Medical - Kansas Economic and Employment Services Manual

8217  Autism Waiver (HCBS/AU) - This waiver serves children under the age of 6 years old who are determined to meet functional eligibility criteria of an Autism Spectrum Disorder (ASD) and would otherwise be at risk of placement in a state mental health hospital. Participation under this waiver shall be limited to a maximum of three years. A one year extension may be approved by the Autism Review team if the child has demonstrated continued improvement.

Individuals seeking coverage under this waiver will file a preliminary functional eligibility application with the waiver program manager. A limited number of children will be served under this waiver. Those children qualifying for an opening will be referred by the program manager for a screening assessment. A wait list (proposed recipient list) will be maintained for those requesting services when no openings exist.

Functional Eligibility Specialists contracted across the state will complete the screening assessments for the waiver. The families of children who meet the clinical autism eligibility criteria will be offered a choice between state mental health hospitalization and HCBS services. If HCBS services are chosen, the family must file an application for medical assistance with eligibility staff.  Once eligibility has been approved by eligibility staff, the Managed Care Organization (MCO) identified on the HCBS choice form will be notified. Autism Specialists will be responsible for developing and maintaining an Individual Behavioral Program/Plan of Care (IBP/POC) including the cost of services to meet the child's and family's needs. HCBS/Autism services may not start until the IBP/POC is authorized by the MCO.

NOTE: Children who are eligible under the waiver and have received SSI benefits in an institutional setting are potentially eligible for a $30/month SSI benefit as though they were institutionalized. The family is to be referred to Social Security if the child meets all waiver criteria and will be Medicaid eligible.

8218 Money Follows the Person (MFP) – Money Follows the Person is a five year demonstration grant program serving individuals transitioning from a nursing facility or an ICF-IID facility to community based care. Individuals must be eligible for Medicaid and otherwise eligible for one of the following HCBS waivers if not for eligibility under MFP: Frail Elderly (HCBS/FE), Physical Disability (HCBS/PD), Intellectual and Developmental Disability (HCBS/I/DD), or Traumatic Brain Injury (HCBS/TBI).

The individual must have received Medicaid for 30 days and been residing in a nursing facility or ICF-IID for 90 days prior to approval under this program. There is no retroactive eligibility for MFP and an individual will be allowed a total of 365 days in the program. Those days need not be consecutive but must begin prior to the end of the five year demonstration grant period. The MFP Program Manager will be responsible for tracking the 365 days.

There is no waiting period for an individual initially qualifying for MFP who leaves the program and later requests services again. An individual receiving coverage under MFP will be enrolled in an existing HCBS waiver that will continue to provide community services once the MFP coverage has been exhausted.

MFP will provide enhanced community services to help make it possible for the individual to return to the community. These enhanced services include funds for utility deposits and reasonable expenses to establish a residence such as dishes, basic furniture and linen as well as life-line and other personal security measures. These funds will be issued directly to the individual via a debit card. The funds are considered a medical reimbursement and are exempt as income and a resource for all programs (see 6410).

Screening and assessments for this program will be conducted by the gateway agencies that currently serve each of the MFP populations.  Individuals potentially eligible for MFP will be targeted and informed about the program. MFP/HCBS care coordinators will notify eligibility staff of eligible individuals via the ES-3160.

Ongoing case management will also be provided by the care coordinator.  Eligibility staff are responsible for informing the case manager concerning the Medicaid eligibility decision, the amount of any client obligation, and any changes in obligation or eligibility. The care coordinator is responsible for providing information to eligibility staff concerning the plan of care, the cost of the care, and any changes in that care or in the client’s living arrangement. The ES-3160/3161 forms shall be used for these purposes.