the re-KAPP…Christmas Edition!

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          SCL Waiver/Regulations UPDATE:

• The SCL regulation we are currently operating under, (SCL2) is this version:  907 KAR 12:010 and payment reg 907 KAR 12:020
• The current SCL went into effect June 2013 (partially), then staggered implementation in 2014 as participant rolled services into SCL2 at their birthdate/LOC date.  That was a particularly confusing time because we operated under SCL1 and SCL2 for the entirety of 2014.  Effective 2015 through TODAY, we are still under 907 KAR 12;010 and 020 (the version in the links above.)
• Pertinent HISTORY & DETAILS:  The waiver itself has to be updated every 5 years at LEAST, per CMS (federal Medicaid.)  The draft waiver update that came out to us for public comment in summer of 2015 is the one we’ve worked so hard to get changes in.  We did public comment and submitted written comments in September/October of 2015.  The statement of consideration the cabinet returned to us (old administration/Commissioner Begley) in November of 2015 were considered unacceptable by KAPP.  With the new administration coming in (Gov. Bevin’s inauguration was December 9, 2015), we requested the regulations be deferred until we could work with the new cabinet on them.  Beginning in January 2016, we met with the new Cabinet officials and literally redlined the regulations and made suggestions for change.  If you remember, these negotiations went back and forth for a few months, with the regs being deferred in January 16, February 16 and again in March 16.  The final draft included all of the changes we’d requested except for the elimination of Daily Notes and MWMA requirements.  The Legislative committee on Regulatory Review approved them in April of 2016.  (I testified at that committee meeting, as well.)   That version was then submitted by Kentucky Medicaid to CMS in Washington/Baltimore for their approval.  That’s where it still sits TODAY.  There have been many questions/answers back and forth from CMS to DMS to CMS, etc. regarding the waiver/regs, including the removal of therapies from them and how that transition will occur for recipients and providers.  That delay in approval by CMS is holding up 240 SCL Waiver SLOTS that were approved in the 2014/2015 (Gov. Beshear’s) budget.  For the first time, we have a large EMERGENCY SCL WAIT LIST.  At last count is was 211.  Everyone is aware of this.  If you read last week’s Re-KAPP, I shared the opportunity I had to meet with ANCOR staff and (outgoing) CMS Director Vikki Wachino.  Daryn Demeritt asked her about a couple of waivers pending, including Kentucky’s SCL.  He asked if they would ensure it was approved before the Trump administration began.  She made a note and promised to follow-up.  The current extension CMS gave Kentucky is December 29th.  Kentucky Medicaid assured me this week that they have submitted everything, including the RAI (Request for Additional Information) to CMS.   Everyone hopes that it is approved by 12/29, but there is no guarantee.  I will keep you posted, but until then, we operate under the version listed above, and the slots are frozen.  
• For your information, not to confuse things, the version that is at CMS, that we are hoping to approve is found on this previous blog post:  SCL Version Pending CMS Approval
• The elements that we got changed, including the elimination of the Focus Tool, elimination of the requirement for supervisors to sign off on summaries, elimination of CEU requirements, elimination of the room and board formula, etc. are all in this pending version.  Those things are NOT in effect yet.  You should reference the current regs, link in bullet 1 above.
  

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  Kentucky HCBS Waiver Redesign Workgroup

• The Kentucky HCBS Waiver Redesign Workgroup (State Staff & Stakeholders) reconvened for its second meeting on 12.14.16 from 9:30 – 12:30 at the History Center in Frankfort.
• One pager summary from the introductory process:  ky-hcbs-one-page-summary_vfinal
• Commissioner Anderson shared the updated document from that meeting HERE: ky-hcbs-waiver-redesign_external-facilitation_session-2_vfinal
• Next Steps:

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ELIGIBILITY UPDATE

• When we met with OATS/DCBS/DMS/DAIL, they promised to set up meetings with us to trouble shoot/problem solve.  They have followed through with that promise.  They are starting with 4 providers.  We had no say in who they were, but some emails went out today, inviting them.  If you received an invitation, please let me know.  The first meeting agenda:
• Waiver Workgroup Agenda, January 6^th
  Morning (9:00-12:00)
  1.       Introductions
  2.       Current Business Process (benefind, MWMA, MMIS)
  3.       Future Program Plans (system enhancements, training)
  4.       High-level Case Research Outcomes
   
  Afternoon (1:00-4:00)
  5.       Case Walkthroughs of the 4 providers
• A small change to the billing eligibility instructions…when you use our Billing Assistance Form, and have emailed the local office without success.  Forward that email (showing that you didn’t receive a response, or didn’t receive a solution), attach the Billing Assistance form and email it to:  Deck.Decker@ky.gov; Laura.Sanders@ky.gov; Alisha.Clark@ky.gov; Liping.Peng@ky.gov and copy me.  Some of you have some other contacts you’re emailing, but if you want the quickest resolution, this is the process we’ve agreed upon with the workgroup.
  

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HCB Final Settings Rule UPDATE

The Commonwealth of Kentucky updated its Statewide Transition Plan (STP), which outlines our process for implementing the Home and Community Based Services (HCBS) Final Rules.  Kentucky received initial approval on its STP in June, 2016, and updated the STP based on additional feedback and comments from the Centers for Medicare and Medicaid Services (CMS).  These updates include further defining our heightened scrutiny and assessment processes.  The STP is open for public comment until January 19, 2017 and is published on the Department for Medicaid Services (DMS)’ webpage: http://chfs.ky.gov/dms/

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Renew your KAPP Membership for 2017:

Download 2017 Membership Application HERE!

RENEW online via this EventBrite Link!

Sign-up for KAPP Committees:

We need your help! Sign-up HERE:  https://www.surveymonkey.com/r/KAPP2017Volunteers

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• I/DD Technical Advisory Committee:  Friday 1/20/17 – 10:00 am – 12:00 pm EDT – Frankfort – 275 E. Main (open to the public)
• Medicaid Advisory Committee:  Thursday 1/26/17 – 10:00 am – 12:00 pm EDT – Frankfort – Capitol Annex  (open to the public)
• THE UNITED 874K COALITION ADVOCACY EVENT – LEGISLATIVE MEETINGS & RALLY –Tuesday, February 22, 2017
  874K Rally 2016

  Capitol Annex & Rotunda – Frankfort

2017 Kentucky General Assembly

• Tuesday January 3rd:  Session Day 1
• Wednesday January 4th:  Frankfort, KY – WELCOME BACK TO FRANKFORT RECEPTIONS – 5:00 pm
• Wednesday February 15th:  Frankfort, KY – Capitol Annex – KAPP DAY!
• 2017 Legislative Calendar

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State by State Disability News for the week:  HERE

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Minn. nonprofits seek to overhaul legal guardianship system for vulnerable adults

Changes to Kentucky health care more likely under Trump presidency

U of L hires a Hal Rogers adviser to work in government relations

Report: Ky’s drop in uninsured poor leads U.S.

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Merry Christmas from my family to yours!

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