STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICES

Aging and Long-Term Support Administration

Home and Community Services Division

PO Box 45600, Olympia, WA 98504-5600

H17-048 – Procedure

June 16, 2017

TO: / Area Agency on Aging (AAA) Directors
FROM: / Kathy Morgan, Acting Director, Home and Community Services Division
Chanh Ly, Director, Management Services Division
SUBJECT: /
CY17 Medicaid Transformation Demonstration Interlocal Agreement
Purpose: / To notify Area Agencies on Aging (AAA) of their allotments, interlocal agreement language, and Milestone pricing template for Calendar Year (CY) 2017.
Background: / On January 9, 2017, the Centers for Medicare & Medicaid Services (CMS) approved a Section 1115 Medicaid waiver, known in Washington State as the Medicaid Transformation Project Demonstration. This five-year contract with CMS authorizes federal investments to promote innovative, sustainable and systemic changes that help improve the overall health of Washingtonians.
This interlocal agreement is in support of Initiative Two: Long Term Supports and Services (LTSS) for the aging population. Medicaid Alternative Care (MAC) will support unpaid caregivers, avoiding or delaying the need for more intensive Medicaid-funded services. This is a new benefit package for individuals who are eligible for Medicaid but not currently using Medicaid-funded LTSS. TailoredSupports for Older Adults (TSOA) will provide a limited set of services and supports to help individuals avoid or delay the need for Medicaid-funded services. This isa new eligibility category and benefit package for people “at risk” of future Medicaid LTSS use who do not meet Medicaid financial eligibility criteria.
What’s new, changed, or
Clarified: / ALTSA and AAAs have been working for many months toward the July 1, 2017 implementation of the new programs. While the agreement with CMS occurred in January, funding doesn’t flow until funding protocols are in place between CMS and Health Care Authority (HCA) and a Service Level Agreement is in place between HCA and DSHS. The CMS agreement is now in place. The HCA agreement is expected in the very near future.
Because these contracts will be back-dated to the start of the funding, January 9, 2017, services provided between January 9 and June 30 will not be impacted by Legislative passage of the State Fiscal Year 2018 budget. Beginning enrollment of clients would be delayed in the unlikely event we do not have an SFY18 budget by July 1.
Payment Methodology
As the result of a joint AAA/ALTSA workgroup, these contracts will pay out based on completion of certain milestones. AAAs will have the opportunity to submit how and when they will complete each milestone and the pricing associated with each milestone for ALTSA approval.
These agreements may be executed once the milestones are submitted and approved, or they can be executed prior to that as a maximum consideration contract. Exhibit B Milestone Schedule and Pricing must be amended into the agreement before any completed milestones may be billed. AAAs may request renegotiation of milestone pricing and/or due dates, though all milestones must be completed by Dec. 31, 2017 to be considered for payment. Unbilled funding will not carry over into the next calendar year agreement.
AAAs need to update cost allocation plans to incorporate MAC/TSOA. All expenditures need to be documented to ensure they are only charged and accounted for once. Activities completed since January 9, 2017 in support of the milestones can be allocated to this funding source.
Any revenues accrued through the milestone payments must be used in support of the five-year Demonstration. Any balances that may remain at the end of the Demonstration must be used in the MAC/TSOA successor programs, or if there is no successor program, reported and tracked as part of a restricted fund balance to use in support of the ALTSA’s Home & Community Based Services (HCBS). AAAs must report their cumulative ending balance and annual expenditures for the Demonstration to ALTSA at their fiscal year-end close. A fund balance report form is included as an attachment to this MB.
ACTION: / Complete Exhibit B Milestone Schedule and Pricing to be added to your contract. If the accompanying Pricing Template is not used, the AAA must provide sufficient information so ALTSA can determine how the pricing was determined. Total pricing of all Milestones cannot exceed the total CY17 allocation for the AAA shown in the attached MAC/TSOA AAA Funding Summary CY17-CY22. Submit to Kim Boon with a cc: to the AAA Specialist and Anna Glaas two weeks prior to first billing.
Use the attached CY17 MAC/TSOA Billing Form to bill ALTSA as Milestones are met. Include any backup documentation as specified in Exhibit B Milestone Schedule and Pricing.
Submit the MTD Fund Balance Report to ALTSA within 45 days from the AAA’s fiscal year end close.
ATTACHMENT(S): / CY17 GTC/STC

/ CY17 Exhibit A Statement of Work
/ Exhibit B Milestone Schedule and Pricing

Demonstration Funding / MAC/TSOA Fund Balance Report
/ CY17 MAC/TSOA Billing Form

CONTACT(S): / Direct program questions including questions regarding milestones or due dates, to Kim Boon or your AAA Specialist:
Kim Boon, MAC/TSOA Operations Program Manager
(360)725-3292

Andrea Meewes Sanchez, AAA Unit Manager
(360) 725-2554

Susan Shepherd, AAA Specialist
(360) 725-2418

Marcy Goodman, AAA Specialist
(360) 725-2446

Paula Renz, AAA Specialist
(360) 725-2560

Caroline Wood, AAA Specialist
(360) 725-2521

Fiscal Questions:
Anna Glaas, AAA Grants Unit Supervisor
(360) 725-2374

Contract Questions:
April Hassett, Contracts Manager
(360) 725-2387

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