HCBS Waiver Consolidation Monthly Stakeholder Meeting

Transcription

1 HCBS Waiver Consolidation Monthly Stakeholder Meeting Traumatic Brain Injury/ Spinal Cord Injury (TBI/SCI) & Adult Cystic Fibrosis (ACF) Waiver Tuesday, November 14 th, 2017

2 Webinar Housekeeping Attendee lines will be muted for the duration of the webinar to minimize disruption. To submit text questions to today s presenter, type your questions into the Questions pane of the control panel located in the top-right corner of your screen. o You may send in your questions at any time during the presentation. Questions will be addressed during the Q&A session at the end of today s presentation. 2

3 As we have entered the statutory blackout period as described in s (23), F.S., due to the upcoming competitive procurements relating to the Statewide Medicaid Managed Care Program, we will not have any discussions relating to the scope, evaluation, or negotiation of those procurements. 3

4 Presentation Focus This month we will focus on: Care Plan Transfer Recipient Outreach Transition Process Long-term Care Enrollment Process 4

5 Assurances The legislative changes ensures: No recipient will lose Florida Medicaid eligibility or services as a result of this change. Adults 18 years and older with a traumatic brain injury or spinal cord injury, and adults with Cystic Fibrosis will continue to be eligible for Florida Medicaid under the same criteria they are now. The Agency is committed to ensuring a smooth transition with no disruption to individual s eligibility or services. 5

6 Assurances The legislative change means that individuals under the TBI/SCI and ACF Waivers: Will continue to have access to medical and prescribed drug services. Will not have to live in a nursing home. The LTC program offers nursing facility services to individuals who choose that option. However, the LTC program is actually designed to help individuals stay in their own home and the community. 6

7 Care Plan Transfer The Agency is partnering with the Department of Health (DOH) to safely transfer TBI/SCI and ACF Waiver recipients care plans to their chosen LTC plan. DOH successfully transferred all care plans to the Agency. The care plans will be available to individual s chosen LTC plans. 7

8 Recipient Outreach Pre-Welcome letters were mailed to individuals enrolled in the TBI/SCI and ACF Waivers. Model letters are available for review on our website. These letters include only an explanation of the consolidation effort The DOH completed telephone calls to all recipients enrolled in the waivers. Additional letters welcoming them to the LTC program and letting them know how to select an LTC plan will also be sent at least 30 days prior to transition. 8

9 Transition Process All individuals who are eligible for the TBI/SCI and ACF Waivers on December 31, 2017 will be transferred to the LTC Waiver effective January 1, There will be no gaps in service The individual s chosen LTC plan will contact them 9

10 Transition Process Individuals who are in the process of enrolling in the ACF and TBI/SCI Waivers, and who do not complete the enrollment by December 31, 2017, will be automatically referred to the LTC Waiver. Individuals who are newly interested in receiving home and community-based services should contact the following to be assessed for enrollment in the LTC Waiver: TBI/SCI Their local Aging Disability Resource Center (ADRC) ACF The Department of Elder Affairs 10

11 Long-term Care Waiver Enrollment Individuals over the age of 18 years who are diagnosed with Cystic Fibrosis or a traumatic brain injury/spinal cord injury who require HCBS will be assessed by the Department of Elder Affairs for clinical eligibility and the Department for Children and Families for financial eligibility. Individuals with TBI/SCI Individuals with CF Contact ADRC Contact DOEA Is there capacity on the waiver? N Waitlist N Is there capacity on the waiver? Y Y Complete Medical Certification for Medicaid Long-term Care Services and Patient Transfer Form, AHCA MedServ Form Complete Adults with Cystic Fibrosis Physician Referral for Individuals at Risk of Hospitalization (608) form DOEA evaluates for nursing facility level of care DCF evaluates for financial eligibility DOEA evaluates for hospital level of care DCF evaluates for financial eligibility Y Y Y Y Enrolled into LTC Enrolled into LTC 11

12 ADRCs 12

13 Resources/Contact Information 13

14 Resources By Phone: Contact the Recipient and Provider Assistance (RPA) line at For additional information about waiver consolidation visit the Agency s Web site at: eral_waivers/waiver_changes.shtml For additional information about the Statewide Medicaid Managed Care program visit the Agency s Web site at: All presentations will be made available following the scheduled webinar date at eral_waivers/pac_waiver_changes.shtml To apply for Florida Medicaid, visit DCF s web site at 14

15 Questions 15