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HCBS Waiver Amendments

HCBS Waiver Amendment Summary

Waiver Amendment Drafts Submitted March 14, 2014

Healthy Connections Prime will integrate all care (primary care, long-term care, and behavioral health) for persons age 65 and older who have both Medicaid and Medicare. The purpose of the Prime program is to improve coordination and align these two complex federal programs, achieving better outcomes and quality of care.

Participants of three existing Community Long Term Care (CLTC) waiver programs will be able to join Healthy Connections Prime if they meet other eligibility requirements.  However, the current waiver documents for those three programs were written without Healthy Connections Prime in mind.  In order for eligible members to have access to the new program, SCDHHS had to make changes by filing waiver amendments with the Centers for Medicare and Medicaid Services (CMS). 

The three waivers with proposed amendments are:

  1. Community Choices Waiver (for elderly adults and people with disabilities)
  2. HIV/AIDS Waiver
  3. Mechanical Ventilator Dependent Waiver

Each of these waivers is a lengthy document that is negotiated between the state and CMS, following a preprint format.  The waivers set forth how the program will be operated. To date, leading up to Healthy Connections Prime, our waivers have not been included in any form of coordinated care.

As we look at bringing these critical services into coordinated care, we will need to spell out in each waiver document how key activities will change if members join the Prime program.  However, we are making as few changes to the waivers as possible as we establish this new program.

It is important to note that participation in Prime is voluntary; therefore, we expect that some persons will choose not to participate.  Others, under the age of 65 in these waivers, will not meet the age requirements for Prime.  SCDHHS, through CLTC, will continue its current waiver operations and oversight for those individuals.

HCBS Waiver Amendment Documents

Waiver Amendment Summary | PDF

HIV/AIDS Waiver Amendment | PDF

HIV/AIDS Waiver Amendment Approval Letter | PDF

Community Choices Waiver Amendment | PDF

Community Choices Waiver Amendment Approval Letter | PDF

Mechanical Ventilator Dependent Waiver Amendment | PDF

Mechanical Ventilator Dependent Wavier Amendment Approval Letter | PDF

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