The Arkansas Waiver Association
The "What's Happening" page is designed to keep us all up to date as to what's going on in the DD world. We'll do our best to provide accurate, unbiased information. It's often important, however, to provide some analysis of what the facts mean, and that results in editorial comment. When we're commenting instead of reporting, the passage will be labeled as "Editorial Comment" and displayed in green.
AWA Members: We recently got a question from one of our members--it's pretty technical and there are some twists and turns, but it's really important stuff, so we wanted to provide the question and the answer that came from DDS:
Is the plight of the physically disabled children on the TEFRA Waiver an issue for the AWA? Given the expiration date for the TEFRA Waiver, I think DDS needs to come up with a transition plan for them. They can either transition them to the ACS as soon as the ACS renewal and the CFCO are approved, or they can push for a readoption of the TEFRA eligibility option. What I don't think is an option is to wait until December 31st, and then discover that a big problem exists. Unless someone like the AWA asks questions, I am afraid that our state will simply avoid the issue until it is too late. I will leave it up to you management types to decide how to handle this matter."
Current TEFRA is good until the end of December 2014. 1115 TEFRA Waiver renewal was submitted today to extend it to December 2017.
Outside of TEFRA, a child with no DD diagnosis, regardless of functional deficits, would not be eligible under current law and policy. The "other" category might fit but only if the condition caused the child the function as if they has ID. Imagine a child with a heart condition or cancer. No ID but lots of deficits. Children with physical disabilities (eligible for Medicaid under any category, including TEFRA) will continue to be eligible for Personal Care State Plan services, but this service is pretty restricted for children. Title V, I believe may provide some support, including respite.
This is an important question to raise with the Department and other policy makers."
Presentations from the 2014 AWA Conference:
DDS has released two documents related to CFCO; CFCO Facts & Timelines for implementation:
CFCO Timelines (PDF Doc)
CFCO Facts July 2014 (Power Point)
To get a copy of the Department of Labor's ruling, CLICK HERE.
From Andy Allison, Arkansas' Medicaid Director, May 28: "After assessing the financial health of the Medicaid program at the end of the fiscal year's third quarter, we continue to see a historic slow down in growth and no longer expect a budget shortfall. Because of that, we no longer anticipate needing to freeze or cut the rates of our Medicaid providers. This should be welcome news for your providers and feel free to share the news."
Here's a chart showing how CFCO will interface with Waiver, proposed in any case. Apparently, ALL services will be CFCO. Waivers will be maintained only to ensure the eligibility criteria remains unchanged (three times SSI for Waiver vs 150 percent of poverty level for CFCO). Since Waiver has to provide at least one Waiver service for the person to be on Waiver, all will receive Case Management only.
EDITORIAL COMMENT: If you can't read the chart, you may download it by clicking HERE. What this all means is if it is not included in CFCO, it is not available. All CFCO plans are a proposal that must be approved by CMS before implementation. We expect some changes as CMS begins to negotiate with Arkansas on what can and cannot be done under CFCO.
DHS has provided a web page to keep all up to date on what is happening in the CFCO arena and to provide an avenue for public input. You can access the information by clicking HERE
Dr. Green has stated there have been no discussions concerning TEFRA at DHS, Medicaid, or DDS. The exact words are, ".... there have been NO discussions regarding the discontinuation of the program. It’s a valuable asset for our families in Arkansas and we intend to support it."
EDITORIAL COMMENT: Thank you.