October 12, 2018
Emily McClellan, Regulatory Manager
Department of Medical Assistance Services
600 E. Broad St, Suite 1300
Richmond, VA 23219
RE: CCC Plus Manual
Dear Ms. McClellan,
The disAbility Law Center of Virginia (dLCV) is the Commonwealth’s federally mandated protection and advocacy system. We respectfully submit the following public comment in relation to modifications of the Commonwealth Coordinated Care Plus (CCC Plus) Waiver Manual. This manual is a combination of the former Elderly or Disabled with Consumer Directed Services (EDCD) and the Technology Assisted (TECH) Waiver and private Duty Nursing Services Provider Manuals. We ask the Department to consider the following issues:
(CCC Plus Waiver Manual, Covered Services and Limitations, Chapter IV, page 75).
The requirement to share funds, with a limit of $5,000 per household, as opposed to per individual, is inconsistent with the State Plan, which does not require the sharing of benefits. (12 Va. Admin. Code § 30-120-758, 762 (2014)). This restriction would penalize individuals who reside in the same household, but whose EM needs may be entirely distinct, by reducing the funds available to each individual.
(CCC Plus Waiver Manual, Covered Services and Limitations, Chapter IV, page 81).
Individuals receiving waiver services may receive up to $5,000 in AT per fiscal year. (12 Va. Admin. Code § 30-120-758, 762 (2014).) The proposed requirement that individuals shall share AT is unclear and ambiguous, and in effect lessens the benefit available to an individual beneficiary. Although the Manual does not expressly state that the AT limit is per household, providers could interpret this language to mean that multiple Medicaid recipients in the same home must share any AT within their $5,000 maximum allowance.
The Department should revise the proposed CCC Plus Waiver Manual to comply with the intent of the State Plan and VAC. 12 Va. Admin. Code § 30-120-758, 762 (2014). Specifically,
dLCV is concerned that these proposed requirements will effectively reduce benefits to Medicaid waiver recipients, and deny them the individualized AT and EM that they need. These requirements as proposed would also penalize individuals by reducing the Medicaid waiver benefits of recipients who, through choice or necessity, share a home or household with other individuals with disabilities, or reside in a congregate setting.
Thank you for your thoughtful consideration of dLCV’s public comment.
Sincerely,
Colleen Miller
Executive Director