Community Pathways Waiver Amendment #1 - Proposal

Active Treatment Changes

Purpose:

Remove requirement for active treatment in order to be eligible for the Waiver.

Overview:

All waiver participants must meet the definition of "developmental disability" found in Maryland Annotated Code, Health-General Article, Section 7-101(e), which is comparable to the federal definition found at 45 CFR 1385.3. Individuals meeting the Section 7-101 (e) definition of "development disability" meet the waiver's level of care criteria for an ICF/IID.

During the waiver renewal, in an attempt to clarify and explain the level of care eligibility criteria for the waiver, the need for active treatment (as described in 42 CFR § 483.440 and as required by 42 CFR § 440.150(a)) was added. This is because section 1915 (c) of the federal statute restricts home and community-based services to individuals for whom there has been a determination that, but for the provision of waiver services, the individual would require the level of care provided in an institution. The federal criteria for admission to an institution (an ICF/IID) includes the need for active treatment. However, use of the specific term, “active treatment,” is reserved for care and treatment provided in an ICF/IID. That specific word cannot be used to describe the level of care needed to get into a home and community services based waiver. Therefore, the term “active treatment” will be removed from the waiver application.

Current language page 30:
Maryland seeks to serve individuals with developmental disabilities of any age in the Community Pathways waiver. All waiver participants will meet the criteria for developmental disability in accordance with Annotated Code of Maryland, Health - General Article, Section 7-701 (e)which is comparable to the federal definition found at 45 CFR 1385.3. The level of care instrument and process are the same for both the HCBS Waiver and ICF/IIDs. In accordance with COMAR 10.09.26.11, in order to be eligible for the Waiver, individuals meeting the Section 7-101 (e) definition of "developmental disability" must also meet the level of care criteria for an ICF/IID, including the need for active treatment, as described in 42 CFR § 483.440 and as required by 42 CFR § 440.150(a).
Reference: Community Pathways Waiver pages 30 on the DDA Website at: MD0023R0600.pdf

Revision:
Maryland seeks to serve individuals with developmental disabilities of any age in the Community Pathways waiver. All waiver participants will meet the criteria for developmental disability in accordance with Annotated Code of Maryland, Health - General Article, Section 7-701 (e)which is comparable to the federal definition found at 45 CFR 1385.3. The level of care instrument and process are the same for both the HCBS Waiver and ICF/IIDs. In accordance with COMAR 10.09.26.11, in order to be eligible for the Waiver, individuals meeting the Section 7-101 (e) definition of "developmental disability" must also meet the level of care criteria for an ICF/IID, including the need for active treatment, as described in 42 CFR § 483.440 and as required by 42 CFR § 440.150(a).

Current language page 45:
All waiver participants will meet the definition of "developmental disability" found in Maryland Annotated Code, Health-General Article, Section 7-101(e), which is comparable to the federal definition found at 45 CFR 1385.3. In accordance with COMAR 10.09.26.11, in order to be eligible for the Waiver, individuals meeting the Section 7-101 (e) definition of "development disability" must also meet the level of care criteria for an ICF/IID, including the need for active treatment, as described in 42 CFR § 483.440 and as required by 42 CFR § 440.150(a).
Reference: Community Pathways Waiver pages 45 on the DDA Website at: MD0023R0600.pdf

Revision:
All waiver participants will meet the definition of "developmental disability" found in Maryland Annotated Code, Health-General Article, Section 7-101(e), which is comparable to the federal definition found at 45 CFR 1385.3. In accordance with COMAR 10.09.26.11, in order to be eligible for the Waiver, individuals meeting the Section 7-101 (e) definition of "development disability" must also meet the level of care criteria for an ICF/IID, including the need for active treatment, as described in 42 CFR § 483.440 and as required by 42 CFR § 440.150(a).