SB 6387 directs the secretary of DSHS to prioritize services through the developmental disability administration to Medicaid eligible clients. Services may be made available to non-Medicaid eligible clients based on available funding. Services available through the state Medicaid plan must be provided to those individuals who meet the eligibility criteria. The department shall establish and maintain a service request list database for individuals who are found to be eligible and have an assessed and unmet need for programs and services offered under a home and community-based services waiver, but the provision of a specific service would exceed the biennially budgeted capacity.
Funds are included in the bill to develop and implement a Medicaid program to replace the individual and family services program for Medicaid-eligible clients. Funds are also appropriated to increase the number of individuals served on the home and community-based services basic plus waiver program.
The bill was amended in Senate Ways and Means.
Early Learning and Human Services: As amended the bill requires the Department of Social and Health Services (DSHS) to implement a Medicaid program to replace the Individual and Family Services program by May 30, 2016, and the number of clients served in this new program must increase by at least 4,000 by 2017. It requires the DSHS to expand the Home and Community-Based Services Basic Plus waiver client caseload beginning June 30, 2015, which must be increased by at least 1,000 individuals by 2017. And finally, the bill requires the DSHS to refinance Medicaid Personal Care services under the Community First Choice Option.
Final bill: In its final form SB6387 states that DSHS must establish and maintain a service request list for individuals who are found to be eligible and have an assessed and unmet need for services offered under a home and community-based services waiver, but funding is not available to provide that service. Services must be prioritized for Medicaid-eligible clients and made available to non-Medicaid eligible clients based on available funding. DSHS must develop and implement a Medicaid program to replace the Individual and Family Services program for Medicaid-eligible clients beginning May 1, 2015. The new Medicaid program must offer services that resemble the services offered through the Individual and Family Services program. By June 30, 2017, DSHS must increase the number of clients served on the new Medicaid program by 4000. General Fund-State dollars previously provided for the Individual and Family Services program may be used to cover the costs of increasing the number of clients served.
Additionally, SB6387 directs DSHS to expand the Home and Community Based Services Basic Plus Waiver client caseload beginning June 30, 2015. By June 30, 2017, DSHS must increase the number of clients served on the Home and Community Based Services Basic Plus Waiver program by 1000. General Fund-State dollars previously provided for the Individual and Family Services may be used to cover the costs of increasing the number of clients served. DSHS must refinance Medicaid personal care services under the Community First Choice Option (CFCO). CFCO must be fully implemented no later than August 30, 2015. Stakeholders must be included in the benefit design. Without express legislative authorization, the per-capita cost of all services offered in the new CFCO benefit design must not exceed a 3 percent increase over the per-capita costs of services provided to this population prior to the refinance. For fiscal year 2015, the general fund savings achieved by implementing a Medicaid program to replace the Individual and Family Services program must be used to implement CFCO. For the 2015-17 and 2017-19 biennia, the general fund savings achieved by refinancing Medicaid personal care services under CFCO must be used to offset costs relating to the increased client caseloads, and the remaining savings must revert to the general fund.
