Is it possible to add the specific language to the CCC Plus waiver manual, Chapter 4, which was provided by the cccpluswaiver@dmas.virginia.gov email address to the section on initial assessments by the agency RN  (starting on page 10)?

The specific language is:

“The assessment by the RN must be done in the home.  The RN need to access the surroundings and since they will be receiving care in the home, this is where the assessment need to be done.  RN need to assess what the member need in the home and complete the plan of care based on needs of member in the home.”

Currently there is no specific requirement that the initial agency (RN) assessment be done in the home. Thank you for your consideration.

In the CCC Plus waiver manual, Chapter 4, starting on page 6, is it possible to specifically list which procedure codes and descriptions to which the patient pay should be applied?  The patient pay section does not specifically state which procedure codes or descriptions. A chart listing only the codes / descriptions to which patient pay can be applied would  be very helpful.

Thank you for your consideration.

May the CCC Plus waiver manual, Chapter 4, the bottom of page 7, the paragraph titled Nursing Facility or Inpatient Rehabilitation hospital admission be reviewed?  If Inpatient Rehabilitation hospital refers to Acute Inpatient Rehabilitation and not SNF, then this paragraph may need to be updated.  Inpatient Rehabilitation hospital is not a LOC in the DMAS portal and does not require a MLTSS screening and therefore the CCC Plus waiver is not ended upon admission to the Inpatient Rehabilitation hospital.  The member retains their CCC Plus waiver while in this facility so a DMAS 225 for discharge from the CCC Plus waiver is not sent to LDSS.  

Is it possible to specify that Inpatient Rehabilitation hospital  refers to Acute Inpatient Rehabilitation and not SNF?

Outside of the COVID flexibilities a DMAS 225 is sent to LDSS when an individual with the CCC Plus waiver has experienced more than 30 consecutive days without LTSS, which may occur if the member is admitted to a hospital and / or  Inpatient Rehabilitation hospital for more than 30 consecutive days.   If the individual retains Medicaid eligibility, they also retain the CCC Plus waiver.

The CCC Plus waiver is ended upon SNF admission as SNF is a LOC in the portal and requires a MLTSS screening (outside of the COVID flexibilities). A DMAS 225 is sent to LDSS for SNF admissions and discharges. 

Thank you for your consideration.

Add language that describes what should happen when a private duty nursing agency is unable to staff all of the hours needed for the individual at the time of referral.

• TITLE Commonwealth Coordinated Care (CCC) Plus Waiver Member Assessment:

  • This only lists the “CCC+ Waiver.”  What about services under DD Waivers/EPSDT?  Will they use the same form?  If not, what form will be used.  If they will use the same form, then continue using the original title of “Community-Based Care Assessment” so that the form can be used for all waiver types and not cause administrative problems.

  • Please consider providing updated provider training explaining how best to use the finalized form.

  • SUGGESTION:  Create a form for CD services and a form for AD services.  Also create forms for Waiver type/program.

• SUPPORT SYSTEM (pg3)

  • Waiver Services (top of pg):  Add CD Companion Care as a service

  • PERS/SUPERVISION: PERS and Supervision are not interchangeable; one does not replace the other.  Please separate this section into 2: one for PERS, one for Supervision, one for medication monitoring.  There is no instruction for the PERS section on the form in the CD instructions.  It is only listed under AD instructions

• SF/RN/LPN SUPERVISION (pg 3-4)

  • “Does the aide document accurately the care provided? Yes No”

    • Is this only for AD?  If not, please include Attendant, and provide information as to what form a CD attendant needs use to document

  • "Does the Service Plan reflect the needs of the recipient member? Yes/No"

    • rephrase: Does the Service Plan MEET the needs of the member? Yes No

• The revision dates at the bottom of page 1 and page 4 are inconsistent with each other and current date.  Please modify for consistency and accuracy.

Pg 17 - Management Training (S5116)

• Rephrase include “... program rules and changes.”

Pg 88-89 - Disenrollment

• Please clarify and specify with examples:

  • “The waiver individual has medication or skilled nursing needs or has medical or behavioral conditions that cannot be met through CD services or other services;

Pg 91 - Transitions 

• Will the SF receive the ISP prior to the waiver start date?

  • Request that the requirement be spelled out that the SC will make the ISP available to  SF provider within X business days of the waiver start date

• When can the SF expect to receive info/contact that a slot was awarded?

  • Request that the requirement be spelled out

• “The CCC Plus Waiver service authorization will automatically end based on the effective date of the DD Waiver enrollment.”

  • This is problematic

  • SFs have to submit discharge paperwork

  • Additionally, Fiscal Agent changes may occur which would cause a significant impact to services for the member if authorizations are automatically ended.

• Specificity required for Continuity of Care

  • Effective when?  From the start date of the waiver or the date the WASC team awards slot?

• What will be the result of the delay by the SC in getting the Part III of the ISP to the SF?