DSL Memo Series
2002-13
Supercedes 2000-01
September 13, 2002
STATE OF WISCONSIN
Department of Health and Family Services
Division of Supportive Living
To:
Area Administrators/Assistant Area Administrators
DHCF Bureau/Office Directors
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
DSL Section Chiefs
County/Tribal Aging Directors
Tribal Chairpersons/Human Services Facilitators
From:
Sinikka McCabe, Administrator
Re: FUNDING ALLOCATION METHODOLOGY FOR CIP II
Document Summary
This memo announces a revised methodology for allocating CIP II slots
when nursing home beds close.
Purpose:
The Community Integration Program for the elderly and persons with
physical disabilities (CIP II) is intended to increase the capacity of the
home and community-based care programs when nursing home resources are
lost due to closing of facilities or reducing the number of licensed beds.
Formerly, funding for "slots" for CIP II was created at the time
beds or facilities were closing. A particular problem has been that the
Medicaid budget may already reflect a reduction in nursing home days of
care by the time new CIP II slots are needed, so funding new slots becomes
difficult.
To fulfill the purpose of CIP II, which is to capture savings from
reduction in nursing home capacity and correspondingly increase community
care capacity, DHFS has budgeted for CIP II as a separate category of
funding in the Medicaid budget to assure that resources will be available
when needed.
Budget
For the 2002-2003 biennium, the Department has received 686 slots for
FY02 to add to the CIP II budget. No additional slots were added for FY03.
These resources will only be awarded to counties when nursing home beds
are closed.
Allocation of CIP II to Counties Within Budgeted Levels
CIP II slots will be allocated to a county for the following two
priorities, on a one-for-one basis:
- When a county closes beds in a county-owned nursing
facility, CIP II slots will be awarded effective the date of bed
closure, regardless of the occupancy status of the beds that close.
- When an individual resident, funded by MA, is relocated to
the community from a private nursing facility and the bed is closed,
CIP II will be awarded effective the date of the relocation.
CIP II slots may be awarded at the end of the fiscal year when beds are
closed at a private facility without the relocation of a resident to
the community. The number of CIP II slots awarded for private facility
bed closures without relocations depends upon the available resources in
the budget.
- If an adequate number of slots remain, after awards are made for (a)
and (b) above, 100% of the number of closed beds will be converted to
CIP II slots.
- If there were insufficient slots remaining, the slots would be
prorated among counties with private bed closures. A record will be
maintained of the number of closed beds which were not converted to
CIP II (as a form of "credit" for the next fiscal year).
- In a subsequent year, if all CIP II slots authorized in the state
budget are not given out for beds closed in county facilities or
relocations (priorities (a) and (b)), additional slots will be awarded
to counties with credits. Credits from a previous year and new bed
closures from private facilities will be treated the same for the
current year and prorated if there are again insufficient slots to
award 100% of the closed beds as CIP II slots.
- CIP II slots will not be awarded for beds that are delicensed while
in the bed bank or delicensed after withdrawn from the bed bank.
"Bed bank" is defined in Chapter 49.45 (6m).
Allocations Above the Budgeted Level
When CIP II resources are used up and additional bed closings occur,
the following procedure will be used:
- If a county facility closes beds but no relocations of
persons occur, those counties will not receive CIP II slots until
additional slots are allocated in a biennial budget.
- If an individual receiving Medical Assistance funding is relocated
to the community from a county-owned or private nursing home and the
bed is closed, a CIP II slot will be awarded effective the date of the
relocation. This funding will be in addition to the budgeted slots.
- When beds are closed under a phase-down agreement or an entire
facility closes, CIP II slots will be made available outside of the
prospective budgeted slots for persons receiving Medical Assistance
funding in the nursing home who are relocated to the community.
All funds awarded to counties will be drawn against the CIP II
appropriation (called the numeric) within the MA budget.
CIP II Funds Awarded to Counties in Which Facilities Close Beds
CIP II resources are usually awarded to the county in which the
facility is located. There are two exceptions to this general policy:
- The facility is a regional facility, with at least 10% of the
residents originating from other counties. CIP II slots are awarded
to the counties of origin based on the proportion of residents from
the counties in the facility at the time of the most recent nursing
home survey.
- Counties with significant unused Medicaid waiver resources will
not receive additional CIP II slots for beds closed in the county
until the need for additional resources is demonstrated by the full
use of existing allocations. These slots will be made available to
other counties on a loan basis until the county where the facility
beds closed has used all of its available community care resources
for the elderly and physically disabled. The new CIP II slots will
then be awarded as they are freed up in the counties that received
the loan slots.
- The use of CIP II slots is intended to be for the expansion of
community care resources for the eligible populations in communities
where long term care resources are inadequate. The Department may
deny CIP II slots to an eligible county if they will be used to
supplant rather than expand community care resources for the elderly
and persons with physical disabilities.
REGIONAL OFFICE CONTACT:
Assistant Area Administrator-Adult Services
CENTRAL OFFICE CONTACT:
Lisa Kelly
Bureau of Aging and Long Term Care Resources
P. O. Box 7851
Madison, WI 53707-7851
608/267-3202
kellylm@dhfs.state.wi.us
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