<p> STATE OF WASHINGTON DEPARTMENT OF SOCIAL AND HEALTH SERVICES Aging and Long-Term Support Administration Home and Community Services Division PO Box 45600, Olympia, WA 98504-5600</p><p>HCS MANAGEMENT BULLETIN</p><p>H13-071– Procedure November 21, 2013</p><p>TO: Area Agencies on Aging (AAA) Directors Developmental Disabilities Administration (DDA) Regional Administrators Home and Community Services Division (HCS) Regional Administrators FROM: Bea Rector, Director, Home and Community Services Division Don Clintsman, Deputy Assistant Secretary, Developmental Disabilities Administration SUBJECT: Changes to Dental Coverage for Adults, Age 21 and Older PURPOSE: To provide information regarding changes to comprehensive dental care benefits for Medicaid beneficiaries 21 years of age and older effective January 1, 2014. BACKGROUND: As a result of the 2011-2013 biennial budget, notification was sent to the field in September 2011 (DDA and HCS MB D11-022 and H11-05) to communicate changes that were occurring to the dental coverage for Medicaid beneficiaries. This notice indicated that Medicaid beneficiaries would only have access to emergency dental coverage unless the individual was enrolled in one of the following programs:  A 1915(c) HCBS waiver operated by DDA or HCS;  Roads to Community Living (RCL) program;  Skilled nursing facilities (SNF), State Veteran’s Home, and Intermediate Care Facilities for individuals with Intellectual Disabilities (ICF/IID); or  Pregnant Women’s Medical coverage group. WHAT’S NEW, Effective January 1, 2014, comprehensive adult dental services will be CHANGED, OR restored to the Medicaid State Plan per legislative directive. Therefore this CLARIFIED service will be removed from the waivers and RCL benefit package as of 12/31/13. All enrolled waiver and RCL participants will receive a written notice (attached below) from DDA and HCS Headquarters during the week of November 25, 2013. This will notify them that comprehensive dental services will continue to be available but through their Medicaid medical coverage rather than through their current waiver (Basic Plus, Core, Community Protection, COPES, or New Freedom) or RCL program. Participants’ legal representatives and client-identified necessary </p><p>1 supplemental accommodation (NSA) representatives will also receive a copy of the client notice. Translated copies will be sent along with an English copy for those individuals whose preferred written language is something other than English. </p><p>A copy of the mailing list will be placed in the following locations for each region/PSA to access:  DDA Waiver SharePoint under “Adult Dental Services” document (link to DDA Waiver SharePoint site)  Home and Community Programs SharePoint at the “Adult Dental Services” site HCS SharePoint Adult Dental Elimination folder.</p><p>The client notice will serve as an amendment to each participant’s plan of care. Headquarters will maintain the mailing list for all notices mailed from HQ and the template of the client notice so copies do not need to be placed into the client’s record.</p><p>DDA and HCS Headquarters will also distribute a flyer to various stakeholders providing them with the information regarding the restoration of adult dental services benefit to the Medicaid State Plan (attached below). </p><p>The transition of dental services from the waiver to the state plan is anticipated to be seamless to waiver and RCL participants because the dental and transportation providers utilized for comprehensive adult dental services are the same under both the waiver and the Medicaid State Plan. Clients will continue to be able to use Medicaid Transportation brokerage vendors to get to/from their dental appointments.</p><p>The Health Care Authority (HCA) is distributing notices to dental service providers and to Medicaid transportation brokerage providers. HCA will also be revising billing procedure manuals and will be filing emergency and regular Medicaid WAC to add adult comprehensive dental to the benefit package (see related references below).</p><p>ACTION: Case managers must review the mailing list on SharePoint to identify any waiver or RCL recipient on their caseload who is not listed and therefore did not receive the notice via the mass mailing from Headquarters.</p><p>For these identified clients, the case manager must mail a copy of the attached notice to the client and the client’s guardian or NSA representative (if any) by November 25, 2013. </p><p>If you need a translated version of the notice please contact Patty McDonald at (360) 725-2559 or by email at: [email protected]. </p><p>After January 1, 2014, at the client’s next annual or significant change assessment, the case manager must remove “adult dental” from the Treatment screen in CARE.</p><p>“Adult Dental” will be removed as an option on the CARE Treatment screen and the “Services” dropdown list in the PAN template. CARE F1 screens will also be updated. The date this change will occur has not 2 been determined. It will be included in a CARE Release MB.</p><p>Clients who were receiving MPC services under the State Plan from DDA or HCS/AAA but enrolled in the COPES waiver after July 1, 2011 in order to receive dental services must be reviewed during their next annual assessment to determine if their needs can be met by the MPC program. If so, they should be transitioned back to MPC. If the client transitioning back to MPC from COPES is DDA enrolled, the case should be transferred back to DDA for authorization of MPC services. All clients transitioning back to the MPC program from COPES will be provided with administrative hearing rights related to their service plan as per the standard practice.</p><p>DDA filed Emergency Rules to add dental services to the waivers which will end effective 12/31/13.</p><p>HCS WAC for the New Freedom waiver has been changed to indicate that waiver services will no longer include adult dental services as of January 1, 2014. The Emergency Rule for the COPES waiver related to adult dental services will end effective 12/31/13. RELATED REFERENCES: HCA proposed dental WAC Health Care Authority News Release - Restoring Adult Dental Benefit HCA's Medicaid & Health Care Assistance web page</p><p>ATTACHMENT(S): Client Notice template:</p><p>Client letter template - Dental Nov 2013.pdf Stakeholder Flyer:</p><p> stakeholder notice .pdf</p><p>CONTACT(S): Kris Pederson, DDA Waiver Program Manager (360) 725-3445 [email protected]</p><p>Debbie Johnson, HCS Waiver Program Manager (360) 725-2531 [email protected]</p><p>Marcy Goodman, New Freedom Program Manager (360) 725-2446 [email protected]</p><p>Debbie Blackner, RCL Program Manager (360) 725-2557 [email protected]</p><p>3</p>