1. Additional CCC Plus Waiver Information

2. Managed Care Delivery of HCBS
Combination 1915 b and 1915 c waiver authorities
1915 b Waiver
Allows the state to require enrollment in a managed care delivery system
Must be cost-effective, efficient and consistent with the principles of the Medicaid program
1915 c Waiver
Must not cost more than institutional care
Ensures health and welfare protections
Services follow an individualized and person-centered plan of care
Waiver services will be available through a managed care approach. The state will use a combination of 1915 b and 1915 c waiver authorities, the 1915 b waiver allows the state to require managed care enrollment while the 1915 c waiver (current authority) allows the state to provide person-centered services in the community instead of an institution.

3. Elderly or Disabled with Consumer Direction (EDCD)
Current 1915 c Waivers
Elderly or Disabled with Consumer Direction (EDCD)
Aging or have a physical disability
Technology Assisted (Tech)
Dependent on technological support and require substantial, on-going skilled nursing care
Today, the EDCD waiver serves more than 30,000 individuals who are aging or have a physical disabilty and the Tech waiver serves approximately 300 individuals who require on-going skilled nursing support due to their need for technologies such as ventilators.

4. Combination of Existing 1915 c Waivers
Combines Elderly or Disabled with Consumer Direction and Technology Assisted Waiver
Expands current services to both populations
Waiver becomes Commonwealth Coordinated Care Waiver
Effective 7/1/2017
EDCD Waiver
Tech
Waiver
CCC Plus Waiver
The state recevied approval from CMS to combine the Tech and EDCD waivers and renamed it CCC Plus waiver. The CCC+ waiver will serve both EDCD populations (aging or have a physical disability) and the tech waiver population. With this combination, services are being expanded to both populations (AT and EM) and the waiver is effective 7/1/17.

5. CCC Plus Waiver Services
Adult Day Health Care
Personal Assistance Services
Private Duty Nursing
Respite care
Services Facilitation
Assistive Technology (AT)
Environmental Modifications (EM)
Personal Emergency Response System
Transition Services
The services offered in the waiver are as follows to anyone meeting service criteria.

6. CCC Plus Waiver Services
AT and EM
Limited to $5000 per year for each service
Private Duty Nursing
Must meet current Tech waiver criteria
Respite
Limited to 480 hours/ fiscal year
Increase from 360 hours for Tech waiver
AT and EM will be expanded to include EDCD population with annual limits of $5000 for each service
PDN will continue to be available to those who meet the Tech waiver criteria – these are individuals who are dependent on ventilator for a portion o fthe day or require complex tracheostomy care.
Respite will be 480 for all individuals- currently tech waiver has a limit of This will be increased to 360 based on fiscal year.

7. Services will automatically continue through CCC Plus Waiver
No Changes to FFS waiver processes
Pre-admission screening processes unchanged
Enrollment and service authorization process unchanged
Current service authorizations will continue
No action is required by providers
Individuals currently served through either the EDCD or Tech waiver will automatically continue services through the CCC Plus Waiver.
All service authorizations for the EDCD and TECH Waivers services will continue;
service providers do not need to take any additional actions

8. CCC Plus Waiver Upcoming Medicaid Memo
Emergency regulations being promulgated
CCC Plus Medicaid Manual being developed
Follow current Medicaid Manuals for EDCD and Tech until the new manual is posted
Individuals currently served through either the EDCD or Tech waiver will automatically continue services through the CCC Plus Waiver.
All service authorizations for the EDCD and TECH Waivers services will continue;
service providers do not need to take any additional actions
A medicaid memo will be published soon to announce this change to providers. The key take away is that no processes for FFS will change. New waiver enrollments will continue to be processed through Kepro based on the level of care ( EDCD or Tech)

9. VA Medicaid Behavioral Health Service Delivery Systems
Fee For Service
CCC Plus
2017
Jan 2018
In Patient/ Out Patient/ARTS
Magellan
Health Plan
Community Mental Health Rehabilitation Services

10. Medicaid Population
Waiver Services
DD/ID Case Management
Other Services (excluding waiver and case management)
For Individuals in DD Waivers
Service authorization: Provider to CSB to DBHDS for authorization
Billing: DMAS FFS pays the provider
CSB/private provider provides the ID or DD case management
CSB bills DMAS FFS directly
CCC Plus health plans
For individuals on the DD waivers wait list
None
CSB/private provider provides the ID or DD case management, as applicable
CCC Plus Health Plans
CCC Plus waiver (EDCD) while on DD wait list
CCC Plus waiver services paid for by CCC Plus Health Plan
CCC Plus Health Plan