||MARCIA J.NIELSEN, PhD, MPH Executive Director
ANDREW ALLISON, PhD Deputy Director
EES Eligibility and Clearinghouse Staff
December 11, 2008
Tim T Schroeder, E&D Medical Eligibility Policy Manager
Implementation Instructions for the HCBS PD Waiver Waiting List
The purpose of this memo is to provide instruction to EES eligibility and Clearinghouse staff concerning the implementation of a waiting list for individuals seeking services under the Home and Community Based Services (HCBS) Physical Disability (PD) Waiver.
Effective December 1, 2008, no new participants will be added to the HCBS PD Waiver. This change will be in effect until at least July 1, 2009. This action will allow SRS to continue providing services to approximately 7,000 Kansans currently receiving services under the waiver. This action is not taken to cut the budget, but to avoid further overspending.
Individuals meeting specific exceptions outlined in this memo may avoid placement on the waiting list. The exceptions allow individuals needing continuity of services or who meet specific crisis criteria to receive services under the HCBS PD waiver.
A. Transition – The waiting list process, including exception and crisis exception criteria, is effective with any assessment completed on or after December 1, 2008. Pending applications/requests for HCBS PD medical assistance prior to this date shall be processed as follows:
- Assessment Completed – Individuals with an assessment completed prior to December 1, 2008 who are determined eligible and whose services are in the process of being established may be approved for HCBS coverage if otherwise eligible. HCBS coverage can be approved even if the application for assistance is approved after December 1, 2008.
- Assessment Has Not Been Completed – Individuals without an assessment completed prior to December 1, 2008 may not be approved for HCBS coverage. Those individuals shall be placed on the waiting list for services depending on the outcome of the assessment, unless they meet one of the listed exceptions.
The HCBS case manager has 30 days from the date the assessment is completed to initiate services, with the ability to request an additional 30 days if needed. Because of this, it is anticipated that there are many individuals across the state currently in the process of initiating services who will ultimately be approved for HCBS coverage based on an assessment completed prior to December 1, 2008.
Individuals assessed on or after December 1, 2008 shall be placed on the waiting list, unless they meet one of the exceptions described below as determined by the HCBS PD Waiver Program Manager.
B. Exceptions – To ensure continuity of services to specific individuals, the following exceptions apply to the waiting list:
- An individual may transition to the HCBS PD waiver from another HCBS waiver without being placed on the waiting list.
- An individual may transition from the Work Opportunities Reward Kansans (WORK) program back to the HCBS PD waiver without being placed on the waiting list.
- An individual discharging from an institutional setting who will be utilizing funding under the Money Follows the Person (MFP) program shall not be subject to the waiting list.
- An individual currently receiving services under the HCBS PD waiver who returns to the community after a planned brief stay in an institution shall not be subject to the waiting list.
C. Crisis Exception – In addition to the exceptions listed above, individuals meeting one of the following crisis exceptions may be approved for HCBS PD waiver services without being subject to the waiting list.
- SRS Adult Protective Services (APS) has confirmed a finding of abuse, neglect or exploitation of the individual seeking services.
- There is a risk of family unit dissolution involving a minor dependent child or dependent spouse.
- The individual is in the end stages of a terminal illness and the life expectancy is documented by a physician to be less than six months.
- The individual is the victim of domestic violence.
D. Responsibilities – The HCBS PD case managers, the HCBS PD Waiver Program Manager and the EES eligibility staff shall have the following responsibilities concerning management of the waiting list:
HCBS Case Managers – The case managers will continue to accept referrals for HCBS PD services and to complete the assessments to determine eligibility for the waiver. EES eligibility staff shall be notified of the outcome of the assessment via the ES-3160 communication form. If the individual has been placed on the waiting list, it shall be clearly indicated on the form. The case manager shall also notify EES eligibility staff where an individual has been approved for services due to one of the exceptions or crisis exceptions.
HCBS PD Waiver Program Manager – The Program Manager shall maintain the waiting list for all individuals assessed as eligible and placed on the list. Case managers shall be notified immediately once an individual on the waiting list has been approved for placement on the waiver. The Program Manager shall also notify the case manager when an individual is transitioning to the HCBS PD waiver from another HCBS waiver, is returning to the HCBS PD waiver from the WORK program, is returning from a planned brief stay in an institution, or is utilizing Money Follows the Person funding.
The Program Manager shall also be responsible for notifying regional contacts via e-mail when an individual has been approved for services under one of the crisis exceptions. The designated regional contact shall then forward the e-mail to the appropriate EES eligibility worker responsible for processing the application/request.
The regional contacts are:
KC Metro Region: Kimberly Reynolds
Northeast Region: Kacee Roberson
Southeast Region: Paula George
South Central Region: Margo Lytton
West Region: Vicki Garrison
Wichita Region: Randy Bottorff
EES Eligibility Staff – EES eligibility staff shall continue to accept applications for HCBS PD waiver coverage, to make referrals to the appropriate case managers via the ES-3160 form, and to process the application/request for assistance based on the results of the assessment.
- If the individual fails the assessment process or is placed on the waiting list, the application should be processed for independent living medical assistance. If warranted, the individual should be referred for other supportive services, including the WORK program or to APS for potential assistance. It would also be appropriate to complete the resource assessment for couples under the spousal impoverishment provisions once the results of the HCBS PD assessment are received.
- If the individual is assessed as eligible for services and has been approved under one of the exceptions listed above, the application/request shall be approved for HCBS PD coverage if otherwise eligible. The HCBS effective date shall be clearly indicated on the ES-3160 form received from either the case manager or the Program Manager.
An application/request approved for HCBS PD coverage under the crisis exception shall be
promptly processed by the eligibility worker to ensure needed services are in place as soon as
Communication between the eligibility worker and the case manager is critical in this process since services cannot begin until the case has been processed and properly coded for HCBS PD coverage.
Should you have any questions about the waiting list process, please contact Candace Cobb at (785) 296-6140 or Candace.Cobb@srs.ks.gov. If you have questions about this memo, please contact Tim T Schroeder at (785) 296-1144 or Tim.Schroeder@khpa.ks.gov.