Kansas Department of Social and Rehabilitation Services
Janet Schalansky, Secretary
Integrated Service Delivery - Candy Shively, Deputy Secretary (785) 296-3271
Economic and Employment Support - Sandra Hazlett, Director
The purpose of this memo is to provide instructions to EES staff for the implementation of changes in the Home and Community Based Service (HCBS) waivers and Nursing Facility programs. Changes involve a reduction in the Protected Income Level (PIL) for HCBS cases, an increase in the Level of Care (LOC) score for some HCBS waiver and NF cases and the elimination of adult coverage of several optional medical services. These changes are being made as a result of budget reductions imposed on both SRS and the Kansas Department on Aging (KDOA) by the Governor. The mandate reduced the budgets of most state agencies by 3.9% through the implementation of an allotment due to a budget shortfall. Although additional reductions are also planned as a result of the allotment, this memo provides instructions and information on those changes which require additional action by EES staff at this time.
pen and ink change incorporating the new policies will
be made to the Kansas Economic and Employment Support
Manual (KEESM) and will be sent separately.
The following changes have been made as a result of the allotment:
Implementation Instructions- PIL Change:
To implement the new HCBS standard, the KAECSES table will be updated in preparation for a special emergency mass change, much like the process followed for COLA mass change. The mass change will run the weekend of January 3-5, 2003. This mass change will rebudget all MS programs and incorporate the new HCBS standard. The new standard will be applied to all MS programs with a medical program subtype of HC. Other income and expenses currently included in the budget will not be adjusted. Any resulting HCBS obligation will be computed and reflected on the SPEN screen for the benefit month of 02/03.
The LOTC screen will also be automatically updated to incorporate the new HCBS obligation amount and a 02-01-03 effective date. This update will also occur over the weekend of January 3 - 5. All cases with an effective date prior to 02-01-03 and an HCBS obligation different that the amount appearing on SPEN in February will be updated. The LOTC screen must be updated manually if these conditions are not met. LOTC will not update if a later effective date is present on LOTC.
the mass change will reprocess all MS cases, some NF,
WH and IL cases may be adjusted because of this update.
begin planning potential workload, a list of all open
MS HC cases is attached. The list is sorted by section-unit-caseload,
county and is meant to be used a guide only.
For each case updated by the LOTC process, a notice situation will be created. The Z056, MS Mass Change/Chge in Patient Liability, will be produced. Because of the possibility of other changes occurring, such as non-covered medical expenses or other benefit changes, these notices will not be printed immediately after the mass run to allow the eligibility worker a window to make such adjustments. If no further changes are made and the mass change notice is not deleted, the system generated notice will be printed and mailed beginning 01-15-03. This mailing delay gives the worker until the close of business on 01-14-03 to make any necessary changes and delete the MS mass change notice. If action is taken to make other changes to the obligation prior to this time, the system-generated notice must be deleted and a new notice sent which describes the PIL change as well as the additional changes. Because the effective dates and amounts are driven by notice keywords, these fields cannot be changed through a notice update on NOHS. The N757, MS Mass Change/Chge in Obligation, has been created for this purpose. A sample notice is included with this memo.
To inform the case manager/independent living counselor (CM/ILC) of the change, a notice will be created with mass change for each HCBS individual whose obligation was updated. This notice provides the client name, case number, old and new liability amount with effective dates, the client's address and the worker name. A copy of the notice is to be made and put in the case file for documentation. The notice is then to be sent to the HCBS CM/ILC to inform them of the change. If adjustments are made to the obligation after this notice is produced, a pen and ink change will be made to the notice. Because the case manager notice will be sent, an ES-3161 will not be necessary for these obligation changes. All notices will be mailed to the area offices on or about 01-06-03. Notices are also available for viewing on SAR by entering report ID SWY03873-R17. For control purposes, an alpha listing of all HCBS case manager notices will also be available on SAR. The list, sorted by caseload, will be available on 01-06-03 by entering SAR report ID SWY0373-R35.
receiving the notice of new obligation, the CM/ILC must
adjust the plan of care. This involves notifying both
the consumer and the provider(s) involved of the change
in obligation. Because many new persons may now have
an obligation, the CM/ILC may also have to provide initial
client obligation education to the consumer. To provide
the CM/ILC with as much time as possible to make changes,
it is imperative that EES staff feed updated obligation
information to them as quickly as possible and do so
as cases are processed. Do not hold all CM/ILC notices
until 01-15 to batch and send. By sending notices quickly,
the workload is better distributed throughout the month.
Implementation of new LOC Score:
For HCBS cases, the IL counselor/ case manager is responsible for communicating any waiver terminations according to standard procedures. An ES-3161 will be sent to the appropriate EES contact as notification of functional eligibility termination. Financial eligibility shall then be adjusted as per KEESM 8173. These terminations are effective 02-01-03.
Persons currently employed must be considered for Working Healthy. The ILC will also coordinate with the local Benefits Specialist and EES Specialist for persons interested in returning to work to ensure coverage under Working Healthy is considered.
of Non-covered Services:
If you have any questions or concerns about these changes, please contact me at (785)296-8866. Please report any concerns regarding mass change processing to SRSTSC at (785) 296-4357.