Virginia – Commonwealth Coordinated Care Plus, Family and Individual Supports, Community Living, and Building Independence

Waiver Title

Commonwealth Coordinated Care Plus, Family and Individual Supports, Community Living, and Building Independence

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

Commonwealth Coordinated Care Plus (0321.R04.00): Provides adult day health care, personal assistance services, respite care services, services facilitation, assistive technology, environmental modifications, personal emergency response system (PERS), private duty nursing, transition services for aged individuals 65 yrs – no max age, disabled- physical 0-64 yrs, disabled- other 0-64 yrs, and technology dependent 0- no max age. Family and Individual Support Waiver (0358.R04.00): Provides group day services, in-home support services, individual supported employment, personal assistance services, respite services, services facilitation, assistive technology, benefits planning, center-based crisis supports, community coaching, community engagement, community guide, community-based crisis supports, companion services, crisis support services, electronic home-based supports, employment and community transportation, environmental modifications, group supported employment, individual and family/caregiver training, peer mentor supports, personal emergency response system (PERS), private duty nursing, shared living, skilled nursing, supported living residential, therapeutic consultation, transition services, workplace assistance for individuals w/autism and ID/DD ages 0 – no max age. Community Living (CL) Waiver (0372.R04.00): Provides group day services, group home residential, individual supported employment, personal assistance services, respite, consumer-directed services facilitation, assistive technology, benefits planning, center-based crisis supports, community coaching, community engagement, community guide, community-based crisis supports, companion services, crisis support services, electronic home-based services, employment and community transportation, environmental modifications, group supported employment, in-home support services, peer mentor supports, personal emergency response system, private duty nursing, shared living, skilled nursing, sponsored residential, supported living, therapeutic consultation, transition services, workplace assistance services for individuals w/autism and ID/DD ages 0 – no max age. Building Independence Waiver (0430.R03.00): Provides group day services, independent living supports, individual supported employment, assistive technology, benefits planning, center-based crisis supports, community coaching, community engagement, community guide, community-based crisis supports, crisis support services, electronic home-based supports, employment and community transportation, environmental modifications, group supported employment, peer mentor supports, personal emergency response system (PERS), shared living, transition services for individuals w/autism and ID/DD ages 18 – no max age.

Start Date

27-01-20

End Date

30-06-20

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

N/A

Provide Service Out of State

N/A

Allow Payment for Services by Families

N/A

Modification of Provider Qualifications

Allow personal care and respite, and companion aides hired by an agency to provide services prior to receiving the standard 40-hour training. Providers will be required to ensure that aides are proficient in the skills needed to care for participants prior to providing care. Aides must receive the 40 hour training within 90 days of starting care.

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 beneficiaries to receive monthly monitoring when services are furnished on a less than monthly basis. Reduce quality sampling requirements for waiver services due to limited provider capacity to provide files for desk audit.

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, 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

Allow beneficiaries to receive monthly monitoring when services are furnished on a less than monthly basis. Reduce quality sampling requirements for waiver services due to limited provider capacity to provide files for desk audit.

Other Changes Necessary

Allow beneficiaries to receive monthly monitoring when services are furnished on a less than monthly basis. Reduce quality sampling requirements for waiver services due to limited provider capacity to provide files for desk audit.

Provider Qualifications

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

X

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

N/A

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/va-combined-appendix-k-appvl.pdf

Link to Approval Letter

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