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Appendix AI Public Comment Matrix

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Appendix AI Public Comment Matrix 1 NOTE: Transition Plan workgroups will receive and review all public comment submissions pertaining to the workgroup’s setting type or content area. Many of the comments received are subject matters or considerations for the implementation phase of the Transition Plan versus decisions that need to be made in order to finalize the Systemic Assessment and Transition Plan. Furthermore, AHCCCS contends that it is preferable to incorporate these matters into the discussions and deliberations of the multi-stakeholder workgroups. General Reference Stakeholder Question(s)/Comment(s) AHCCCS Response Topic: AHCCCS Communication and Information Forum 18 Managed Care (AHCCCS) email address? [email protected] Organization Forum 38 Family Member May I have a copy of today’s presentation sent to me? Presentation available on the AHCCCS website (www.azahcccs.gov/hcbs). Forum 48 Managed Care How/where was this forum advertised? Was family member and agencies notified? How Please refer to the Public Comment Section of the Assessment and Transition Organization will we know as things progress throughout the years – another forum? Plan Forum 68 Non-Provider I work for the Pascua Yaqui Tribe Senior Center as an Ombudsman and I would like to Information regarding the ALTCS program can be found on the AHCCCS Organization learn more about the long term care system part. I would like more understanding about website at http://www.azahcccs.gov/applicants/application/ALTCS.aspx (Ombudsman) how it works. Forum 70 Provider Why doesn’t AHCCCS cover podiatry care anymore? AHCCCS covers podiatry care such as care provided by a physician. Services provided by a podiatrist are excluded by Arizona state law for person 21 years of age and older. Forum 84 Family Member For long term care: for people will they be able to get their teeth clean, or for anything The 1115 Waiver submission for October 2015 includes a request to CMS for a else their teeth need to be work on for every 6 months? $1000 dental benefit for ALTCS members. Forum 119 Undisclosed For long term medical care does it have Dental where they can ge their teeth check out The 1115 Waiver submission for October 2015 includes a request to CMS for a for every 6 month or some who has Diabetic where they lose their teeth because of their $1000 dental benefit for ALTCS member meds? Can I get the list for the providers for all compliants in the mail? Forum 85 Family Member What is the split (percentage) of State (Arizona) and Feds for HCBS Services? State funding 33%; Federal Funding 67% Forum 107 Family Member I am interested in knowing about of federal moneies versus state monies that support State funding 33%; Federal Funding 67% these programs. Email 78 Family Member On P. 4, AHCCCS said they sought to promote the values of choice, independence, Thank you for your comment. dignity, self-determination, and individuality for its membership. While they tried, since 2013, I do not see evidence of that. In fact I doubt if the 86% who receive HCBS services knows what self-determination is. They had something about member-directed options, but my case managers never knew what that was, even though someone sent me a letter about it. Email 98 Member My question is how do you propose utilizing Arizona first responders in regards to Thank you for the information. persons with behavioral health challenges, overall, when other States are struggling to find solutions to the growing epidemic of homelessness going into center-based employment? An article from the New York Times about what is happening in San Francisco, a sister city, for your reading pleasure: http://www.msn.com/en-us/news/us/san-francisco-firefighters-an-unintended-safety-net- for-the-homeless/ar-BBm8oUs?ocid=spartandhp 2 Topic: Scope of the HCBS Rules Forum 1 Member Is this just for residential homes? Will impact home services? The HCBS Rule applies to residential and non residential setting but does not apply to an individual’s private home. Forum 2 Non-Provider What is actually new or different in the rules? Sounds like many “bells & whistles” are Please refer to the “Assessment and Transition Plan” sections of the document. Organization not required? (Treasure House) Forum 2 Non-Provider What does “intermediate care for ID” mean? ICF/ID means Intermediate Care Facility for Individuals with Intellectual Organization Disabilities (Treasure House) Forum 4 Non-Provider Do new rules apply to privately funded programs? No. The HCBS Rule applies to programs receiving Medicaid funding for Home Organization and Community Based services (Treasure House) Forum 12 Non-Provider So excited to see the human rights, choices, and integration being enforced in all Thank you for your comment. Organization services. If you need a committee member, let me know. (Arizona Bridge to Independent Living) Forum 16 Provider What about behavioral health services funded by the RBHA (Regional Behavioral Health The HCBS Rules do not apply to RBHA funded services. Authority)? Forum 17 Educator So this change is only going to implement higher standards/rules for settings (residential Yes. This is a Federal Rule requirement applicable to all programs receiving & non-residential) after assessing current realities? Is this being implemented in other Medicaid funding for Home and Community Based services in all states. states? Forum 29 Non-Provider Are compliance with the rules just for 1115 Waivers? [Paraphrase of verbal comment] No. This is a Federal Rule requirement applicable to all programs receiving Organization Medicaid funding for Home and Community Based services in all states. (Arizona Bridge to Independent Living) Email 144 Non-Provider The final federal regulations for HCBS were published in January 2014. Despite The Federal HCBS Rule requirement is applicable to 1915 (c), (i), and (k) Organization the promulgation of regulations, AHCCCS did not publish its proposed “assessment and waivers. http://www.medicaid.gov/federal-policy-guidance/downloads/cib-01-10- (William E. Morris transition plan” until August 1, 2015. First, the timeline is seriously delayed. The plan 14.pdf Institute for Justice does not even begin work until October 2016, fully 2.5 years after the regulations and Arizona Center became effective. Our understanding is http://www.medicaid.gov/medicaid-chip-program-information/by-topics/long- for Disability Law) that no other state has proposed a schedule that extends beyond the regulatory term-services-and-supports/home-and-community-based- requirement – March 17, 2019. Arizona proposes to be 30 months late in 2021. services/downloads/final-q-and-a.pdf Significantly, the plan to identify and develop remedies for deficiencies occurs very late in this delayed process. The state offers no explanation or justification for such delayed Arizona operates solei under an 1115 waiver and received direction from CMS implementation. related to the Rule Requirement in May 2015. Clarification is now provided in the “Introduction” Section of the document. Email 64 Family Member Briefly mentioned in the proposal is the "Affordable Care Act ". Does this program have The Affordable Care Act reference pertains to the Person Centered Planning a direct reflection on the compliance issues? [Exerpt of email submission] requirements. Forum 52 Managed Care Do you expect legislation in order to implement any rule changes? No. Not at this time. 3 Organization Forum 52 Managed Care Can MCOs expect HCBS rule changes for the next RFP cycle? The HCBS Rule requirements are new standards for the ALTCS program. Organization Forum 109 Family Member There needs to be a way for all the states to share information on what changes they are State to State information/best practices is shared through several national making that are effective. No need for states to beat their head against a wall if 1 state organizations. Transition workgroups may choose to research best and promising has developed specific solutions that can be implemented. practices. Forum 61 Provider If families do not get the services they need to support the member living in the family Thank you for your comment. home, there is no incentive to keep the member at home. [Paraphrase of verbal comment] Email 10 Family Member While I understand and appreciate that we want to give our members as many rights as Thank you for your comment. most normal individuals, I have come across many members who do not fit into the mold of the 5-Year Plan and should be exceptions to the rules. I was concerned about the following topics that were presented. I did understand from your presentation at the public forum, that there will members who will be exceptions to the rules, based on their medical and functional limitations, but wanted to share my thoughts all the same. [Exerpt of email submission] Email 81 Provider We hope that AHCCCS will consider flexibility in these new requirements for Health and Safety considerations and limitations on HCBS Rules requirements individuals with intellectual and developmental disabilities; full autonomy is not always will be addressed through an individual’s person centered planning process. the safest decision for individuals. Email 19 Provider We hope that AHCCCS will consider flexibility in these new requirements for Health and Safety considerations and limitations on HCBS Rules requirements individuals with intellectual and developmental disabilities; full autonomy is not always will be addressed through an individual’s person centered planning process. the safest decision for individuals. Email 141 Family Member Based on the AHCCCS meetings I have recently attended, I see both good and not so Thank you for your comment. good things in the proposed changes. Of course, it is our hope that [NAME] and others like him will continue to make progress toward more independence and greater ability to integrate into "normal" society.
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