LTHHCP Waiver Amendment Letter

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services
New York Regional Office
26 Federal Plaza, Room 37-100
New York, NY 10278

Division of Medicaid and Children´s Health Operations

March 29, 2013

Jason Helgerson
Medicaid Director, Deputy Commissioner
Office of Health Insurance Programs
NYS Department of Health
Corning Tower (OCP -1211) Albany, New York 11237

Re: New York Long Term Home Health Care Program (LTHHCP) NY.0034.R06.02 Waiver Amendment

Dear Mr. Helgerson:

This is to inform you that your request to amend your 1915(c) Home and Community Based Se:rvices Waiver for seniors and individuals with disabilities who are medically eligible for nursing facility (NF) level of care has been approved. This approved waiver amendment has been assigned CMS c:ontrol Number NY.0034.R06.02, which should be referenced on all future correspondence relating to this waiver.

CMS approves this waiver amendment with an effective date of April l, 2013.

Beginning April 1, 2013, all Medicaid recipients, age 21 and over, in need of certain community-based long term care services for over 120 days-including 1915(c) Long Term Home Health Care Program (LTHHCP) waiver participants-will be required to enroll in a Managed Long Term Care (MLTC) Plan. The 1915(c) amendment request is to align the approved waiver with the planned impact of the phased MLTC enrollment plan.

Non-duals who reside in counties without MLTC capa.city will be offered the option to remain in the LTHHCP or assisted to apply for another 1915(c) waiver program that contains the same level of services available to individuals in the LTHHCP. Local districts of social services and the LTHHCP agencies are required to assist in the discharge and/or transition of LTHHCP participants from the program.

The LTHHCP waiver continues to offer the following supports for partiCipants remain en:rolled: Respite, Assistive Technology, Community Transitional Services, Congregate and Home Delivered Meals, Environmental Modifications, Home and Community Support Services, Home Maint(mance Services, Medical Social Services, Moving Assistance, Nutritional Counseling!Education Services, Respiratory Therapy, Social Day Care Transportation, Social Day Care

The following estimates of unduplicated recipients and the average per capita cost of waiver services have been approved:

Unduplicated
Recipients
(Factor C)		 Community
Costs
(Factor D+D´)		 Institutional
Costs
(Factor G+G´)		 Total Waiver
Costs (Factor C × Factor D)
Year 3 23711 32704.35 66001.00 73,523 068.80
Year 4 15349 32374.17 68151.00 15,597,!93.33
Year 5 3749 33712.39 70372.00 3,004,073.70

We would like to express our gratitude for the effort and cooperation provided by your staff during our review of your renewal request.

Should you have any questions, please do not hesitate to contact me at: (212) 616-2438 or Dominique Mathurin at (212) 616-2422.

Sincerely,

John Guhl
Acting Associate Regional Director
Division of Medicaid and Children´s Health

CC: Dominique Mathurin
       Colleen Gauruder
       Vicky Rockefeller
       Mark Kissinger