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Public Health Emergency News

On December 15th, the Dept. of Health Care Policy and Financing (HCPF) released an update on the Public Health Emergency (PHE) declared by the U.S. Dept. of Health and Human Services (HHS) in March 2020.  The PHE was extended on October 13, 2022, for another 90 days by HHS.  HHS says they will provide states with 60 days’ notice before ending the PHE.  HCPF did not receive a notice from HHS in November which indicates that the PHE will likely be extended for another 90 days on January 11, 2023.  That extension would end on April 11, 2023.  HCPF states that if they don’t receive a 60-day notice by February 10th, they will expect the PHE to be renewed on April 11, 2023.

Why is this important?

When the PHE ending notice is received by HCPF, they have 14 months to complete the redetermination of eligibility for 1.6 million Medicaid recipients.  This is a huge process involving your county human service office/social service office which processes the financial eligibility of every Medicaid recipient.  All Medicaid recipients should ensure that their current address and other contact information are up to date in the Medicaid system. Recipients will receive their redetermination packets by MAIL and these packets are time-sensitive.  Let’s remember that counties and states have not done very many eligibility packets since March 2020 and the state anticipates up to 800,000 Medicaid recipients could lose their benefits.

How will people potentially lose benefits? Many people have moved and did not update their address in the Medicaid system and won’t get their packet.  Failure to return a packet will result in Medicaid eligibility termination (however, you can always reapply).  Some people will no longer be financially eligible for Medicaid and will lose benefits.  Some may no longer meet the waiver requirements and long-term care screens and will lose Medicaid. We cannot stress enough the importance of returning your redetermination packets on time with all of the information requested to ensure that services and eligibility are not interrupted.

Prepare for the End of the PHE

Community First Choice Waiver

HCPF continues to meet with a small stakeholder group concerning their plan for Community First Choice services.  They intend to start Community First Choice on July 1, 2025, and when it starts both IHSS and CDASS will be two of the services offered.  HCPF is asking for stakeholder feedback on the CFC stakeholder group meetings.  If you have attended any of the meetings, please use this link for a survey from HCPF.

Case Management Redesign

HCPF intends to start piloting the new Assessment and Support Planning Tool in Spring 2023 and will be training case managers to utilize the tool. PLEASE BE AWARE: This tool can be considerably longer than any previous assessment tool but does have opportunities to skip sections. If someone does the entire assessment and support plan, it could take up to 4 hours to complete. This can be completed in more than one session if need be. During the development of this tool, there was testing on existing clients to determine how this new tool might affect their eligibility. There were many changes made to try to ensure that the tool was equitable in determining eligibility.

HCPF will be releasing a Request for Proposals for case management agencies to respond to. HCPF intends to create a more streamlined case management system and there will be only one case management agency in each of the 20 catchment areas HCPF has decided on. That means that the state will go from 44+ case management agencies to just 20. They will release the RFP after the first of the year and all 20 catchment areas will be operating by July 1, 2024. This is a big change. For those of you who have worked with small private case management agencies, it has not been determined yet if they will still be able to provide those services. We have advocated to keep these small agencies because they provide valuable expertise for children’s services that is not always available at the larger case management agencies. More to come as it plays out.

Legislative News

We have been attending the HCPF briefings of the Joint Budget Committee (JBC) and have submitted many questions concerning the HCPF budget proposal.  There are services that PASCO consumers utilize through other agencies, like day programs.  Some services have not had sufficient funding for them to be viable entities.  The JBC is asking about the equity in funding Medicaid services and we will continue to provide information and questions to JBC members so they can make informed decisions about the budget.  The JBC only has one holdover member for this legislative session and 5 new members.  The Advocacy Team and our association, CLASP, are setting meetings up so we can educate JBC members and offer our expertise regarding home health, home care, and IDD services.  The legislature convenes its 120-day session on January 9, 2023.  Every month through May, we will provide information on bills that affect home health, home care, and IDD services.

We have asked the JBC to require HCPF to provide information on how the two Utilization Management agencies are performing their jobs.  KEPRO and Telligen continue to deny services or cut services that people with disabilities need.  If you are receiving PAR denials due to the review by these two entities, you have the right to appeal their decision.