CIH #Waiver Amendment Comment Period

From: Nicole Norvell, Director, Division of Disability and Rehabilitative Services
Re: CIH Waiver Amendment 

Date: November 17, 2015

The Family of Social Services Administration’s Division of Disability and Rehabilitative Services (DDRS) and the Office of Medicaid Policy and Planning (OMPP) are drafting an amendment application for the Community Integration and Habilitation (CIH) Waiver and are requesting comments on the draft amendment.

The amendment application must be submitted to the Centers for Medicare and Medicaid Services (CMS) no later than December 31, 2014. DDRS has posted a draft of the CIH Waiver amendment, Draft ID # IN.006.03.01, for review and comment, on the Draft Polices for Public Comment webpage.

Proposed changes within the CIH Draft IN.006.03.01, are detailed in the Purpose of Amendment section at the beginning of the draft. Highlights include:

·         Extended Services is being proposed as a service that will provide ongoing employment supports which will enable an individual to maintain integrated competitive employment in a community setting. Extended Service will replace the existing service definition for Supported Employment Follow Along (SEFA). Extended Services includes many work- and community-based training and support options. Pre-Vocational services cannot be rendered at the same time as Extended Services. DDRS believes that the allowable activities within this new definition for Extended Services will provide for individuals to receive training on the skills they will need to maintain their job and thrive in the community. The definition for Extended Services is broader than the past definition of SEFA, ensuring that vocational skills training can now be provided away from the job site and, at times, in small groups. Additionally, due to changes occurring within the Vocational Rehabilitation (VR) program, the options for skill development to obtain employment are readily available for teams to utilize through the VR program. DDRS acknowledges that there are many individuals who will utilize this service who are currently receiving Pre-Vocational services, and these individuals will remain in both services for a six to nine month transition period so that DDRS, case managers, participants and families can work together to adjust plans of care.

·         Residential Habilitation and Support Daily (RHS Daily) is being proposed as a new residential service with a daily rate.

·         Community-Based Habilitation (Individual) will be capped at 10 hours monthly for users of RHS Daily.

·         Transportation service definition clarified to include that it may be used to access places of employment.

·         Reporting requirements for providers have been changed from monthly to quarterly.

·         DDRS posted the revised Home- and Community-Based Services Waiver (HCBS) Transition Plan and a summary of the last public comments within the CIH waiver amendment.

·         Participant-Centered Planning and Service Delivery was updated to reflect current practice and expectations as well as clarification of roles.

·         Risk Assessment and Mitigation now clarifies that the Individualized Support Team determines the party or parties responsible for development of risk plan(s).

·         Details on FSSA as the single state Medicaid Agency were updated reflecting the current roles and revised organizational structure of the State Medicaid Agency.

·         Roles and responsibilities have been clarified throughout the application.

Comments and suggestions will be received for a period of 30 days, beginning on November 17, 2014, and ending on December 17, 2014, and may be emailed to DDRSpolicies@fssa.IN.gov  or submitted in writing to:

DDRS Policies – MS 18
c/o The Division of Disability and Rehabilitative Services
PO Box 7083
402 W. Washington St., Rm. W451
Indianapolis, IN 46207-7083