Community Pathways Waiver Amendment #1 – Proposal

Amendment #1 Purpose

The amendment is based on feedback from individuals receiving services and their families including 15 listening sessions across the State, recommendations from independent consultants, and is aimed at furthering compliance with new federal rules and requirements from the Center for Medicare and Medicaid Services (CMS) and the Department of Labor (DOL).

Additional information regarding listening sessions can be viewed at Community Pathways Waiver Feedback 2015

Additional information and examples of amendment changes can be viewed by clicking on the “Reference” links below.

The purposes of this amendment are to:

  1. Enhance self-directed service model by removing 82 hour service preauthorization requirement and update personal support services by removing support staff hour requirements and restrictions including preauthorization requirement for more than 40 hour work week, 8 consecutive hours, time off between shifts, and time spent sleeping.
    Reference: Personal Support Changes
  2. Update program capacity by adjusting projections for the number of unduplicated participant based on current trends, new reserved capacity, and legislative appropriation to support new participants each year.
    Reference: Program Capacity Changes
  3. Update and establish new reserve waiver capacity for waiver participants.
    Reference: Reserved Capacity Changes
  4. Update projected service cost based on adjustment to unduplicated participant count and current service utilization;
    Reference: Projected Service Cost Changes
  5. Remove requirement for active treatment in order to be eligible for the Waiver.
    Reference: Active Treatment Changes
  6. Change personal supports unit of service from an hour to 15 minute units.
    Reference: Personal Support Unit Changes
  7. Update terminology, language, and calculations (such as removing previous information about waiver merger and replacing resource coordination with coordination of community services) in various sections including: Waiver Descriptions, Program Goals, Public Input, Transition Plan, Independent Advocacy, Attachment 1 – Transition Plan, Attachment #2 – Home and Community-Based Setting Waiver Transition Plan, and Cost Neutrality Demonstration.
    Reference: Terminology and Language Changes