Texas – Medically Dependent Children Program (MDCP)

Waiver Title

Medically Dependent Children Program (MDCP)

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.). HHSC requests approval to implement the following flexibilities up through the end of the disaster period. Based on the evolving situation, HHSC continues to determine the most appropriate timeframe for each waiver or modification, which is not to exceed the disaster period.

Waiver Description

Medically Dependent Children Program (0181.R06.00): Provides respite, supported employment, financial management services, adaptive aids, employment assistance, flexible family support services, minor home modifications, transition assistance services for medically fragile individuals ages 0 – 20

Start Date

3/13/2020

End Date

1/26/2021

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 or in response to the 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

N/A

Provide Service Out of State

N/A

Allow Payment for Services by Families

N/A

Modification of Provider Qualifications

N/A

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

N/A

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

N/A

Institute/Expand Opportunities for Self-Direction

N/A

Increase Factor C

N/A

Other Changes Necessary

Allow individuals who will no longer be eligible for the STAR Kids MDCP or STAR Health MDCP program due to turning 21 during the COVID pandemic to stay in STAR Kids MDCP or STAR Health MDCP rather than transitioning to STAR+PLUS to comply with House Resolution (H.R.) 6201 (116th Congress, 2019-2020; Public Law No: 116-127). Allow the state to suspend releasing individuals from waiver interest lists. When an individual’s name is released from the MDCP waiver interest list, a face-to-face assessment must be conducted to determine the individual’s eligibility for the waiver program. Updated Factor C (unduplicated participants) waiver year 3 total 6,563. Updated PIT waiver year 3 total 5,979. The reduction in the Factor C numbers will not result in any currently enrolled waiver participants losing their eligibility.

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, other: Financial Management Services Agencies (FMSA) initial orientation

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

Allow individuals who will no longer be eligible for the STAR Kids MDCP or STAR Health MDCP program due to turning 21 during the COVID pandemic to stay in STAR Kids MDCP or STAR Health MDCP rather than transitioning to STAR+PLUS to comply with House Resolution (H.R.) 6201 (116th Congress, 2019-2020; Public Law No: 116-127). Allow the state to suspend releasing individuals from waiver interest lists. When an individual’s name is released from the MDCP waiver interest list, a face-to-face assessment must be conducted to determine the individual’s eligibility for the waiver program. Updated Factor C (unduplicated participants) waiver year 3 total 6,563. Updated PIT waiver year 3 total 5,979. The reduction in the Factor C numbers will not result in any currently enrolled waiver participants losing their eligibility.

Other Changes Necessary

Allow individuals who will no longer be eligible for the STAR Kids MDCP or STAR Health MDCP program due to turning 21 during the COVID pandemic to stay in STAR Kids MDCP or STAR Health MDCP rather than transitioning to STAR+PLUS to comply with House Resolution (H.R.) 6201 (116th Congress, 2019-2020; Public Law No: 116-127). Allow the state to suspend releasing individuals from waiver interest lists. When an individual’s name is released from the MDCP waiver interest list, a face-to-face assessment must be conducted to determine the individual’s eligibility for the waiver program. Updated Factor C (unduplicated participants) waiver year 3 total 6,563. Updated PIT waiver year 3 total 5,979. The reduction in the Factor C numbers will not result in any currently enrolled waiver participants losing their eligibility.

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

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

X

Adjust Assessment Requirements

N/A

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/tx-0181-appendix-k-appvl.pdf

Link to Approval Letter

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