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2011-2013 MEDICAID EFFICIENCIES Conversion of 1915(i) Home and Community Based Services to 1937 Benchmark Alternative Benefits Plan Category: Service Delivery Ref
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orm Focus Area: Individuals with Severe and Persistent Mental Illness Projected Savings: Budget Neutral Proposed Implementation Date: 2012 Implementation Mechanism: State Plan Amendment (SPA) Description: The Department will transition the current 1915(i) Home and Community Based Services for individuals with severe and persistent mental illness to a 1937 Benchmark Alternative Benefits Plan. o o o o Currently, Wisconsin counties have the ability to claim federal dollars for individuals with severe and persistent mental illness through the state's 1915(i) Home and Community Services State Plan benefit. There are 154 people who currently receive services under the 1915(i) benefit. An example of services provided include the following psycho-social rehabilitative services: o Community living supportive services which lead to independent living and recovery o Peer specialist supports o Supported employment The Centers for Medicare and Medicaid Services (CMS) under the Patient Protection and Affordable Care Act (PPACA) changed regulations related to 1915(i) Home and Community Based Services to require the program to be statewide with no limit on who can access these services. This change prohibits the state from maintaining the programs' current geographical footprint, and leaves the state and counties with the choice of either statewide implementation or no implementation. Due to budget restraints at both the state and county level, full expansion is not feasible. However, by converting the benefit to a 1937 Benchmark Alternative Benefits plan, the state and counties can continue to provide services in the current geographical areas that have willing and engaged providers. Effect of this change: o o o The change to a 1937 Benchmark Alternative Benefits plan will allow the state and selected counties to continue to provide services to individuals with severe and persistent mental illness and will allow for expansion as finances allow. This proposal is part of the Department's efforts to improve community based mental health services and treatments while maintaining fiscal stability. A key part of this proposal is the use of peer specialist supports. Working in collaboration with stakeholders, the Department continues to look for ways to expand the use of these services. The 1937 Benchmark Alternative Benefits plan includes these supports. 12584
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