Home Care 2015-16 Medicaid Rate Increase Begins Feb. 1, 2016

HCPF Announces CMS Approval 

The Department (of Health Care Policy & Financing) has received approval from the Centers for Medicare and Medicaid Services for amendments made to three Home and Community Based Service (HCBS) Medicaid Waiver programs.

 

These changes are effective February 1, 2016. Department staff will be working with Single Entry Point case managers and our HCBS provider agencies to ensure timely implementation of these changes.

 

Brain Injury Waiver, Community Mental Health Supports Waiver and the Elderly, Blind, and Disabled Waiver received approval for the following changes:

 

·        Home Modification Increase: Overall lifetime cap for the Home Modification benefit is increased to $14,000.

 

·        Consumer Directed Attendant Support Services received approval for the Agency with Choice and Fiscal Employer Agent Financial Management Service Models.

 

·        Agency based personal care and homemaker services received a targeted rate increase ($15.36 to $17.00 / hour)

 

·        In-Home Respite Targeted Rate Increase.

 

In addition, the Elderly, Blind, and Disabled Waiver received approval for changes to the In Home Support Services (IHSS) benefits:

 

·        IHSS can be provided in the community.

 

·        Clarifies that the client or the client's authorized representative is responsible for directing their care, including scheduling, managing, and supervising attendants.

 

·        Allowing clients or the client's authorized representative to work with the IHSS agency to determine the amount of oversight provided by a licensed health care professional.

 

·        Added a spouse as an eligible family member who may act as an attendant providing IHSS.

 

·        Removed the 444 hour per year family member reimbursement limit for personal care and established a new 40 hour per week family member reimbursement limit for personal care.

 

The Department anticipates receiving approval for the Spinal Cord Injury Waiver, the Children with Life-Limiting Illness Waiver and the Children’s Home and Community Based Services Waiver in the near future.

 

The Department will communicate with stakeholders and providers once approvals are received.

 

For additional information on approved Home and Community Based Services Medicaid Waivers please contact a waiver manager

 

Elderly, Blind and Disabled Waiver: Lana.Mutters@state.co.us

 

Community Mental Health Supports Waiver: Cassandra.Keller@state.co.us

 

Brain Injury Waiver: Diane.Byrne@state.co.us

 

Spinal Cord Injury Waiver:  Samantha.Saxe@state.co.us

 

Children with Life-Limiting Illness: Candace.Bailey@state.co.us

 

Children’s Home and Community Based Services Waiver: Dennis.Royjr@state.co.us

 

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Home Care 2015-16 Medicaid Rate Increase Summary

The 2015-16 Medicaid rate increases are mentioned in the Budget Package and Long Bill Narrativeon the bottom of page 55.

Begins Feb. 1, 2016:

HCBS Personal Care  / Homemaking – from $15.36/hour to $17/hour (10.7% increase)

 

Was retroactive to July 1, 2015:

Private Duty Nursing – from $40.83/hour to $45/hour (10.2% increase)

RN, PT, OT, ST and other home care services – from current rates plus .05 percent

 

 

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