INFO MEMO 2007-13
STATE OF WISCONSIN
Department of Health and Family Services
Division of Long Term Care
Info Memo Series
Date: November 15, 2007
To: Listserv
For: County Departments of Human Services Directors
County Departments of Social Services Directors
County 51 Coordinators
County Fiscal Contacts
County COP and Waiver Coordinators
Human Services Area Coordinators
Area Administrators
Community Integrations Specialists
From: Sinikka Santala, Administrator
Subject: LTC Fiscal Update Memo #3
This memo addresses the following:
- The Department of Health and Family Services' (DHFS) review and
approval process for Community Options Program (COP) Exceptional
Expense requests beginning CY 2008,
- Enrollment of new individuals in Home and Community Based Waivers (HCBWs)
immediately prior to and during a county's transition to managed
long-term care, and
- Development of community placements for individuals relocating from
institutions (nursing homes, ICFs-MR, and State Centers) immediately
prior to and during a county's transition to managed long-term care.
COP High Cost Funds - Submitting Requests for Review
DHFS is centralizing review and approval of COP Exceptional Expense
requests beginning in CY 2008. This change is to simplify state
administration of these requests. As of January 1, 2008, all COP
Exceptional Expense requests should be sent to Kimberly Schindler in the
Community Options Section. COP Exceptional Expense requests will no longer
be accepted in the Childrens Section or Developmental Disabilities
Services Section.
Counties should use the approved request form when submitting a
request. Before a COP High Cost request will be reviewed at DHFS, the
request must be approved by the County's Long Term care planning committee
and, when applicable, the appropriate Community Integration Specialist,
Children's Services Specialist or TMG Quality Assurance Consultant.
For more information on requesting COP Exceptional Expense funds,
including information on how to obtain the required forms, please refer to
the COP Information Memo #177 or contact the individuals listed below.
Enrolling New Individuals in HCBWs Immediately Prior to and During
Managed Long-term Care Transition
A county may enroll new individuals into existing waiver slots up to
the day the county begins its transition to managed care (transition to
managed care begins the day current waiver participants begin enrolling in
managed long term care). However the Department will stop approving new
waiver slots 90 days prior to the managed care start date, to better
manage transition. The Department will consider exceptions to the 90 day
freeze for emergency situations. In addition, there is an exception for
slots created for approved relocations under CRI, ICF-MR restructuring
and/or CIP IA (state center relocations). An individual relocating from an
institution may get a new waiver slot up to the day a county begins its
transition to managed care. No new individuals may enroll in the adult
HCBWs after the county begins its transition to managed care.
When developing a HCBW plan for an individual, a county anticipating
managed long-term care transition must coordinate and communicate with the
MCO planning to operate in the county. This will increase continuity of
care and limit disruptions to the community living plan developed for the
individual.
Development of Community Placements for Individuals Relocating from
Institutions Immediately Prior to and During Managed Long-term Care
Transition
The Department encourages counties planning a transition to managed
long-term care to continue to assess, conduct person-centered plans and
develop community placements for individuals residing in institutions
(nursing homes, ICFs-MR and State Ceters). Counties may place these
individuals in community settings and enroll them into the waivers up to
the day the county begins its transition to managed care.
Counties anticipating a managed long-term care transition must
coordinate and communicate with the MCO when developing a community
placement for an individual relocating from an institution. As similarly
noted above for other HCBW care plans developed during the period a county
is planning it's managed long term care transition, coordination with the
MCO will increase continuity of care and limit disruptions of the
community living developed for the relocated individual.
Although no new individuals may enroll in HCBWs after a county begins
its transition to managed long-term care, individuals relocating from
nursing homes, ICFs-MR or State Centers during transition may enroll
immediately in the MCO and do not count against a county's wait list
enrollment limit. These individuals do not need to first be enrolled in a
waiver placement to be prioritized for managed care enrollment.
We hope you find these changes helpful. If you have questions or
concerns, please contact the following individuals:
REGIONAL OFFICE CONTACT:
CENTRAL OFFICE CONTACT:
MEMO WEB SITE: http://dhfs.wisconsin.gov/dsl_info/
cc: Joyce Allen, DMHSAS
Fredi Bove, DLTC
John Easterday, DMHSAS
Beth Wroblewski, BLTS
Irene Anderson, BLTS
Mike Linak, BLTS
Sandy Blakeney, BLTS
FMBS Team
Last Revised: November 15, 2007 |
