Availability of Amendments to the Office of Long-Term Living's Aging, Attendant Care and Independence Waivers; Renewal of the Waiver for Persons with AIDS or Symptomatic HIV Disease (AIDS Waiver); and Accompanying Home and Community-Based Settings Transition Plans
[44 Pa.B. 7492]
[Saturday, November 29, 2014]
The Department of Human Services (Department) is making available for public review and comment the Office of Long-Term Living's proposed Aging, Attendant Care and Independence waiver amendments, the proposed AIDS waiver renewal and accompanying transition plans.
Aging, Attendant Care and Independence Waivers
To receive Federal matching funds for home and community-based services (HCBS) Aging, Attendant Care and Independence waiver services, the Department must receive approval from the Centers for Medicare and Medicaid Services (CMS) for the unduplicated number of participants to be served during each year of the approved waiver. The number of unduplicated recipients is estimated for each year of the waivers and, with Federal approval, can be adjusted as actual experience within the waivers is monitored. The Aging, Attendant Care and Independence waiver amendments propose to increase the number of unduplicated recipients served in each waiver during the 2013-2014 State Fiscal Year (SFY), as well as to add transition plans for home and community-based settings that are specific to each waiver.
Based on experience in SFY 2013-2014, the Department has determined the need to increase the maximum number of unduplicated recipients it intends to serve in the waivers. The Department intends to submit amendments to CMS to increase the maximum number of unduplicated recipients as follows:
• Aging Waiver—increase the number of unduplicated recipients from 28,500 to 29,000.
• Attendant Care Waiver—increase the number of unduplicated recipients from 10,250 to 10,700.
• Independence Waiver—increase the number of unduplicated recipients from 8,600 to 10,500.
Under 42 CFR 430.25(h)(2)(i) (relating to waivers of State plan requiements) to continue receiving Federal matching funds for HCBS AIDS waiver services, CMS requires that existing HCBS waivers be renewed every 5 years. The AIDS Waiver was last renewed by CMS effective January 1, 2010.
The CMS published a final rule for HCBS at 79 FR 2948 (January 16, 2014), with an effective date of March 17, 2014. This final rule amends the Medicaid regulation for HCBS waivers under section 1915(c) of the Social Security Act (42 U.S.C.A. § 1396n(c)) to provide requirements regarding characteristics of settings that are home and community-based as well as settings that may not be home and community-based. See 42 CFR Parts 430, 431, 435, 436, 440, 441 and 447. These requirements reflect CMS' intent that individuals receiving services and supports through Medicaid waivers receive services in settings that are integrated in and support full access to the greater community. For more details about the HCBS Final Rule, refer to the CMS HCBS webpage at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html.
The final rule requires that a waiver-specific transition plan be submitted with each waiver amendment or waiver renewal. The proposed transition plans for the Aging, Attendant Care, Independence and AIDS waivers include the steps that the Department anticipates taking to achieve compliance in the following areas: Assessment, Remediation Strategies and Outreach and Engagement of Stakeholders.
The proposed Aging, Attendant Care and Independence waiver amendments, the proposed AIDS waiver renewal and accompanying transition plans are available at http://www.dpw.state.pa.us/dpworganization/officeoflongtermliving/index.htm or by contacting the Department of Human Services, Office of Long-Term Living at (717) 783-8412.
For Fiscal Year 2014-2015, the fiscal impact of the Aging, Attendant Care and Independence waiver amendments is $59.527 million ($28.603 million in State funds). The renewal of the AIDS waiver is anticipated to be budget neutral; therefore, there is no anticipated fiscal impact.
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Jennifer Hale, P. O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department at RAfirstname.lastname@example.org. Comments received within 30 days will be reviewed and considered for revisions to the proposed waiver amendments, waiver renewal and the proposed transition plans.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
BEVERLY D. MACKERETH,
Fiscal Note: 14-NOT-919. (1) General Fund;
(7) Home and Community-Based Services; (2) Implementing Year 2013-14 is $0; (3) 1st Succeeding Year 2014-15 through 5th Succeeding Year 2018-19 are $3,559,000; (4) 2012-13 Program—$184,500,000; 2011-12 Program—$175,162,000; 2010-11 Program—$0;
(7) Attendant Care; (2) Implementing Year 2013-14 is $0; (3) 1st Succeeding Year 2014-15 through 5th Succeeding Year 2018-19 are $3,097,000; (4) 2012-13 Program—$107,830,000; 2011-12 Program—$102,704,000; 2010-11 Program—$97,869,000;
(7) Services to Persons with Disabilities; (2) Implementing Year 2013-14 is $6,208,000; (3) 1st Succeeding Year 2014-15 through 5th Succeeding Year 2018-19 are $21,947,000; (4) 2012-13 Program—$195,135,000; 2011-12 Program—$163,987,000; 2010-11 Program—$115,635,000;
(8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 14-2480. Filed for public inspection November 26, 2014, 9:00 a.m.]
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