Health, Health Care Financing, Coverage and Reimbursement Policy

Rule R414-61

Home and Community-Based Services Waivers

Notice of Proposed Rule

(Amendment)

DAR File No.: 34314
Filed: 12/15/2010 05:19:41 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this amendment is to incorporate by reference changes to the New Choices Waiver.

Summary of the rule or change:

This amendment incorporates by reference changes to the New Choices Waiver, effective 07/01/2010. The major change in this renewal was increasing the number of participants the waiver can serve from 1,000 to 1,200. Other changes include the modification of the following services: Institutional Transition, Chore, and Professional Medication Monitoring. The description of Chore Services was modified to allow carpet cleaning and pest eradication. Institutional Transition Services was renamed Community Transition Services and moving services were added to the services description. Professional Medication Monitoring Service now includes limited medication administration when the service is unavailable through the Medicaid State Plan or through any other funding source. In addition, changes in the waiver application for home and community-based services allow the Department to explain quality improvement strategies in greater detail in relation to participant direction of services, participant rights, participant safeguards, and systems improvements.

State statutory or constitutional authorization for this rule:

• Section 26-18-3
• Section 26-1-5

This rule or change incorporates by reference the following material:

• Updates New Choices Waiver, published by Division of Medicaid and Health Financing, 07/01/2010

Anticipated cost or savings to:

the state budget:

The Department estimates an annual savings of $22,076 (state and federal funds) or $6,623 (state only funds) for each client that leaves a nursing facility and is served by the New Choices Waiver. The state funds for this program are seeded by the Department of Health.

local governments:

There is no impact to local governments because they do not fund or provide waiver services for Medicaid clients.

small businesses:

The Department estimates an annual savings of $22,076 (state and federal funds) or $6,623 (state only funds) for each client that leaves a nursing facility and is served by the New Choices Waiver. The state funds for this program are seeded by the Department of Health.

persons other than small businesses, businesses, or local governmental entities:

The Department estimates an annual savings of $22,076 (state and federal funds) or $6,623 (state only funds) for each client that leaves a nursing facility and is served by the New Choices Waiver. The state funds for this program are seeded by the Department of Health.

Compliance costs for affected persons:

There are no compliance costs because there are only increases in revenue for all Medicaid providers. In addition, these changes only result in savings to Medicaid clients.

Comments by the department head on the fiscal impact the rule may have on businesses:

This update to the rule is expected to have a positive fiscal impact on providers.

David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
288 N 1460 W
SALT LAKE CITY, UT 84116-3231

Direct questions regarding this rule to:

• Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at cdevashrayee@utah.gov

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

01/31/2011

This rule may become effective on:

02/07/2011

Authorized by:

David Sundwall, Executive Director

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-61. Home and Community-Based Services Waivers.

R414-61-1. Introduction and Authority.

(1) This rule establishes authority for the Department of Health to administer all Section 1915(c) waivers.

(2) The rule is authorized by Section 26-18-3 and Section 1915(c) of the Social Security Act.

 

R414-61-2. Incorporation by Reference.

The Department incorporates by reference the following home and community-based services waivers:

(1) Waiver for Technology Dependent/Medically Fragile Individuals, effective July 1, 2008;

(2) Waiver for Individuals Age 65 or Older, effective July 1, 2010;

(3) Waiver for Individuals with Acquired Brain Injuries, effective July 1, 2009;

(4) Waiver for Individuals with Physical Disabilities, effective July 1, 2006;

(5) Community Supports Waiver for Individuals with Intellectual Disabilities and Other Related Conditions, effective July 1, 2010;

(6) New Choices Waiver, effective [April]July 1, 20[07]10.

These documents are available for public inspection during business hours at the Utah Department of Health, Division of Medicaid and Health Financing, located at 288 North 1460 West, Salt Lake City, UT, 84114-3102.

 

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [November 1, 2010]2011

Notice of Continuation: February 24, 2010

Authorizing, and Implemented or Interpreted Law: 26-18-3