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hcbs

The Office of Long-Term Living (OLTL) has announced changes that are being made to the enrollment process for Home and Community-based Services (HCBS), including the Aging Waiver, Attendance Care Waiver, CommCare Waiver, Independence Waiver, OBRA Waiver, and Act 150 Program. Effective Tuesday, March 1, 2016, OLTL will enter into a new contract with MAXIMUS, the PA Independent Enrollment Broker (IEB). According to OLTL, the adjustments being made and expectations regarding this new contract will streamline the enrollment process, as well as ensure consistency across all home and community-based programs, in anticipation of the roll-out of Community HealthChoices (CHC), a Managed Long-Term Services and Supports program for older Pennsylvanians and adults with physical disabilities. CHC will move the Commonwealth’s home and community-based waiver system from fee-for service to a capitated Medicaid managed long-term services and supports delivery system. The changes OLTL is making to the enrollment process support the Commonwealth’s efforts to ensure that the enrollment process is conflict free, strengthening necessary firewalls between enrollment in services and the provision of ongoing service coordination and other services.

Changes made to improve the IEB process:

  • The enrollment timeframe requirement has been reduced from 90 days to 60 days. This change is effective March 1, 2016.
  • The IEB will assume the Aging Waiver enrollment process effective April 1, 2016.
  • Enrollments that are already in process before April 1 will remain the responsibility of the Area Agency on Aging. Aging Waiver applications initiated prior to April 1 must be completed by the AAA prior to June 30. Applications still pending on June 30 will revert to Maximus for completion. OLTL will provide additional information on this process in an upcoming webinar.
  • These changes, which affect all OLTL Home- and Community-Based Programs – Aging, Attendant Care, CommCare, Independence, OBRA and the Act 150 program administered through the Office of Long-Term Living – will be completed by the PA Independent Enrollment Broker (IEB), Maximus.

The tasks completed by the IEB (Maximus) include the following:

  • Coordinate with the County Assistance Office to ensure timely completion of the PA 600L Medical Assistance Applications.
  • Coordinate with the Area Agency on Aging to ensure timely completion of the Clinical Eligibility Determination (formerly known as the Level of Care Determination). Complete in-home visit with applicant to gather information for enrollment.
  • Complete the Program Eligibility Determination.
  • Provide applicant with choice of Service Coordination provider.
  • Enroll applicant in waiver upon receipt of PA 162.
  • Transfer record and enrollment documentation to the selected Service Coordination agency.

If you have any questions, please contact Amy High, Office of Long-Term Living, Bureau of Participant Operations, at 717-787-8091.