Medicaid Waiver Applications

Overview

Notice of Intent to Submit Amendments to the Comprehensive Supports Medicaid Waiver, Individual and Family Support Medicaid Waiver, and Employment and Day Supports Medicaid Waiver

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (DSS) intends to submit various amendments to the Centers for Medicare and Medicaid Services (“CMS”) related to the following 1915(c) home and community-based services waivers operated by the Department of Developmental Services (DDS) and hereinafter collectively referred to as “the DDS Medicaid waivers:”

Comprehensive Supports Medicaid waiver
Individual and Family Support Medicaid waiver
Employment and Day Supports Medicaid waiver

The intent of these amendments is to comply with section 60 of Public Act 23-137. This legislation requires the Commissioner of Social Services, in consultation with the Commissioner of Developmental Services, to authorize, subject to the approval of CMS, compensation for parents of school age children and legal guardians providing personal care assistance services on the DDS Medicaid waivers. For the purposes of this legislation, family caregiver is defined as a caregiver related by blood, marriage or a legal guardian of a participant in a DDS Medicaid waiver program.

The DDS Medicaid waivers currently provide the flexibility to compensate family caregivers, except for when the family caregiver is: the employer of record; a parent of a school age child; or a legal guardian. The proposed waiver amendments will extend compensation to parents of school-age children and legal guardians under certain criteria.

The following services on the DDS Medicaid waivers have a personal care assistance component and will be amended to allow for compensation for parents of school-age children and legal guardians:

Individualized Home Support (IHS
Respite
Individualized Day Supports
Personal Supports
Senior Supports

Additional criteria proposed in these waiver amendments, which must be met as part of the process to approve compensation for parents of school-age children and legal guardians, include:

Requiring an assessment to determine age-appropriate dependency demonstrating a need for “extraordinary care,” as required by CMS for compensation of parents of school-age children;
Limitations on hours of support that can be provided on an annual basis, with the ability to request exceptions;
Prohibiting employers of record from providing any other supports outside of their role as employer of record. This includes being compensated for personal care services as a parent of a school age child or legal guardian;
Ensuring that the provision of services is in the best interest of the waiver participant, as required by CMS.

For a copy of the Notice of Intent, please follow this link

For a copy of the full waiver application for the amendment of the Comprehensive Supports Medicaid waiver, please follow this link

For a copy of the full waiver application for the amendment of the Individual and Family Support Medicaid waiver, please follow this link

For a copy of the full waiver application for the amendment of the Employment and Day Supports Medicaid waiver, please follow this link

All written comments regarding these applications must be submitted by November 30, 2023 to: Krista Ostaszewski, Health Management Administrator, DDS Central Office, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Krista.Ostaszewski@ct.gov.

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Notice of Intent to Submit Amendments to the Comprehensive Supports Medicaid Waiver, Individual and Family Support Medicaid Waiver, and Employment and Day Supports Medicaid Waiver

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (“DSS” or the “Department”) intends to submit various amendments to the Centers for Medicare and Medicaid Services (“CMS”) related to the following 1915(c) home and community-based services waivers operated by the Department of Developmental Services (DDS):

Comprehensive Supports Medicaid waiver
Individual and Family Support Medicaid waiver
Employment and Day Supports Medicaid waiver

The intent of these amendments is to transfer the temporary authority of already approved Appendix K provisions to the permanent authorities under the aforementioned Medicaid waivers. All provisions were previously approved by the Connecticut General Assembly and pending approval by CMS.

Appendix K provisions are temporary and expire six months following the expiration of the federal public health emergency related to the continued consequences of the Coronavirus Disease (COVID-19) pandemic, November 2023.

The provisions must be amended into the permanent Medicaid waivers to ensure the ability to execute section 9817 of the American Rescue Plan Act (ARPA) throughout the ARPA period until March 2025.

A summary of the provisions include the following:

Stabilization payments for qualified provider types;
Payments for qualified provider types to modernize billing processes and systems;
Incentive-based outcome payments to any qualified day provider covered under the specific waivers that submits a transition plan that is approved by DDS;
Incentive-based outcome payments to any qualified residential or day provider covered under the specific waivers that transitions a waiver participant from a congregate residential setting toward a more integrated community-based setting or a waiver participant from a congregate day setting toward a more community-based employment setting, as identified in the approved transition plan;
Incentive-based outcome payments to any qualified residential or day provider covered under the specific waivers that completes one of the objectives listed in the application, as part of the approved transition plan to the satisfaction of DDS;
An incentive payment for any DDS qualified provider that completes the National Core Indicator IDD State of the Workforce Survey;
An incentive payment for any DDS qualified provider for each job coach or job developer that completes training expectations consistent with professional standards from accepted accreditation or certification entities such as the Association of People Supporting Employment First (APSE), Association of Community Rehabilitation Educators (ACRE), or other similarly recognized organizations;
An incentive payment for any DDS qualified provider that has one or more of their staff complete training certification expectations consistent with Technology First SHIFT LLC, Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) Assistive Technology professional, or other similarly recognized organizations that focus on utilization of assistive technology;
Temporary enhanced rate/rate increases for specific employment and residential waiver service authorizations covered under the specific waivers.

For a copy of the Notice of Intent summarizing the proposed changes, please follow this link.

For a copy of the full waiver Application for the amendment of the Comprehensive Supports Waiver, please follow this link.

For a copy of the full waiver Application for the amendment of the Individual and Family Support Waiver, please follow this link.

For a copy of the full waiver Application for the amendment of the Employment and Day Supports Waiver, please follow this link.

All written comments regarding these applications must be submitted by July 13, 2023 to: Krista Ostaszewski, Health Management Administrator, DDS Central Office, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Krista.Ostaszewski@ct.gov.

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Notice of Intent to Amend the Following 1915(c) Home and Community-Based Services Medicaid Waivers: Home and Community Based Services Waiver for Elders; Personal Care Assistance Waiver; Acquired Brain Injury Waiver; Acquired Brain Injury Waiver II; Home and Community Supports Waiver for Persons with Autism; Mental Health Waiver; Katie Beckett Waiver

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (“DSS” or the “Department”) intends to submit amendments to the Centers for Medicare & Medicaid Services (“CMS”) for seven of the Department’s 1915(c) home and community-based services (HCBS) Medicaid waivers. To the extent necessary, DSS will amend the Medicaid State Plan for the section 1915(i) portion of the Connecticut Home Care Program for Elders (CHCPE) to align with the provisions of the section 1915(c) CHCPE waiver.

In addition to proposing certain new provisions, the Department is also proposing to transfer the temporary authority of certain previously approved Emergency Preparedness and Response Amendment (“Appendix K amendment”) provisions to permanent authorities under the aforementioned Medicaid waivers. Permanent authority for these previously approved Appendix K provisions is necessary because Appendix K amendments are temporary authorities and expire on November 11, 2023, six months following the expiration of the federal public health emergency related to the consequences of the Coronavirus Disease (COVID-19) pandemic. In addition, the existing temporary authority in the Appendix K amendments must be transferred to permanent authority to ensure the Department’s ability to execute the state’s approved Spending Plan for Implementation of the American Rescue Plan Act of 2021, Section 9817, as updated (ARPA HCBS Spending Plan) throughout the ARPA period, which concludes in March 2025.

The following is a summary of the proposed changes, as more fully described in the Notice of Intent and the applications for amendments to each waiver.

The Department is proposing to transfer its authority, which currently exists only under the temporary Appendix K amendment provisions, to the base waivers in order to continue previously approved rate increases and supplemental payments to enhance, expand, and/or strengthen HCBS.

These previously approved rate increases and supplemental payments are implemented in accordance with the state’s ARPA HCBS Spending Plan, would expire on November 11, 2023 unless added to the base waiver documents, and apply to providers of certain services in the following 1915(c) HCBS Medicaid waivers:

Home and Community Based Services Waiver for Elders
Personal Care Assistance Waiver
Acquired Brain Injury Waiver
Acquired Brain Injury Waiver II
Home and Community Supports Waiver for Persons with Autism
Mental Health Waiver
Katie Beckett Waiver

II. The Department is proposing to transfer its authority, from expiring temporary Appendix K authority to permanent authority in the base waivers, for the modification of certain services in the following 1915(c) HCBS Medicaid waivers:

Home and Community Based Services Waiver for Elders
Personal Care Assistance Waiver
Acquired Brain Injury Waiver
Acquired Brain Injury Waiver II
Home and Community Supports Waiver for Persons with Autism

These previously approved (with the exception of Remote Services in E. below) service changes, as more fully described in the Amendment application, include the following:

A. Expanding the definition of assistive technology to reference remote equipment and associated requirements for internet access.

B. Addition of a new service titled “Training and Counseling Services for Unpaid Caregivers Supporting Participants” for all waivers referenced above.

c. Addition of a new service titled “Participant Training and Engagement to Support Goal Attainment and Independence.”

D. Amending the definition of “Environmental Adaptations” service and adding it as a new service where applicable.

E. Addition of Remote Support as a new service (Request for temporary Appendix K authority is still under final review by CMS).

III. The Department is proposing to modify its authority, from expiring temporary Appendix K authority to permanent authority in the base waivers, as follows:

A. For the ABI and ABI II waivers, the Department is proposing to modify its expiring temporary authority from allowing virtual assessments and reassessments into permanent authority to allow such virtual assessments and reassessments, when clinically appropriate and with consent of the participant, in instances of: contagious illness, or recovery from such illness; exacerbation of a chronic condition; or inclement weather.

B. For the Home and Community Based Services Waiver for Elders, the Department is proposing to modify its expiring temporary authority that permits:

Mental health counseling to be provided virtually or telephonically into permanent authority to provide such counseling virtually, but not telephonically.
Adult day programs to provide virtual services via video communication, including virtual assessments, and at least two meals per day, into permanent authority to allow Remote Services (virtual support) when a client is unable to attend the center in person. The absence may be due to symptoms of contagious illness; injury, illness or recovery from such; exacerbation of a chronic condition; or inclement weather. The adult day center must, at a minimum, provide a documented wellness call, and delivery of two meals per day.

IV. The Department is proposing the following new amendments to certain HCBS waivers:

A. Amending the PCA waiver to add Meals on Wheels as a covered service.

B. Amending the ABI and ABI II waivers to add Licensed Clinical Social Worker (LCSW) as an approved provider type under the Cognitive Behavioral Programs service.

C. In consultation with the Department of Mental Health and Addiction Services (DMHAS), amending the Mental Health waiver as follows:

Adding residential care homes (RCHs) as an approved setting;
Adding Licensed Master Social Worker (LMSW), Licensed Professional Counselor Associate (LPCA) and Licensed Marriage and Family Therapist (LMFT) as authorized provider types under Mental Health Counseling; and
Waiving the face-to-face requirement for Community Support Program, Recovery Assistant, Peer Supports, and Mental Health Counseling services in situations where it is temporarily unsafe to enter the home (i.e., contagious illness, infestation, etc.).

D. Amending all waivers to update the description of how residential and non-residential settings in the waivers comply with federal home and community-based settings requirements, in accordance with guidance from CMS.

For a copy of the Notice of Intent summarizing the proposed changes, please follow this link.

For a copy of the full waiver Application for the amendment of the Home and Community Based Services Waiver for Elders, please follow this link.

For a copy of the full waiver Application for the amendment of the Personal Care Assistance Waiver, please follow this link.

For a copy of the full waiver Application for the amendment of the Acquired Brain Injury Waiver, please follow this link.

For a copy of the full waiver Application for the amendment of the Acquired Brain Injury Waiver II, please follow this link.

For a copy of the full waiver Application for the amendment of the Home and Community Supports Waiver for Persons with Autism, please follow this link.

For a copy of the full waiver Application for the amendment of the Mental Health Waiver, please follow this link.

For a copy of the full waiver Application for the amendment of the Katie Beckett Waiver, please follow this link.

Any written comments must be submitted by July 13, 2023 to the Department of Social Services, Community Options Unit, 55 Farmington Ave, Hartford, CT 06105, Attention: Amy Dumont, Interim Director; or via email to Amy.Dumont@ct.gov.

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Notice of Intent to Renew the Comprehensive Supports Medicaid Waiver

In accordance with the provisions of section 17b-8(c) of the Connecticut General Statutes, notice is hereby given that the Commissioner of Social Services intends to submit an application to the Centers for Medicare and Medicaid Services (“CMS”) to renew the Medicaid Waiver for Comprehensive Supports, effective October 1, 2023. The waiver is operated by the Department of Developmental Services.

There are no changes, other than those related to routine operational issues, proposed in this waiver renewal.

All written comments regarding this application must be submitted by April 27, 2023 to: Krista Ostaszewski, Health Management Administrator, DDS Central Office, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Krista.Ostaszewski@ct.gov.

For a copy of the Notice of Intent, please follow this link

For a copy of the full application to renew the Comprehensive Supports Medicaid Waiver, please follow this link

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Notice of Intent to Submit Emergency Preparedness and Response Amendment (Appendix K) to the Comprehensive Supports Medicaid Waiver, Individual and Family Support Medicaid Waiver, and Employment and Day Supports Medicaid Waiver

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (“DSS” or the “Department”) intends to submit an Emergency Preparedness and Response Amendment (“Appendix K amendment”) to the Centers for Medicare and Medicaid Services (“CMS”) related to the following 1915(c) home and community-based services waivers operated by the Department of Developmental Services (DDS):

Comprehensive Supports Medicaid waiver
Individual and Family Support Medicaid waiver
Employment and Day Supports Medicaid waiver

This Appendix K is additive to the previously approved Appendix Ks and modifies the language in the Appendix K approved March 17, 2022.

For a copy of the Notice of Intent summarizing the proposed changes, please follow this link

For a copy of the complete Appendix K amendment, please follow this link

Any written comments must be submitted by April 13, 2023 to: Krista Ostaszewski, Health Management Administrator, DDS Central Office, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Krista.Ostaszewski@ct.gov.

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Notice of Intent to Submit Emergency Preparedness and Response Amendments (Appendix K) to 1915(c) Home and Community-Based Medicaid Waivers

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (“DSS” or the “Department”) intends to submit two Emergency Preparedness and Response Amendments (“Appendix K amendments”) related to certain of the Department’s 1915(c) home and community-based services (HCBS) Medicaid waivers.

The Appendix K amendments are temporary and expire six months following the expiration of the Federal public health emergency related to the continued consequences of the Coronavirus Disease (COVID-19) pandemic. The amendments are additive to the previously approved Appendix Ks.

For a copy of the Notice of Intent summarizing the proposed changes, please follow this link.

For a copy of the complete Appendix K amendment proposing temporary increases in provider payment rates for the following 1915(c) HCBS Medicaid waivers, please follow this link:

Home and Community Based Services Waiver for Elders
Personal Care Assistance Waiver
Acquired Brain Injury Waiver
Acquired Brain Injury Waiver II
Home and Community Supports Waiver for Persons with Autism
Mental Health Waiver
Katie Beckett Waiver

For a copy of the complete Appendix K amendment proposing other changes in the following 1915(c) HCBS Medicaid waivers, please follow this link:

Home and Community Based Services Waiver for Elders
Personal Care Assistance Waiver
Acquired Brain Injury Waiver
Acquired Brain Injury Waiver II
Home and Community Supports Waiver for Persons with Autism

Any written comments must be submitted by January 27, 2023 to the Department of Social Services, Community Options Unit, 55 Farmington Ave, Hartford, CT 06105, Attention: Jennifer Cavallaro, Director; or via email to Jennifer.Cavallaro@ct.gov.

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Notice of Intent to Renew the DDS Individual and Family Support Medicaid Waiver and Amend the Employment and Day Supports & Comprehensive Medicaid Waivers

In accordance with the provisions of section 17b-8(c) of the Connecticut General Statutes, notice is hereby given that the Commissioner of Social Services intends to submit the following three applications to the Centers for Medicare and Medicaid Services (“CMS”), each to be effective February 1, 2023:

Renewal of the Medicaid Waiver for Individual and Family Support;
Amend the Medicaid Waiver for Employment and Day Supports; and
Amend the Medicaid Waiver for Comprehensive Supports

All of the above-referenced waivers are operated by the Department of Developmental Services. Substantive proposed changes are outlined in the Notice of Intent linked below.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full waiver Application for the renewal of the Individual and Family Support Waiver, please follow this link.

For a copy of the full waiver Application for the amendment of the Employment and Day Supports Waiver, please follow this link.

For a copy of the full waiver Application for the amendment of the Comprehensive Supports Waiver, please follow this link.

All written comments regarding these applications must be submitted by September 29, 2022 to: Krista Ostaszewski, Health Management Administrator, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Krista.Ostaszewski@ct.gov.

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Notice of Intent to Renew and Amend the Home and Community Supports Waiver for Persons with Autism (“Autism Waiver”)

In accordance with the provisions of section 17b-8(c) of the Connecticut General Statutes, notice is hereby given that the Commissioner of Social Services intends to submit a renewal of the Home and Community Supports Waiver for Persons with Autism (commonly referred to as the “Autism Waiver”) to the Centers for Medicare and Medicaid Services (“CMS”), to be effective January 1, 2023.

The Department of Social Services is proposing the following changes upon renewal:

Adding Nutrition as a service. The service includes the clinical assessment and development of special diets; positioning techniques for eating; recommendations for adaptive equipment for eating and counseling for dietary needs related to medical diagnosis for participants; and training for paid support staff to ensure compliance with the participant's dietary needs. These services are not covered in the Medicaid State Plan.
Adjusting the maximum total number of participants. The waiver was expanded legislatively to add 50 slots beginning July 1, 2021, and an additional 150 slots beginning July 1, 2022.
Amending the service definitions of social skills groups, life skills coach and clinical behavioral support services to permit these services to be provided by alternate means beyond face-to-face, including virtually. The alternate means of service delivery is currently permitted for life skills coaching services on a temporary basis pursuant to an Appendix K Emergency Preparedness and Response Amendment, however such authority will expire six months after the end of the COVID-19 public health emergency.
Amending the qualifications for individual and agency providers of life skills coaching. The amendment removes the requirements that providers must have a bachelor’s degree and pass competency tests for Autism Program Orientation Training Level I and II within three months of working with an individual. The qualifications have been updated to include the requirement that providers have a high school diploma or equivalent and have experience with those on the autism spectrum.
Technical updates.

All written comments regarding this renewal application must be submitted by August 25, 2022, to: Department of Social Services, Community Options Unit, 55 Farmington Ave, Hartford, CT 06105, Attention: Jennifer Cavallaro, Director; or via email to Jennifer.Cavallaro@ct.gov.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full Application to Renew the Autism Waiver, please follow this link.

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In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (“DSS” or the “Department”) intends to submit an Emergency Preparedness and Response Amendment (“Appendix K amendment”) to the Centers for Medicare and Medicaid Services (“CMS”) related to the following 1915(c) home and community-based services waivers operated by the Department of Developmental Services (DDS):

Comprehensive Supports Medicaid waiver
Individual and Family Support Medicaid waiver
Employment and Day Supports Medicaid waiver

Appendix K amendments are temporary and expire six months following the expiration of the federal public health emergency related to the continued consequences of the Coronavirus Disease (COVID-19) pandemic. The following is a summary of the proposed changes, as more fully described in the Appendix K amendments:

As permitted by Section 2 of CMS State Medicaid Director (SMD) Letter #21-003, DDS is proposing to permit an additional three 30-day periods of provider retainer payments, retroactive to January 2021, for all habilitation programs (both residential and day supports) that include personal care to ensure continuous operations and sustainability of waiver services. Each episode of retainer payments may not exceed 30 consecutive days. DDS is choosing to utilize multiple 30-day retainer payment periods with a limit of three. These three 30-day periods are in addition to the initial three 30-day retainer payment periods contained in the Appendix K amendments to these waivers approved by CMS on November 5, 2020 (CMS Amendment Control Numbers CT.0426.R03.05, CT.0437.R03.04 and CT.0881.R01.05).
Stabilization payments to certain qualified provider types covered under the waivers listed in this Appendix K. Rate methodology would be increased proportionally by stabilization funds during the approved rate setting process. The intent of the payments is to assist qualified providers impacted by the pandemic, as well as to assist with recruitment and retention of provider staff.Incentive-based outcome payments to any qualified residential provider covered under the waivers listed in this Appendix K that transitions a waiver participant from a congregate residential setting toward a more integrated community-based setting.
Temporary rate increases for specific employment and residential waiver service authorizations covered under the waivers listed in this Appendix K that move a waiver participant toward a more independent residential setting or toward competitively-based employment.
Temporary rate increases for qualified residential and day provider types covered under the waivers listed in this Appendix K to allow such providers to modernize technology-based infrastructure, including billing processes and systems.
Temporary increase in the service amount cap for the Assistive Technology service covered under the waivers in this Appendix K from $15,000 to $30,000.

For a copy of the Notice of Intent summarizing the proposed changes, please follow this link.

For a copy of the complete Appendix K amendments, please follow the following links - Appendix K rate increases and AT and Appendix K retainer payments.

All written comments regarding these applications must be submitted by February 17, 2022 to: Krista Ostaszewski, Health Management Administrator, DDS Central Office, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Krista.Ostaszewski@ct.gov.

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Notice of Intent to Submit Emergency Preparedness and Response Amendment (Appendix K) to 1915(c) Home and Community-Based Medicaid Waivers

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (“DSS” or the “Department”) intends to submit an Emergency Preparedness and Response Amendment (“Appendix K amendment”) related to the following 1915(c) Home and Community-Based Medicaid Waivers:

Connecticut Home Care Program for Elders
Personal Care Assistance Waiver
Acquired Brain Injury Waiver
Home & Community Supports Waiver for Persons with Autism
Acquired Brain Injury Waiver II
Mental Health Waiver
Katie Beckett Waiver

For a copy of the Notice of Intent summarizing the proposed changes, please follow this link.

For a copy of the complete Appendix K amendment, please follow this link.

Any written comments must be submitted by December 30, 2021 to the Department of Social Services, Community Options Unit, 55 Farmington Ave, Hartford, CT 06105, Attention: Jennifer Cavallaro, Director; or via email to Jennifer.Cavallaro@ct.gov.

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Notice of Intent to Renew and Amend the Mental Health Home and Community-Based Services Waiver

In accordance with the provisions of section 17b-8(c) of the Connecticut General Statutes, notice is hereby given that the Commissioner of Social Services intends to submit a renewal of the Mental Health Home and Community-Based Services Waiver to the Centers for Medicare and Medicaid Services (“CMS”), to be effective April 1, 2022.

The above-referenced waiver is operated by the Department of Mental Health and Addiction Services (DMHAS).

The Department of Social Services and DMHAS are proposing the following changes upon renewal:

Adding Interpreter Services, which would allow monolingual participants to have interpreter services more readily available during assessments and meetings.
Adding Mental Health Counseling Services, which would allow participants the choice of receiving counseling in their home environment as opposed to an office or clinic setting.
Administratively removing Group Recovery Assistant and Group Community Support Program, as the group component of these two services can now be authorized and billed using a modifier with the standard Recovery Assistant and Community Support Program codes.
Increasing the per-participant annual limit for Assistive Technology services from $1,000 to $2,000.
Reducing the number of annual Money Follows the Person reserved slots from 60 to 30 to more accurately reflect historical usage.
Technical updates, including: updating performance measures as recommended by CMS; identifying services that utilize electronic visit verification (EVV); and indicating that certain services are billed directly through the state’s Medicaid claims payment system rather than through a fiscal intermediary.

All written comments regarding this renewal application must be submitted by November 26, 2021 to: Erin Leavitt-Smith, Director Long Term Services and Supports, Mental Health Waiver Program, Department of Mental Health and Addition Services, PO Box 351, Middletown, Connecticut, 06457; or via email to Erin.Leavitt-Smith@ct.gov.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full Application to Renew and Amend theMental Health Home and Community-Based Services Waiver, please follow this link.

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Notice of Intent to Renew the Acquired Brain Injury Medicaid Waiver (ABI I)

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (DSS) intends to renew the Acquired Brain Injury Medicaid Waiver (ABI I). This waiver currently expires on December 31, 2021. There are no changes, other than those related to routine operational issues, proposed in this waiver renewal.

Any written comments regarding this waiver renewal must be submitted by August 28, 2021 to the Department of Social Services, Community Options Unit, 55 Farmington Ave, Hartford, CT 06105, Attention: Jennifer Cavallaro, Director; or via email to Jennifer.Cavallaro@ct.gov.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full Application to Renew the Acquired Brain Injury Medicaid Waiver (ABI I), please follow this link.

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Notice of Intent to Renew the Katie Beckett Medicaid Waiver

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services (DSS) intends to renew the Katie Beckett Medicaid Waiver. This waiver currently expires on December 31, 2021. There are no changes, other than those related to routine operational issues, proposed in this waiver renewal.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full Application to Renew the Katie Beckett Medicaid Waiver, please follow this link.

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Notice of Intent to Amend the Medicaid Waivers for Individual and Family Support and Comprehensive Supports

Notice is hereby given that the Commissioner of Social Services intends to submit to the Centers for Medicare and Medicaid Services (“CMS”) an amendment pertaining to routine operational issues of both the Individual and Family Supports Waiver and the Comprehensive Supports Waiver, each to be effective September 1, 2021.

The above-referenced waivers are operated by the Department of Developmental Services.

The Department of Social Services and the Department of Developmental Services are proposing to amend the performance measures in these two Medicaid Waivers to align with those already approved to take effect on April 1, 2021 in the Medicaid Waiver for Employment and Day Supports.

No current enrollees will be negatively impacted by the changes proposed in the application.

All written comments regarding these applications must be submitted by May 13, 2021 to: Krista Ostaszewski, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Krista.Ostaszewski@ct.gov.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full Application to Amend the Individual and Family Supports Waiver, please follow this link.

For a copy of the full Application to Amend the Comprehensive Supports Waiver, please follow this link.

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Notice of Intent to Renew the Employment and Day Supports Medicaid Waiver

In accordance with the provisions of section 17b-8(c) of the Connecticut General Statutes, notice is hereby given that the Commissioner of Social Services intends to renew the Employment and Day Supports Medicaid waiver to be effective April 1, 2021. This waiver is operated by the Department of Developmental Services and is designed to support individuals with intellectual disability who live with family or in their own homes and require career development, supported employment or community-based day supports, respite, and/or behavioral supports to remain in the community.

As part of the renewal application, the Department of Social Services and the Department of Developmental Services are proposing the following changes to the Employment and Day Supports Medicaid waiver:

Differentiating Transitional Employment Services from Prevocational Services in the waiver and modifying their definitions to match those used in the Individual and Family Supports and Comprehensive waivers. Prior to this renewal, Prevocational Services was incorrectly listed as an alternate service title to Transitional Employment Services, rather than as a separate service.
Modifying and aligning performance measures to ensure consistency across all Connecticut Medicaid waivers, including those revisions requested by the Centers for Medicare & Medicaid Services (“CMS”); and
Technical and administrative clarifications, including those revisions requested by CMS.

No current enrollees will be negatively impacted by the changes proposed in the application.

All written comments regarding these applications must be submitted by Friday, November 27, 2020 to: Tammy Venenga, 460 Capitol Avenue Hartford, Connecticut, 06106, or via email at Tammy.Venenga@ct.gov.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full Application to Renew the Employment and Day Supports Medicaid Waiver, please follow this link.

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Notice of Intent to Amend the Personal Care Assistant Medicaid Waiver

DSS proposes to add Personal Emergency Response Systems (PERS) and Home Delivered Meals (MOW) to the PCA waiver because these services are not currently available to individuals who opt for agency-based PCA services under the PCA waiver. These two services are currently available to persons who are self-directing their PCA Services under the 1915k state plan Community First Choice Option. By adding PERS and MOW to the PCA waiver, the services would be available to all individuals on the PCA waiver regardless of whether they choose to self-direct their PCA services or opt for agency-based PCA services.

The Department will be requesting a retroactive effective date of 10/1/19 to add these services.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full waiver Application to Amend the Personal Care Assistant Medicaid Waiver, please follow this link.

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Notice of Intent to Renew the CT Home Care Program for Elders Medicaid Waiver and the 1915(b)-4 Selective Contracting Program

In accordance with the provisions of section 17b-8 of the Connecticut General Statutes, notice is hereby given that the Commissioner of the Department of Social Services intends to renew the CT Home Care Program for Elders Medicaid Waiver and the 1915(b)-4 Selective Contracting Program effective 7/1/20. The 1915(b)-4 allows the state to select providers of care management under DSS’ Medicaid waiver programs based on a competitive procurement.

The only change proposed in this renewal is to eliminate Support and Planning Coach as a Waiver Service. The Support and Planning Coach service is available under the state’s 1915(k) Community First Choice program and is intended to assist persons in their efforts to self direct their services. Retaining the service in this waiver would be duplicative. No waiver participants will lose any services or be impacted negatively as a result of this change.

For a copy of the Notice of Intent, please follow this link.

For a copy of the full waiver Application for Renewal of the CT Home Care Program for Elders Medicaid Waiver, please follow this link.

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Addendum to CT Home Care Program for Elders Case Management Freedom of Choice Waiver

Part I: Program Overview

Tribal Consultation (continued):

After email notifications have been sent, the State determines that the tribes do not have any questions or concerns regarding the proposal if comments or questions are not received within two (2) weeks. In addition to the aforementioned notification and consultation process, the State will also arrange for a meeting or teleconference with the tribal representatives to discuss the proposed change for State Plan Amendments that may have a unique or particular impact on tribal members.

For this 1915(b)(4) waiver application, DSS emailed a “Notice of Intent to Renew the Home and Community Based Services Waiver” to the medical directors and their respective designees of both tribes on January XX, 2020. Specifically, the notice was sent to Carrie Janus and Connie Hilbert with the Mohegan Tribe and Barbara Poirer and Shanna Reels with the Mashantucket Pequot Tribal Nation. CMS was also alerted to the tribal notification. In the time since the notice was sent, DSS has not received questions or comments from either tribe on the 1915(b)(4) waiver application. Since this time period has exceeded two (2) weeks, DSS has determined that the tribes do not have any questions or concerns regarding the proposal.

For a copy of the Addendum, please follow this link.

For a copy of the Application for Renewal of the CT Home Care Program for Elders Case Management Freedom of Choice Waiver, please follow this link.

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