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Summary of Revisions to the Medicaid Home and Community-Based Services Waiver Manual for the Children’s Long-Term Support Waiver Program

The updates included in the most recent (October 2022) version of the Medicaid Home and Community-Based Services (HCBS) Waiver Manual for the CLTS Waiver Program, P-02256 (PDF), are summarized below. 

Chapter 1–Overview and Administration

No changes

Chapter 2–Eligibility

§ 2.4: Clarification of allowable methods to complete a CLTS functional screen (FS) (F-00367 (PDF))

Chapter 3–Financial Eligibility

§ 3.4: Changes to parental payment limits requirements and processes 

Chapter 4–Provider Requirements and Allowable Services

§§ 4.1-4.2: Changes related to new provider registry and directory

§ 4.2: Clarification that providers are qualified on a service-by-service basis

§ 4.3.2: Added audio-only remote services policy

§ 4.4.3: Added requirement relating to educating participants about annual well child visits with their primary care physicians

§ 4.6.2.3: Clarification of assistive technology service limitation related to ongoing service charges for a device covered under the service or to assistive technology-related subscriptions

§ 4.6.3.2: Removed child care service limitation that prohibited including the cost of CLTS child care in determination of parental payment limit

§ 4.6.6.6: Clarification of community/competitive integrated employment — individual service documentation related to coordination of benefits with programs funded under section 110 of the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Improvement Act of 2004 (IDEA)

§ 4.6.7.3: Added community/competitive integrated employment — small group service limitation related to coordination of benefits with funding through the Department of Public Instruction and the Department of Workforce Development, Division of Vocational Rehabilitation, to align with service limitations for community/competitive integrated employment — individual services

§ 4.6.7.6: Clarification of community/competitive integrated employment — individual service documentation related to coordination of benefits with programs funded under section 110 of the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Improvement Act of 2004 (IDEA)

§ 4.6.8.5: Removed general provider standard requiring providers to have attained either a bachelor’s level or master’s level degree in a human service discipline, or be supervised by someone with either a bachelor’s or master’s degree

§ 4.6.11.5: Corrected that day services family child care centers providers may be either agency or individual providers

§4.6.16.1: Removed allowance to use grief and bereavement counseling service in case of unexpected participant death

§ 4.6.17.1: Clarification of allowance for health and wellness service coverage of family fitness and health club memberships

§ 4.6.18.4: Clarification related to home modifications that add square footage to a home

§ 4.6.32.3: Clarification of virtual equipment and supports service limitation related to ongoing service charges for a device covered under the service or to virtual equipment and supports-related subscriptions

Chapter 5–Use of Funding in Substitute Care

No changes

Chapter 6–Enrollment and Recertification

 § 6.1.1.1: Clarification for requirements for initial home visits, in cases when it is not in the best interest of a participant for their parent to attend the meeting or when their parent or legal guardian is not able to attend the meeting

Chapter 7–Individual Service Plan

§ 7.1.1: Added Deciding Together resource (P-02246C)

§ 7.3: Clarification for requirements for service planning assessment meetings, in cases when it is not in the best interest of a participant for their parent to attend the meeting or when their parent or legal guardian is not able to attend the meeting

§ 7.5: Clarification for requirements for in-person ISP review meetings in the participant’s home, in cases when it is not in the best interest of a participant for their parent to attend the meeting or when their parent or legal guardian is not able to attend the meeting

Chapter 8–Participant Rights and Appeal and Grievance Processes

§ 8.3.1.1: Added compulsion order for parental payment (refer to § 3.4) as an action subject to appeal

§ 8.3.2: Added requirement for CWAs to have a written grievance procedure for actions related to parental payment liability determination, billing, and collections

Chapter 9–Health and Safety

§ 9.4.6: Added requirement related to documenting use of unapproved restrictive measures in incident reports

Chapter 10–Transition

No changes

Appendix A

Added

Last revised October 20, 2022