No. 29311 (Amendment): R414-61. Home and Community-Based Waivers

DAR File No.: 29311
Filed: 12/11/2006, 04:23
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

In accordance with Subsection 26-18-3(2), this rule implements current versions of home and community-based services waivers. The rule incorporates these waivers by reference.

Summary of the rule or change:

For clarification, the word "services" is added to the title of this rule, which is now "Home and Community-Based Services Waivers." Language that incorporates the State Plan by reference is removed because Rule R414-1, Utah Medicaid Program, already incorporates the State Plan by reference. The effective date for the "Waiver for Individuals Age 65 or Older" is updated to 07/01/2005. This waiver eliminates financial management as a service and includes it as an administrative function. The effective date for the "Waiver for Individuals with Physical Disabilities" is updated to 07/01/2006. This waiver adds financial management services, incident reporting requirements, and individual risk analysis requirements. The title, "Waiver for Individuals with Developmental Disabilities or Retardation," is changed to "Waiver for Individuals with Mental Retardation and Other Related Conditions." The effective date for this waiver is updated to 07/01/2005. This waiver eliminates senior support services, educational support services, and specialized support services. It adds behavior consultation services, extends living support services, companion services, family training and preparation services, financial management services, living start-up costs, massage therapy, and professional medication monitoring and personal budget assistance.

State statutory or constitutional authorization for this rule:

Sections 26-18-3 and 26-1-5, and Section 1915(c) of the Social Security Act

This rule or change incorporates by reference the following material:

Medicaid 1915(c) Home and Community-Based Services Waiver for Individuals Age 65 or Older, effective 07/01/2005; Medicaid 1915(c) Home and Community-Based Services Waiver for Individuals with Physical Disabilities, effective 07/01/2006; and Medicaid 1915(c) Home and Community-Based Services Waiver for Individuals with Mental Retardation and Other Related Conditions, effective 07/01/2005

Anticipated cost or savings to:

the state budget:

There is no budget impact because discontinued waiver services are offset by new waiver services.

local governments:

There is no budget impact because local governments do not provide home and community-based services.

other persons:

There is no budget impact because discontinued waiver services are offset by new waiver services.

Compliance costs for affected persons:

There are no compliance costs because discontinued waiver services are offset by new waiver services.

Comments by the department head on the fiscal impact the rule may have on businesses:

No fiscal impact on business is anticipated as new waiver services offset discontinued waiver services. David N. Sundwall, MD, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Health
Health Care Financing, Coverage and Reimbursement Policy
CANNON HEALTH BLDG
288 N 1460 W
SALT LAKE CITY UT 84116-3231

Direct questions regarding this rule to:

Craig Devashrayee at the above address, by phone at 801-538-6641, by FAX at 801-538-6099, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

01/31/2007

This rule may become effective on:

02/08/2007

Authorized by:

David N. Sundwall, Executive Director

RULE TEXT

R414. Health, Health Care Financing, Coverage and Reimbursement Policy.

R414-61. Home and Community-Based Services Waivers.

R414-61-1. Introduction and Authority.

(1) This rule establishes authority for the Department of Health to administer all Section 1915(c) waivers.

(2) The rule is authorized by Section 26-18-3 and Section 1915(c) of the Social Security Act.

 

R414-61-2. Incorporation by Reference.

[The Department adopts the document entitled "Utah State Plan under Title XIX of the Social Security Act" 1999 edition, and the document entitled "Home and Community Based Waiver Implementation Plan", 1999 edition, which are incorporated by reference within this rule. These documents are available for public inspection during normal working hours, at the State Health Department Building, located at 288 North, 1460 West, Salt Lake City, UT, 84114-3102, at the office of the Division of Health Care Financing. These documents will be used by the Division for the provision of services under the following waivers:]The Department incorporates by reference the following home and community-based services waivers:

(1) Waiver for Technology Dependent/Medically Fragile Individuals, [dated]Effective July 1, 2003;

(2) Waiver for Individuals Age 65 [and]or Older, [dated]Effective July 1, 200[4]5;

(3) Waiver for Individuals with Acquired Brain Injuries, [dated]Effective July 1, 2004;

(4) Waiver for Individuals with Physical Disabilities, [dated]Effective July 1, 200[3]6;

(5) Waiver for Individuals with [Developmental Disabilities or ]Mental Retardation and Other Related Conditions, [dated]Effective July 1, 200[3]5;

(6) New Choices Waiver, Effective January 1, 2007.

These documents are available for public inspection during business hours at the Utah Department of Health, Division of Health Care Financing, located at 288 North 1460 West, Salt Lake City, UT, 84114-3102.

 

KEY: Medicaid

Date of Enactment or Last Substantive Amendment: [February 1, 2005]2007

Notice of Continuation: March 11, 2005

Authorizing, and Implemented or Interpreted Law: 26-18-3