DSL Memo Series 2002-09
ACTION MEMO

August 26, 2002

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

To:
Area Administrators/Assistant Area Administrators-Adult Services
Bureau/Office Directors
County COP Contacts
County COP-Waiver Contacts
County LTS Planning Committee Chairpersons
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
COP Lead Agency Directors
Section Chiefs
Tribal Chairpersons/Human Services Facilitators

From:
Sinikka McCabe, Administrator

Re: HUMAN SERVICES REPORTING SYSTEM (HSRS) LONG TERM SUPPORT MODULE CHANGES

Document Summary

The Department has modified HSRS to collect information on persons who, based on a preliminary review, are likely to meet criteria for COP and Medicaid Home and Community Waivers programs, but who do not currently receive services under one of these programs. With the release of this memo, counties are required to register these individuals on HSRS. This memo provides instructions to counties on how to enter required information.

Effective with the publication of this memo, counties are required to use the Human Services Reporting System (HSRS) to register persons who are requesting community based long-term supports, are likely to be eligible, and who are appropriate for further consideration when resources can be made available under the Community Options Program (COP) and/or any Medicaid Home and Community Based Waiver (HCBW) but who are not currently receiving funding under any of these programs. This memo provides instructions on the use of new codes created to capture information on these individuals. This memo: 1) gives background on the new requirement; 2) describes categories for registration on HSRS; 3) specifies the screening criteria to use for registering applicants; 4) provides a description of the data to record; and 5) sets timeframes for meeting the requirements.

Currently the Department has no statewide source of standardized data about persons who, based on a preliminary review are likely to meet the functional, financial and other criteria for COP and/or HCBW benefits, but who are not yet receiving funding under any of these programs. Therefore, we do not have information that we can use effectively in program planning or that is sufficient to meet legislative or federal requests for accurate point-in-time information of this nature. To remedy this situation, the Department is requiring counties to register on the Human Services Reporting System (HSRS) applicants who meet the criteria described in this memo.

County reporting will be instrumental in creating a statewide database with information about the characteristics of these registrants, regardless of the waiver for which they apply. This information will be more useful, verifiable and timely than the annual reporting of numbers of individuals that the Department currently receives from the counties. This data also for the first time will give us information on what portion of these people receive other services, such as those available with a Medicaid card. Finally, the Department of Health and Family Services may use this database when making allocation decisions for new funds for COP and waivers.

II. Applicants to be registered on HSRS

Under this statewide policy, the HSRS registration process applies only to those applicants of any age who meet the criteria described in this memo and who are seeking community based/long term care services under one or more of the following programs: the Community Options Program (COP) and the following waivers: Community Options Program Waiver (COP-W), Community Supported Living Arrangement (CSLA) Waiver, Brain Injury Waiver (BIW), Community Integration Program 1A (CIP 1A), Community Integration Program 1B (CIP 1B), and Community Integration Program II (CIP II).

Applicants who are entered into HSRS under this policy will fall in one of the categories described in the table found below. Factors to be considered are current residence in an institution and presence of public long-term care funding (other than COP or HCBW).

Persons will be identified by one of three new HSRS SPC/Subprogram codes in Field 24 of the Long-Term Support module and will be identified in Field 14 as Applicant Register (W).

Updating HSRS. Applicants may change categories in Field 24 over time. When a county becomes aware of a change in an applicant’s circumstances that affects the category to which the applicant should be assigned, the county should enter an SPC end date for the original SPC/Subprogram code and open the applicant for the new SPC code. If a person is removed from applicant status (Field 14) for a reason other than being opened for services (e.g., failure to meet COP/HCBW criteria, moved, deceased), an end date should be entered and a closure reason provided.

Participants needing additional services. Persons already receiving COP or HCBW services who are waiting for additional services are not to be registered. Persons can be reported either as a "client" or as a "registered applicant" but not both. Counties may keep data locally in different formats to satisfy local policy or management requirements, but counties must meet the criteria in this memo for purposes of statewide HSRS reporting.

Counties should make a preliminary determination whether an applicant likely meets functional, financial and other applicable criteria as specified in Section 4.07, B.1. of the COP Guidelines. Counties must register applicants who upon further consideration are likely to meet these criteria when the availability of state and/or federal funds enables services to be provided.

Counties are not required as a part of this process to make a referral to the Economic Support Agency for a determination whether the applicant actually meets applicable financial criteria. However, there may be other reasons why referral to the Economic Support Agency should be made, such as:

• Medicaid eligibility for other services is indicated (for example, Medicaid card services, Medicaid Medically Needy with or without a deductible, Medicaid Purchase Plan, etc.);
• The applicant may benefit from having asset allocation for spousal impoverishment calculated upon initial inquiry about COP and Medicaid HCBW services.

For COP and HCBW applicants being registered on HSRS, counties must complete all required fields as currently instructed in the HSRS manual (See Attachment 1). The following fields have been modified to accommodate the new reporting requirements.

Field 13 – Type of Movement

The description of this Field was modified to indicate that it is optional for persons in Special Project Status "W" (see Field 14).

Field 14 – Special Project Status

A new category has been added to this Field: the letter "W" will designate individuals who have applied for and have passed the preliminary screen for COP/HCBW funded services. Use of the "W" in Field 14 requires the entry of an appropriate SPC/Subprogram code under Field 24.

Field 16 – Court Ordered Placement

Under previous instruction, Field 16 was used to capture court ordered placement status for
CIP 1 and BIW participants only. This Field now applies to all COP and HCBW applicants and participants, including persons who are being registered under this new policy. [To ease county administration burden, this field is optional for former applicants already on county waiting lists.]

Field 17 – Indicator of Financial Eligibility

A new financial eligibility category is added ("D") for COP eligibility. Use category "D" for individuals in Special Project Status "W".

Field 18 – Indicator of Waiver Mandate

The description of this Field was modified to indicate that it is optional for persons in Special Project Status "W" (see Field 14).

Field 24 – SPC/Subprogram Codes

Use the appropriate SPC/Subprogram code as described above for persons in Special Project Status "W". If a person is open in SPC/Subprogram Code 897, 898 or 899, a county will be unable to enter any other SPC/subprogram code for the same time period, except for SPC Codes 603-01 or 603-02 (COP Assessment and COP Plan).

Field 28 – SPC Start Date

Use this Field to enter the date on which the applicant was first determined to meet the preliminary review criteria for COP/HCBW after requesting consideration for community based services.

Field 29 – SPC End Date

Use this Field to enter the date on which the applicant’s case is opened for services or the date the person withdraws his or her application or ceases to meet applicable criteria.

Counties must register new applicants using the procedures described in this memo within 60 days of the individual meeting the preliminary screening criteria for COP and/or HCBW services. By
December 31, 2002, counties must also register applicants for COP and/or HCBW who are already identified on county lists of people waiting for service, and who meet the preliminary screening criteria established in this memo. Please contact Kate Fitzgerald or Christine Pomerening if your county will have significant difficulties meeting this time frame. To assist counties with costs associated with this initial conversion and entry into HSRS, the Department will reimburse counties approximately $20 for every applicant who is registered by November 1, 2002.

HSRS training is available by request. Contact the SOS Desk at 608/266-9198 or e-mail soshelp@dhfs.state.wi.us for more information.

Thank you for your cooperation in collecting this information that will be more timely and accurate.

ACTION STATEMENT: Counties must register each new applicant for COP/HCBW on HSRS within 60 days of the person having been determined to meet preliminary screening criteria for COP/HCBW. Counties should have applicants who previously have met these criteria registered on HSRS by December 31, 2002.

REGIONAL OFFICE CONTACT:
Assistant Area Administrator – Adult Services

CENTRAL OFFICE CONTACT: 
Kate Fitzgerald
Bureau of Aging and Long Term Care Resources
P.O. Box 7851
Madison, WI 53707-7851
Phone: 608/266-0429
Fax: 608/267-3203
E-mail: fitzgks@dhfs.state.wi.uw

Or

Christine Pomerening
Bureau of Developmental Disabilities Services
P.O. Box 7851
Madison, WI 53707-7851
Phone: 608/267-9741
Fax: 608/261-6752
E-mail: pomerca@dhfs.state.wi.us

Attachment  

ATTACHMENT 1

HSRS Long-Term Support Module Fields Related to Registration of