plans and to develop a backup plan in case a service could not be provided. If a provider is unable to provide an authorized service, the service coordinator must work with the participant to secure another provider to provide the service as specified in the participant’s backup plan. In addition, service coordinators and providers must report critical incidents, including any occurring as a result of the participant’s failure to receive services which placed the participant’s health or safety at risk, in accordance with OLTL’s Critical Incident Management Bulletin.

Policy
With the implementation of Community HealthChoices (CHC), OLTL is adopting a different reporting process for HCBS similar to the process currently implemented in the HealthChoices program. Since CHC-MCOs cover all authorized home health skilled care, home health aide, and personal assistance services, OLTL is expanding the current HealthChoices operations report to identify all missed services for participants who utilize these services.

Providers of CHC-covered home health skilled care, home health aide services, and personal assistance services must submit information on missed services to the CHC-MCOs. CHC-MCOs must submit a missed services operations report to OLTL on a monthly basis that includes detailed information on missed services, such as the date of the missed service, the reason for the missed service, and actions taken to address the missed service in both the short and long term.

In its CHC oversight role, OLTL will review these monthly reports along with complaint and grievance, CHC-MCO inquiry, and EIM data to monitor the health and welfare of CHC participants. Providers who do not submit the required information to the CHC-MCO may face corrective actions.

CHC-MCOs will notify their home health and home care network providers of their reporting requirements. Please direct any questions about these reporting requirements to the CHC-MCOs.

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