The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver renewal. The renewal became effective on January 1, 2020.
Key changes in the approved waiver include:
- Revised the Residential Habilitation service definition by modifying the number of hours that are defined as a day unit from a minimum of 12 hours to a minimum of 8 hours.
- To the service definitions of Job Finding, Job Coaching, Employment Skills Development, Career Assessment and Benefits Counseling, added language that Office of Vocational Rehabilitation (OVR) services are considered to not be available if OVR has not made an eligibility determination within 120 days; and added language to address when employment services through the CHC waiver can be provided should OVR close the order of selection, thereby creating a waiting list for OVR services.
- Modified the qualifications for Service Coordinators and Service Coordinator supervisors.
- Clarified that if a CHC Managed Care Organization (MCO) identifies that a participant has not been receiving services for 5 or more days, and if the suspension of services was not pre-planned, then the CHC-MCO must communicate with the participant to determine the reason for the service suspension within 24 hours. If the participant’s health status or needs have changed, the CHC-MCO must conduct a comprehensive needs reassessment of the participant’s needs within fourteen (14) days of identifying the issue.
- Added that an emergency back-up plan must be included in the Person-Centered Service Plan.
- Modified language to reflect that the CHC waiver will be fully operational statewide as of January 1, 2020.
- Updated language to reflect that the Department utilizes IDEMIA as the data system to process fingerprint-based Federal Bureau of Investigation (FBI) criminal record checks.
- Updated the OLTL bureau names and responsibilities.
Questions surrounding the CHC Waiver Renewal should be directed to the OLTL Bureau of Policy Development and Communications Management at 717-857-3280.