Pg 17 - Management Training (S5116)

• Rephrase include “... program rules and changes.”

Pg 88-89 - Disenrollment

• Please clarify and specify with examples:

  • “The waiver individual has medication or skilled nursing needs or has medical or behavioral conditions that cannot be met through CD services or other services;

Pg 91 - Transitions 

• Will the SF receive the ISP prior to the waiver start date?

  • Request that the requirement be spelled out that the SC will make the ISP available to  SF provider within X business days of the waiver start date

• When can the SF expect to receive info/contact that a slot was awarded?

  • Request that the requirement be spelled out

• “The CCC Plus Waiver service authorization will automatically end based on the effective date of the DD Waiver enrollment.”

  • This is problematic

  • SFs have to submit discharge paperwork

  • Additionally, Fiscal Agent changes may occur which would cause a significant impact to services for the member if authorizations are automatically ended.

• Specificity required for Continuity of Care

  • Effective when?  From the start date of the waiver or the date the WASC team awards slot?

• What will be the result of the delay by the SC in getting the Part III of the ISP to the SF?