South Dakota – CHOICES (0044.R08.00)

Waiver Title

CHOICES (0044.R08.00)

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.)

Start Date

27-01-20

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

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

N/A

Exceed Service Limitations

N/A

Add Services

N/A

Expand Settings

Habilitation services, including residential, day, career exploration and supported employment, may be provided in an alternative setting necessary to ensure the health and safety of participants. Alternative settings include hotels, shelters, schools, churches and other settings which have not been determined to fully meet the HCBS Settings Rule criteria. This does not include Respite services.

Provide Service Out of State

N/A

Allow Payment for Services by Families

N/A

Modification of Provider Qualifications

When needed, current qualified provider certification may be extended for up to one year when COVID-19 pandemic impacts the ability for providers to obtain/renew license or certification. Currently, qualified providers are required to maintain a two-year certification. Certification is determined by the Division of Developmental Disabilities at a biennial review which occurs prior to the end of the qualified provider’s certification period onMay 31. This extension will allow qualified providers certifications to remain valid until DDD staff are able to safely complete an onsite review. All qualified providers have received an onsite certification review within the last two years. This request allows for those already certified providers to maintain their certification until the pandemic precautions are lifted. Individual’s on the OIG exclusionary list may not receive Medicaid payment during and after the pandemic. Temporarily suspend direct support provider staff training requirements except for techniques for identifying ANE, procedures for reporting alleged ANE, implementation of the person’s ISP and positive behavior support plan and medication administration training for new employees.

Modify Provider Types

N/A

Modify Licensure/Requirements for Waiver Settings

N/A

Modification LOC Eval and Re-Eval Processes

N/A

Increase Payment Rates

N/A

Modifications of ISP

Temporarily suspend all requirements for face to face meetings involving the development, implementation and monitoring of the ISP. All face to face requirements shall be performed by way of remote/electronic means. Temporarily suspend requirements for allowing visitors (providers may prohibit / restrict visitation in line with CMS recommendations for long-term care facilities). Suspend requirements for right to choose whom to share a bedroom with. Temporarily suspend or identify alternative approaches to all non-essential medical appointments and assessments as determined by the person’s ISP team and the person’s health care provider

Modify Incident Reporting/Med Management Safeguards

N/A

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

N/A

Inclusion of Retainer Payments

Agencies that provide day services (facility-based day habilitation, career exploration, supported employment) and residential services, both of which includes personal care, will be eligible to receive retainer payments when individuals receiving services are displaced from those settings due to the COVID-19 pandemic. Retainer payment can only be billed for participants receiving day or residential services and only for the amount authorized. Retainer payments may not exceed the lessor of 30 consecutive days. Retainer payments can only be billed when the individual is not receiving day or residential services in another setting by the provider authorized to receive retainer payments.

Institute/Expand Opportunities for Self-Direction

N/A

Increase Factor C

N/A

Other Changes Necessary

N/A

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, personal care services that only require verbal cueing, in-home habilitation; monthly monitoring

Add Home Delivered Meals

N/A

Add Medical Supplies, Equipment and Appliances

N/A

Add Assistive Technology

N/A

Conflict of Interest

Other Changes Necessary

N/A

Other Changes Necessary

N/A

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

N/A

Allow Other Practitioners in Lieu of Approved Providers Within the Waiver

N/A

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

N/A

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/sd-0044-appendix-k-appvl.pdf

Link to Approval Letter

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