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The Office of Long-Term Living (OLTL) recently released the Request for Information (RFI) to gather feedback regarding the implementation of Agency With Choice (AWC) services for the participants of Medical Assistance (MA) managed care programs, the 1915(c) MA home and community-based services (HCBS) waiver program, and a state-funded program.

Through these programs, eligible participants receive long-term services and supports (LTSS) and other benefits, depending on the particular program. Specifically, this RFI seeks information to assist OLTL in determining how it may improve options for LTSS participants to self-direct their services in the Community HealthChoices Program (CHC), OBRA Waiver, and the state-funded Act 150 Attendant Care Program through the procurement and implementation of AWC.

Through this RFI, OLTL is seeking to become more aware of and knowledgeable about current efforts to increase opportunities for self-direction and feedback on the implementation of AWC through a potential, future procurement. OLTL encourages interested parties, including vendors and stakeholders, to provide feedback in response to this RFI or any part of it. An interested party may respond to all or any of the specific questions or topics included in this RFI.

RFI responses are due by12:00 pm on March 25, 2022. Responses must be submitted electronically with “OLTL Agency With Choice RFI” in the email subject line. While OLTL does not intend to respond to questions or clarifications during the RFI response period, interested parties and individuals may submit administrative questions related to this RFI electronically using “OLTL Agency With Choice” in the email subject line. OLTL may or may not respond based on the nature of the question.

The purpose of the Office of Developmental Programs (ODP) Bulletin 00-22-01 is to communicate and clarify the requirements for Targeted Support Management (TSM) that were approved by the Centers for Medicare and Medicaid Services (CMS). Changes to TSM discussed in this bulletin include:

  • Expansion of TSM services, effective August 20, 2017, to individuals with autism.
  • Expansion of TSM services, effective July 1, 2021, to children age 8 or younger with a developmental disability who are eligible for Medical Assistance (MA) and who have been determined to need an Intermediate Care Facility for Other Related Conditions (ICF/ORC) level of care.
  • Expansion of TSM services, effective July 1, 2021, to individuals age 0 through 21 with a medically complex condition that is a chronic health condition that affects three or more organ systems, and that the individual requires medically necessary skilled nursing intervention to execute medical regimens to use technology for respiration, nutrition, medication administration, or other bodily functions. Individuals must be eligible for MA and have been determined to need an ICF/ORC level of care.
  • Clarification regarding the use of the LifeCourse framework and tools.
  • Clarification of expected assessment activities and the development of the Individual Support Plan (ISP).
  • Addition of enhanced qualification requirements for TSM providers and Targeted Support Manager Supervisors.
  • Clarification that individuals who are enrolled in and receiving case management services under any Home and Community-Based Services (HCBS) program administered via an 1115, 1915(b) and (c), or 1915(a), (b), or (c) waiver are not eligible to receive TSM.

The Office of Long-Term Living (OLTL) has updated its guidance about payments to strengthen the home and community-based services (HCBS) workforce and assist Adult Day Service (ADS) providers. The updated Frequently Asked Questions (FAQ) document is available under the “Strengthening the Workforce” heading on the DHS Long-Term Care Providers page.

To maximize the use of federal funding under Section 9817 of the American Rescue Plan Act (ARPA) of 2021, OLTL has moved the date by which providers must spend “Strengthening the Workforce” and “Adult Day Services” funds from March 31, 2024, to October 1, 2023. This change allows sufficient time for providers to file an expenditure report and return unspent funds as applicable. OLTL will offer additional details about ARPA expenditure reporting in coming months.

Providers that have questions about this information should contact the OLTL Provider Helpline at 800-932-0939.

The Office of Mental Health and Substance Abuse Services (OMHSAS) has just published an FAQ on the Home & Community-Based Services (HCBS) workforce support payments. Any remaining questions may be sent to the RA Account.

Please note that after receiving anticipated payment amounts on the attestation forms that were sent to providers at the locations of qualifying services, some providers alerted us to apparent irregularities in the payment amounts. OMHSAS is pulling our data and rerunning our formulas to ensure that payments are based on proper calculations and a balanced distribution of funds. Revised attestation forms will be sent to any providers who may have been impacted in their total allocation (positively or negatively) with a new due date in early March.

RCPA continues to work with its members and OMHSAS on the attestation and allocation process. Please contact your RCPA Policy Director for guidance or questions.