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SPONSOR: |
Lopez |
DATE TYPED: |
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HB |
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SHORT TITLE: |
Medicaid Self-Directed Care Option |
SB |
392 |
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ANALYST: |
Weber |
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APPROPRIATION
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Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
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FY03 |
FY04 |
FY03 |
FY04 |
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See Narrative |
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(Parenthesis
( ) Indicate Expenditure Decreases)
Responses
Received From
Human
Services Department
Department
of health
Agency
on Aging
Health
Policy Commission
SUMMARY
Synopsis
of Bill
Senate Bill 392 requires that the Human Services
Department establish a self-directed care option in the Disabled and Elderly
(D&E) and Developmentally Disabled (DD) Medicaid waiver programs, which
would allow clients to direct their own care services and still have those services
reimbursable by Medicaid.
Significant
Issues
The
Department of Health and the Human Services Department collaborated to develop
the following information. The D&E
and DD waivers promote person-center planning, individual budgets based on
level of care, freedom of choice to select service providers and recognition of
the essential role of the family or individual in planning and purchasing services. This is done with an annual resource amount
that encourages cost effective decision making.
Both DOH and HSD have been working on self-directed care options for
these populations.
SB
392’s requirement for self-directed medical and related personal care services
reimbursable under the D&E and DD waivers would require the Human Services
Department (HSD) to amend the existing waivers or apply for the Independence
Plus 1915 (c) waiver to Centers for Medicare and Medicaid Services (CMS).
Components
for the CMS definition of self-directed service option, which are not part of
the current D&E and DD framework, include: a fiscal agent and a brokerage
agency to support families and individuals as they direct their own services;
and allowing eligible families and individuals to receive a cash allowance to
purchase services.
FISCAL IMPLICATIONS
It is anticipated this
change can be accomplished at current funding levels. Oversight of such a program would require
operating increases to ensure the quality of care.
ADMINISTRATIVE IMPLICATIONS
A new waiver or waiver
amendment for self-directed services through the D&E and DD waivers would
require the development and implementation of regulations, policies and
procedures, and service standards. SB
392 would require MAD to develop and implement quality assurance policy and
procedures to monitor self-directed services to ensure quality and financial
accountability.
MW/njw