H12-013– Procedure

February 23, 2012
TO: / Home and Community Services ( HCS) Division Regional Administrators
Area Agency on Aging (AAA) Directors
FROM: / Bill Moss, Director, Home and Community Services Division
SUBJECT: /
Consolidation of Medically Needy Waivers into the COPES Waiver
Purpose: / To provide information and instructions regarding the waiver consolidation.
Background: / The Medically Needy In-home (MNI) and Medically Needy Residential (MNR) waivers will be terminated and clients enrolled in those waivers will be transitioned to the COPES waiver. This action will streamline service delivery, case management and waiver administration functions.
What’s new, changed, or
Clarified / Effective April 1, 2012, the Medically Needy income eligibility category will be added to the COPES and New Freedom waivers. Clients who are financially eligible for the MNI and MNR waivers will be financially eligible for the both the COPES and New Freedom waivers. There will be no change to the functional eligibility criteria for the COPES and New Freedom waivers related to this consolidation. Chapter 388-106 WAC is being updated to reflect these program changes.
The MNR and MNI waivers will be terminated effective March 31, 2012.
Written Notifications
MNRW and MNIW-enrolled clients and their guardians, and NSA representatives will receive a written notice by March 1, 2012 alerting them to the upcoming termination of the MN waivers. These notices were mailed Feb 23rd using an automated process. All clients received a notice in English. Translated notices will be mailed by ADSA headquarters staff. The notice serves as an amendment to the client’s plan of care.
The notice (attached below)explains thatMN waiver clients will:
  • Receive services under the COPES waiver effective April 1st;
  • Experience no change in services or providers due to their transition onto the COPES waiver;
  • Have a right to appeal their plan of care through the Office of Administrative Hearings.
Transaction Generator
SSPS will run a Transaction Generator (TG) on April 7th to change all open authorizations (with an end date greater than 3/31/2012) from an MNI or MNR code to the corresponding COPES code. All MNI and MNR authorizations will be terminated with an end date of 3/31/12. All new COPES authorizations will have a begin date of 4/1/12 and the end date will be the same as the previous corresponding MN authorization. For example, if the client was receiving PERS in the MNI waiver under SSPS code 5537, this authorization will be terminated and a new authorization will be created using SSPS code 5237. There will be one exception report generated from the TG. It will be sent to field staff by April 11th and will list all of the authorizations that were not included in the TG. Instructions for field staff will be sent with the exception report.
CARE Algorithm
There will be a CARE Release the evening of March 30th to make the following changes:
  • Remove the “Medically Needy Waiver Services” option in the “Client Is Eligible For” drop down list on the CARE Plan screen.
  • Convert the program selection of “Medically Needy Waiver Services” to “COPES” on all Pending and Current assessments.
  • Convert “MNRW” to “COPES-Residential” and “MNIW” to “COPES-InHome” on all New and Pending (not finalized) Service Planned Action Notices (PANs)
  • Remove the MNIW and MNRW SSPS codes in CARE.
Planned Action Notices (PANs)
All new and pending PANs (not finalized) by 5 pm on 3/30/12 will be automatically changed during the CARE Release (see third bullet above under “CARE Algorithm”). This change includes populating the COPES WACs into the “Authority” section of the PAN based upon the specific service identified in the “Service” drop down on PAN Service Details screen.
ACTION: / Each Region/PSA received the mailing list used to populate the notices via email on Thursday, February 23rd. The mailing list and the attached notice template will be helpful when responding to questions and inquiries.
Written Notifications
If local offices identify clients who are on one of the MN waivers but are not on the mailing list, the local office will need to use the attached notice template and mail the notice to the client and the associated guardian/NSA rep (if any). For Limited English Proficient (LEP) clients, email Patty McDonald at to request translated templates. Include the client’s language in the email message to her. Clients must receive their notice by March 1st. Mail the English notice using attached template and then send the translated notice when it becomes available.
Transaction Generator and New Authorizations
The new COPES authorization created by the TG on April 7thwill not be visible in CARE. When you need to modify the new authorization you will need to complete the following steps:
  1. Login to SSPS WebConnect and select #5 in the Menu (Primary/Service Recipient Look-up by Name);
  2. Enter client’s name (Remember that there is no space between the comma after the last name and the first name – e.g. Doe,John);
  3. Select the authorization number that includes the COPES SSPS code for the service auth you need to modify;
  4. On the SSPS authorization screen in CARE select “Modify” at the bottom of the screen;
  5. Select “Enter Authorization Number”;
  6. Enter the auth number you located in WebConnect;
  7. Proceed as usual.
The TG exception list will be provided to the Regions/PSAs by April 11th. For the clients on this list the field staff will need to do the following:
  • The office SSPS coordinator or designee will use WebConnect to terminate the MN SSPS authorizations on the exception listusing an end date of 3/31/2012.
  • The case manager/social worker will use CARE to create an authorization for the COPES service(s) using the corresponding COPES SSPS code with a begin date of 4/1/2012. For example, if the client was receiving PERS in the MNI waiver under SSPS code 5537 a new authorization would be created using the COPES SSPS code 5237.
Planned Action Notices
For all new and pending PANs that were not finalized by 5 pm on 3/30/12, the case manager/social worker will need to do the following:
  • Review the “Authority” section of the PANs on or after April 1st to ensure that the appropriate WAC citations for the identified services on the PAN have been included; and
  • Add any additional information necessary in the “Authority” section of the PAN.
Assessments
At the next face to face assessment started after the April 1st waiver consolidation, case managers/social workers must do the following:
  • Review the array of service options available under the COPES waiver;
  • Explain the New Freedom waiver option for clients living in King and Pierce Counties; and
  • Obtain an updated 14-225, Acknowledgement of Services, if the client chooses to remain on the COPES waiver.

Related
REFERENCES: / link to CR101 filed to make WAC changes
ATTACHMENT(S): / Letter to Clients: COPES/MN SSPS Code Crosswalk:

CONTACT(S): / Debbie Johnson, COPES Program Manager
(360) 725-2531

Karen Fitzharris, New Freedom Program Manager
(360) 725-2446

Geri-Lyn McNeill, CARE Program Manager
(360) 725-2353

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