Mississippi – TBI/Spinal Cord Injury (0366.R03.00)

Waiver Title

TBI/Spinal Cord Injury (0366.R03.00)

Description of Emergency

COVID-19 pandemic. This amendment will apply waiver-wide for each waiver included in this Appendix, to all individuals impacted by the virus or the response to the virus (e.g. closure of day programs, etc.)

Waiver Description

Provides case management, personal care attendant, respite, environmental accessibility adaptations, specialized medical equipment and supplies, transition assistance services for individuals physically disabled and brain injury ages 0- no max age

Start Date

01-03-20

End Date

26-01-21

Description of Transition Plan

All activities will take place in response to the impact of COVID-19 as efficiently and effectively as possible based upon the complexity of the change. The state will implement additional flexibilities requested as needed at DOM’s discretion based on the severity of the pandemic.

Area(s) Affected

Area Affected

These actions will apply across the waiver to all individuals impacted by the COVID-19 virus.

Increase Cost Limits

N/A

Modify Targeting Criteria

N/A

Modify Scope or Coverage

Home Delivered Meals and Specialized Medical Equipment & Supplies*

Exceed Service Limitations

DOM will temporarily allow participants to exceed the 30 day limit for institutional respite up to a maximum of 90 days. When the stay exceeds 30 consecutive days, the state has mechanisms in place to prevent duplicate billing for both institutional and HCB services.

Add Services

Home Delivered Meals and Specialized Medical Equipment & Supplies*

Expand Settings

N/A

Provide Service Out of State

N/A

Allow Payment for Services by Families

Temporarily allow Personal Care Services and In Home Respite Services to be provided by the family members provided they are not legally responsible for the person to include individuals living in the home with the participant.

Modification of Provider Qualifications

Allow flexibility on expiring state issued identification, training, background checks, etc. at DOM’s discretion throughout the pandemic. Flexibilities include temporarily waiving/delaying requirements for full 40 hour training, state issued ID, TB skin test, physical exam, CPR and first aid certification. To ensure ongoing quality of care and safety, new provider staff or those due for recertification of credentialing will be required to complete training on infection control, proper transferring techniques, and Vulnerable Person’s Act, will be required to complete a HCBS Provider Health Self-Attestation form, and will be required to have a name only background check with results that do not preclude them from providing care in accordance with state law.

Modify Provider Types

Allow for qualified personal care and in home respite agencies to provider personal care and in home respite in addition to individual personal care attendants and in home respite workers.

Modify Licensure/Requirements for Waiver Settings

N/A

Modification LOC Eval and Re-Eval Processes

Allow authority to delay the completion of recertifications throughout the pandemic and/or the authorization to complete them telephonically where appropriate in accordance with HIPAA requirements.

Increase Payment Rates

In instances where an agency provider is used to provide personal care, a higher rate, not to exceed 25% of the current rate, may be paid to account for agency overhead costs.

Modifications of ISP

Allow any face to face/home visits including quarterly plan reviews to be completed telephonically, if needed, in accordance with HIPAA requirements. Case Managers will still be required to complete monthly contacts with participants/caregivers by phone to ensure services are received as authorized.

Modify Incident Reporting/Med Management Safeguards

Allow for any follow up related to critical incident reports to be completed telephonically, as needed, in accordance with HIPAA requirements.

Allow Payment for Services During Acute Care Hospital/Short Term Institutional Stay

N/A

Inclusion of Retainer Payments

N/A

Institute/Expand Opportunities for Self-Direction

N/A

Increase Factor C

N/A

Other Changes Necessary

DOM will waive the requirement that a participant must be terminated from the waiver if he/she is not available for services after 30 days; however, participants will still receive monthly monitoring by Case Managers to assure health and welfare.

Addendum

HCBS Regulations

Not comply with the HCBS settings requirement at 42 CFR 441.301(c)(4)(vi)(D) that individuals are able to have visitors of their choosing at any time, for settings added after March 17, 2014, to minimize the spread of infection during the COVID-19 pandemic.

Services

Add Electronic Method of Service Delivery

case management

Add Home Delivered Meals

X

Add Medical Supplies, Equipment and Appliances

X

Add Assistive Technology

N/A

Conflict of Interest

Other Changes Necessary

DOM will waive the requirement that a participant must be terminated from the waiver if he/she is not available for services after 30 days; however, participants will still receive monthly monitoring by Case Managers to assure health and welfare.

Other Changes Necessary

DOM will waive the requirement that a participant must be terminated from the waiver if he/she is not available for services after 30 days; however, participants will still receive monthly monitoring by Case Managers to assure health and welfare.

Provider Qualifications

Allow Spouses and Parents of Minor Children to Provide Personal Care Servcies

N/A

Allow a Family Member to be Paid to Render Services to an Individual

X

Allow Other Practitioners in Lieu of Approved Providers Within the Waiver

X

Modify Service Providers for Home-Delivered Meals to Allow for Additional Providers, Including Non-Traditional Providers

N/A

Processes

Allow an Extension for Reassessments and Reevaluations for up to One Year Past the Due Date

X

Allow the Option to Conduct Evaluations, Assessments, and Person-Centered Service Planning Meetings Virtually/Remotely in lieu of Face-to-Face Meetings

X

Adjust Prior Approval/Authorization Elements Approved in Waiver

N/A

Adjust Assessment Requirements

X

Add an Electronic Method of Signing Off on Required Documents Duch As The Person-Centered Service Plan

X

Link To Application

https://www.medicaid.gov/state-resource-center/downloads/ms-0366-appendix-k-appvl.pdf

Link to Approval Letter

https://www.medicaid.gov/state-resource-center/downloads/ms-appendix-k-appvl-ltr.pdf