DSL Memo Series 99-03

February 18, 1999

STATE OF WISCONSIN
Department of Health and Family Services
Division of Supportive Living

To:
Area Administrators/Assistant Area Administrators
Bureau Directors
County COP Coordinators
County DD Coordinators
County Departments of Community Program Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
Section Chiefs
Tribal Chairpersons/Human Services Facilitators

From: 
Sinikka McCabe
Administrator

Re:  Modifications to CARS Profile 564, CIP 1B

Document Summary

This memo (and the attached) describes modifications to the Community Aids Reporting System (CARS) Profile 564, CIP IB.

This memo explains modifications to the Community Aids Reporting System (CARS) financial payment system for CIP 1B. This action is necessary to ensure that the CIP 1B waiver expenditures do not exceed the projected amounts in the Medicaid Waiver appropriation.

Background

The CIP 1B Home and Community-Based Medicaid Waiver began in 1987 and serves person who have relocated from Skilled Nursing Facilities / Intermediate Care Facilities and diverts people who are at risk of being admitted to those facilities. The current daily rate is $48.33. State GPR is used as match to capture the 60% federal share. In 1993, counties were given the option of providing "local match", (COP, Community Aids, or Family Support) to capture federal match monies for CIP1B local match. The daily rate for CIP1B local match is also $48.33 and all CIP 1B rules and regulations apply. The CIP 1B local match option has experienced tremendous growth over the past few years.

Changes within the Overall Medicaid Budget and the CARS Profiles

The current system of reporting and managing the CIP 1B waiver is not adequate to accommodate the growth in the waivers. A specific waiver appropriation is being created to separate the Home and Community-Based Waivers within the overall Medicaid Budget. The CARS profiles are also being changed to allow for CIP1B state-match and CIP1B local match to be billed on two separate CARS profiles.

CIP 1B (CARS Profile 564)

Waiver slots in CIP 1B may be "regular slots" or "facility specific slots" that use state GPR funds to match the federal share of Medicaid. Reimbursement will be based on the average daily claims that must be less than or equal to the state per diem rate for program participants. Any costs exceeding the state per diem rate should not be reported on this line. Costs exceeding the state per diem rate must be reported on CIP1B Federal (New Profile 563) and selected local match lines. If the average daily claim for program participants equals less than the state per diem rate, any unused funds will be applied to the CIP1B Federal line (local match slots) to provide MA match during the year-end contract reconciliation. Funding for either type of slot may be used to reimburse the county agency for costs they incur if the costs are included in a valid claim submitted for an eligible CIP1B waiver program participant and associated administrative costs.

CIP 1B FEDERAL (CARS Profile 563) NEW

Waiver slots billed on the CIP 1B Federal line are locally matched slots where only local funds, COP and/or Family Support are allocated by the county agency to match the federal share of Medicaid. Reimbursement will be on the federal share of the average daily claims for all program participants multiplied by the maximum number of days in the year that the participant is eligible. The balance of the daily claims must be charged on county selected local match lines.

In addition, as stated previously, the federal share of costs exceeding the state per diem rate of CIP 1B "regular slots" and "facility specific slots" are reported on CARS line 563.

These changes are effective January 1, 1999.

Christy Pomerening, Accountant for the Bureau of Developmental Disabilities Services and Dennis Dombrowicki, Director of Financial Operations, Division of Supportive Living are available for technical assistance and will be available at the Financial Managers Conference in May, 1999.

REGIONAL OFFICE CONTACT: 
Assistant Area Administrator

CENTRAL OFFICE CONTACT: 
Christine Pomerening
Accountant
Bureau of Developmental Disabilities Services
Division of Supportive Living
(608) 267-9741

Dennis Dombrowicki
Director of Financial Operations
Division of Supportive Living
(608) 266-3057

Attachments (below)

___________________________________________________________________

Waiver slots funded on the CIP 1B Federal line are locally matched slots where only local funds are allocated by the county agency to match the federal share of MA. Reimbursement shall be the federal share of the average daily claims for all program participants multiplied by the maximum number of days in the year the participant is eligible. The balance of the daily claims must be charged on county selected local match lines.

2. The federal share of costs exceeding the state per diem rate of CIP 1B "regular slots" and "facility specific slots" reported on CARS line 564.

TABLE 1-BF: EXAMPLE OF CIP 1B FEDERAL PROFILE CHARGES