Arkansas Session 2019

The AR Legislative session has been going on a few weeks. They will be making important decisions that affect us. Here are some resources to help you stay up-to-date no matter where you live.

See the bills that have been filed:

The boxes are check for 2019. Just click Submit to see the latest list.

http://www.arkleg.state.ar.us/SearchCenter/Pages/historicalbil.aspx

See today’s calendar to decide which committees you want to watch.

Public Health, Welfare, & Labor are committees for both Senate and House that discuss bills that affect Medicaid. Each meeting has an agenda, so you can see if the bill you care about is on the list for today.

http://www.arkleg.state.ar.us/assembly/2019/2019R/Pages/Home.aspx

Watch what’s going on right now:

(Business hours)

http://sg001-harmony.sliq.net/00316/Harmony/en/View/UpcomingEvents/20190208/-1

Watch previous sessions and committees:

Bills travel to different committees, to the House, and Senate before they hit the Governor’s desk. You might want to go back to see how your legislators voted or if they discussed your concerns in the meetings.

http://sg001-harmony.sliq.net/00316/Harmony/en/View/RecentEnded/20190208/-1

AR Choices Update

Here’s an AR Choices update from our friends at Legal Aid Arkansas:


Latest ARChoices update. Last Monday (12/10), the first legislative committee–which didn’t have the power to say no–reviewed the proposed changes to the ARChoices program and sent them on to a second legislative committee, which is called the Rules and Regulations committee. This second committee has the power to say no to the rules (in some circumstances).

THE SECOND COMMITTEE MEETS on Tuesday, 12/18, at 1 p.m. in Room A of the MAC Building in Little Rock. Members of the public have the right to speak. People were limited to two or three minutes at the first committee and were pressured to get straight to the point.

Based on what DHS said at the meeting, media reports, and questions I’ve received from clients, here’s some important information.

(1) ACTUAL CARE HOURS. Our clients’ main concern is getting enough care. Almost 90% of the people on ARChoices use agencies for their care. The remaining people hire their own caregivers (it’s called “self-directing” care; you know you self-direct if you go through Palco; self-directing people may be able to get more hours). For everyone who uses agencies, the absolute maximum number of hours you can get under the new rules is 6.5 hours per day (46 per week) based on the hard budget limit of $30,000 per person per year. We know that is not enough for many of our clients.

6.5 hours per day (46 per week) is the best-case scenario. From experience, we know that the best-case scenario isn’t usually what happens. There are several things that can take away from this.

(A) The first thing that can take away hours is the new Task and Hour Standards, which will allocate a set amount of time for each activity of daily living you need done. Using algorithms, DHS will assign you a severity score in each key ADL. Then, based on that severity score, you can get a certain number of minutes for each activity. For example, if you score a 3 on bathing (3 is the most severe), the DHS nurse can give you between 35 and 45 minutes. DHS does that for each ADL (food prep, eating, dressing, grooming, cleaning, etc.) and then adds it all up. If this comes out lower than 6.5 hours per day, you can only get the number of hours the Task and Hour Standards allows. If that comes out higher than 6.5 hours per day, you can still only get the 6.5 that your budget allows.

(B) The second is if you use other services like home-delivered meals, the personal emergency response system, or respite care. The cost of these things comes out of your budget. IF YOU GET ONE MEAL FIVE DAYS PER WEEK AND HAVE THE EMERGENCY RESPONSE SYSTEM, YOU WILL LOSE ABOUT TWO HOURS OF CARE PER WEEK. And, every hour of respite care you choose means a loss of one hour of attendant care.

(C) The third is if you do not get placed in the budget category of $30,000 per year. There are two other budget categories–one with a $20,000 limit per year and one with a $5,000 limit per year. People in the $20,000 category will only be able to get up to 5 hours per day (36 hours per week). People in the $5,000 category will only be able to get up to 3 hours per day (20 hours per week). Algorithms will determine budget placement.

(2) POSSIBLE ALTERNATIVES. While Legal Aid does not advocate for specific policy fixes, we can analyze factual information and consider alternatives. Our clients’ main concern is getting enough care. We don’t have access to detailed DHS data that would allow for precise calculations, but we can make reasonable assumptions.

SCENARIO ONE. If DHS raised the $30,000 yearly cap to $36,000, it would give people a possibility of 1 more hour of care each day (so, 7.5 total per day, which is 53 per week) and would probably cost less than $1,500,000 total to the budget per year. Based on DHS’s estimates, about 260 people received services this year that cost more than the $30,000 cap. Those people will already be “grandfathered” into the new system and should be accounted for in DHS’s current budget. The extra cost of $1,500,000 assumes another 260 people will need services that cost more than $30,000 per year. This extra 260 people seems like a reasonable estimate. There could be people already on the program who face increased needs (DHS estimated 206 people this year required services that cost between $25,000 and $29,999, so some of them might need more as conditions worsen) or people who come onto the program with higher needs than the people they are replacing. There could also be a few of the grandfathered people who would get a slight bump under an incrased cap (147 people got services that cost between $30,000 and $34,999). And, that $1,500,000 assumes that all of the people who qualify for the increased budget cap will actually receive all $36,000 of services.

***REMEMBER, the increased budget doesn’t automatically mean more hours. The actual hours will be limited by the Task and Hour Standards.

SCENARIO TWO. If DHS raised the $30,000 yearly cap to $39,000, it would give people a possibility of 1.5 more hours of care each day (so, 8 total per day, which is 56 per week, which was the maximum under the system of nurse discretion that existed before RUGs) and would probably cost less than $2,340,000 total to the budget per year. Again, this assumes that 260 people will need services that cost more than $30,000. The 260 people could include some of the 206 people who received services costing between $25,000 and $29,999, some of the 147 people that got services costing between $30,000 and $34,999, some of the 74 people that got services costing between $35,000 and $39,999, and some new people.

***REMEMBER, the increased budget doesn’t automatically mean more hours. The actual hours will be limited by the Task and Hour Standards.

Even with higher budget limits, THE COST OF HOME-BASED CARE IS FAR LESS THAN THE COST OF NURSING HOME CARE. The $39,000 cap comes out to $3,250 per month, and the $36,000 cap comes out to $3,000 per month. By DHS’s own estimates, nursing home care costs around $5,500 per month.

(3) The Proposed System Still Uses ALGORITHMS That Will Be Hard for People to Understand. DHS is publicly saying that the proposed system doesn’t use computer algorithms. This is demonstrably false. DHS has to use algorithms to turn the answers to the 400+ questions on the assessment into placement in an eligibility tier, a budget category, and scores for the ADLs on the Task and Hour Standards. While the new algorithms will work differently than the RUGs algorithm, they are still algorithms. People will probably still have a hard time understanding why they get a particular amount of care.

(4) The Proposed System Could VIOLATE THE AMERICANS WITH DISABILITIES ACT. Some people have heard of the Olmstead case. It was a Supreme Court case that stands for the idea that a state discriminates against people with disabilities if the state’s actions put people at risk of institutionalization. Using a hard budget limit to deny services that are needed for people to be able to stay at home violates the ADA.

(5) The “Flexibility” DHS Has Proposed Doesn’t Address the Issue of Budget Caps. DHS will allow nurses some modest discretion in completing the Task and Hour Standards, but this DOES NOT allow nurses to adjust the hard budget cap. So, even if the nurse uses their discretion to say that you need 8 hours a day of care on the Task and Hour Standards, you cannot get that much if your budget doesn’t allow it. If you need more than $30,000 in services, there is a one-time exception possible for “exceptional, unexpected circumstances” like the death of a caregiver or drastic change in condition but not for people whose regular care requirements involve more than that (i.e. if you are relatively stable, no exception is possible). And, to get this limited exception, you have to go through a DHS review panel–it is NOT in the discretion of the nurse.

NOTE: If you currently receive more than $30,000 in services, you will be “grandfathered” into the new system and get to keep up to your current services next year (your current level will be your budget cap). However, your hours could still go down based on the Task and Hour Standards.

As always, please feel free to write or call me with any questions. 870-732-6370 x 2206.

ARChoices: Update From Legal Aid

This is an update from Kevin De Liban from Legal Aid of Arkansas. He wants to help us understand the latest on ARChoices.


Just a quick update on yesterday’s meeting in the legislature. The Public Health committee gave the RUGs algorithm an unfavorable review, meaning that the committee thinks that DHS should not adopt the RUGs algorithm. At least 4 people on the ARChoices program were present and testified before the legislators, as well as parent caregivers, advocates, case managers, and care agencies. These voices–especially the people on the ARChoices program–let the legislators know the details about how the RUGs algorithm has hurt many beneficiaries. Here is a newspaper article about the meeting.

That is not the end of the process. The RUGs algorithm now goes to the Rules and Regulations Subcommittee on Tuesday, September 18, at 1 p.m. in Room A of the MAC Building. The agenda includes a list of the legislators on the committee as well as other details.

Public comment will be accepted at this meeting. If the Rules subcommittee votes against the RUGs algorithm, it should be the end of it. But, there are some technicalities involved, and I have no way of knowing what the likely outcome is. Whatever happens, it’s inspiring to see how all sorts of people in different situations have been working in their own ways for justice on this issue.


How to contact Kevin with concerns or questions:

Kevin De Liban, Attorney
Economic Justice Practice Group Leader
Legal Aid of Arkansas–West Memphis

310 Mid-Continent Plaza, Suite 420
West Memphis, AR 72301
Phone: (870) 732-6370 x. 2206
Fax: (870) 732-6373

How to Best Communicate with Legislators

read the artic

If you can’t see the graphic above, you can read the article.

AR Choices Update

It’s been over a month since Legal Aid’s last update. After a period of relative quiet, here’s the latest from Kevin De Liban on the ARChoices program. Please note the upcoming legislative committee hearings listed below on 9/13 and 9/18.


(1) Public comments. In July, many people showed up to the public hearings or wrote DHS with comments. Those comments are attached to this email. Though the comments were overwhelmingly against the algorithm, DHS plans to go ahead and start using the RUGs algorithm again in the exact same way as they did before starting on 10/1/18.

RUGs changed the effective limit of attendant care from 8 hours per day to 5.5 or 6. This has not been enough for Legal Aid’s clients. On top of that, the algorithm is nearly impossible to understand, has had multiple software errors, and doesn’t take into account a doctor’s opinion or consider the actual amount of time it takes to provide care to someone on the program.

(2) The legislature is considering the RUGs algorithm this Thursday, 9/13, and next Tuesday, 9/18.  DHS is presenting the algorithm to two separate legislative committees in the next week. Apparently, if the Public Health Committee does not approve it, the algorithm may be delayed or stopped.

Thursday, 9/13, 10 a.m., Public Health Committee, Room A of the MAC Building. I have been told that public comment will be accepted. People who attend must sign in on a sheet to request to speak.

Tuesday, 9/18, 1 p.m., Rules and Regulations Subcommittee, Room A of the MAC Building. I have been told that public comment will be accepted. People who attend must sign in on a sheet to request to speak.

It is not clear that the legislators on these committees will have seen the comments that were submitted to DHS. So, they may not know that most people are against the algorithm. The legislators may not have any source of information other than what DHS tells them. The meetings are open to the public, and I have been told that public comment will be accepted. 

(3) DHS resumed assessments, but only for personal care (not attendant care). People already on the program still cannot get adjustments to their attendant care hours. People who’ve applied for the program are unable to get any attendant care at all. But, after we filed our ongoing lawsuit on behalf of an ARChoices applicant who was denied all services, DHS started determining applicants’ program eligibility and giving them up to 14.5 hours per week of personal care (NOT attendant care, which is slightly different). This isn’t anywhere near enough for many applicants. The lawsuit is continuing and seeks to force DHS to use the prior system of nurse discretion to allocate attendant care until a new valid method is in place.

(4) New Algorithm. As far as we know, DHS is still planning to switch to a new algorithm and new assessment system for ARChoices. This will be based on the same assessment system that is currently in use for personal care, behavioral health, and the development delay waiver. DHS has not provided a timeline for the new algorithm, but, based on the legal timelines required, the new algorithm is not likely to be put into place before 2019.

As always, if you have any questions, please feel free to write me here or call me at my office (800-967-9224 x 2206).

Contact:

Kevin De Liban, Attorney

Economic Justice Practice Group Leader

Legal Aid of Arkansas–West Memphis

310 Mid-Continent Plaza, Suite 420

West Memphis, AR 72301

Phone: (870) 732-6370 x. 2206

Take Action: June Legislative Committee Meetings

Update (6/5/18): The rules were approved in the Public Health joint committee and will be next voted upon by the ALC Rules & Regulations Joint Committee on Tuesday, June 12 at 1pm in Little Rock. Contact the committee members. Read below to catch up if you wonder which issues are being voted upon.


Original post: MSL has announced on Facebook that this committee meeting would be occurring on June 4th and that it was moved to Jonesboro. Here is some information to help you to understand what’s happening when, and what you need to do.

If you’re lost and need to catch up, you can watch a video we previously released on the subject.

Screen Shot 2018-06-03 at 10.01.07 PM

Several important issues are being discussed that affect children as well as adults:

Here is how you can contact the people of the Public Health Committee:

2018 Election Info

It’s election season! In fact, early voting for primaries has begun. That means it’s time for you to do some homework and make decisions about which issues are most important to you. Sometimes your values on different issues may clash, which is why it’s important to rank one of them as most important to you.

Medicaid is a hot topic. We’ve seen a lot of change, and depending on the officials we elect, we may see even more. That’s why it’s important to be informed about election deadlines, requirements, and the candidates.


Your first question might be:

Who’s running?

Click here to find out.


Next you’re probably asking:

What are the deadlines?

Elections for the office of Arkansas House of Representatives will take place soon!

  • candidate filing deadline – March 1, 2018.
  • primary election – May 22, 2018.
  • primary runoff election – June 19, 2018.
  • general election – November 6, 2018.

All 100 House seats are up for election in 2018. Arkansas state representatives serve two-year terms, with all seats up for election every two years.

Elections for the office of Arkansas State Senate are also happening soon.

  • candidate filing deadline – March 1, 2018,
  • primary election – May 22, 2018.
  • primary runoff election – June 19, 2018.
  • general election – November 6, 2018.

A total of 18 seats out of the chamber’s 35 seats are up for election in 2018.Arkansas state senators serve one two-year term and two four-year terms each decade.

Arkansas will also hold elections for Governor, Lieutenant Governor, Attorney General, Secretary of State, Auditor, and Treasurer on November 6, 2018. The candidate filing deadline was March 1, 2018.

The 2018 U.S. House of Representatives will hold elections

  • candidate filing deadline – March 1, 2018,
  • primary election – May 22, 2018.
  • general election – November 6, 2018.

Arkansans elect representatives to the U.S. House, one from each of the state’s four congressional districts.


How can I be informed about the candidates?

As candidates are campaigning, make sure you take every opportunity to inform yourself. Know what questions to ask!


Have I met the requirements to vote?

Voter Registration

To register to vote in Arkansas you should provide one of the following:

  • The Last Four Digits of your Social Security Number
  • Your Arkansas Driver’s License Number

If you do not have any of these IDs, you can provide a copy of one of the following with your registration application:

  • Current and Valid Photo ID
  • Government Issued Document that shows your current name and address
  • Utility Bill
  • Government Check
  • Bank Statement
  • Paycheck that Shows your current name and address

You can alternatively provide one of these documents when you vote to complete your registration.

Voting In-Person

In Arkansas, you need to show a valid ID to vote. You can use any ID from this list:

  • Paycheck that shows your Current Name and Address
  • Current and Valid Photo ID
  • Utility Bill
  • Bank Statement
  • Government Check
  • Government Issued Document that shows your Current Name and Address
  • Veteran Health ID Issued by US Department of Veterans Affairs

Where should I vote?

Find out.


Source 1

Source 2

Source 3

One Therapy Rule – Part 1

MSL has done some research on a change coming our way. You may have heard of it – the “One Therapy Rule,” formally known as the EIDT Program. Watch this video and stay tuned for your opportunity to take action.

Updated PASSE Information

Click the image below to receive comprehensive, updated information on the PASSE systems (as of October 2017). The deadlines have been updated, and if you were wondering what the purpose of the model is, here’s your chance to find out!

Screen Shot 2017-10-31 at 9.36.43 AM

Three PASSEs were officially certified on October 18: Arkansas Advanced Care, ARkansas Total Care and Empower Healthcare Solutions. Read more about them in the image below:

Screen Shot 2017-10-31 at 10.20.51 AM

Making Sense of the Manuals for Public Comment

Screen Shot 2017-07-17 at 10.36.45 AMDHS released several manuals to the Medicaid website on July 13, 2017 that are available for public comment until August 11. Once public comment ends, these rules will be sent through the legislative committees and passed as law.

“In accordance with federal and state law, the Division of Medical Services of the Arkansas Department of Human Services must advertise and make available for public comment proposed new and amended rules and other documents, such as certain initial waiver requests and waiver renewals.”

However, they released over 60 documents actually, which may have left you feeling confused about which one needs your comment or what’s in them all. Here’s your guide to wading through the state terminology and legalese.


RULE #1: When you send in your comments, make sure to list the document that you wish to comment on!

RULE #2: Make sure you send your comments to the appropriate person.


Send your comments to Shelby.Maldonado@dhs.arkansas.gov, and as long as you’ve included the right document title, she will be able to direct it to the correct person.

  • If you’re viewing this on a phone or tablet, you might want to turn it to the side (landscape) to view the width of the table well. The right 2 columns are what MSL has added to help with the list that DHS provided.

img_0478-1

Instead of scrolling through the long table, which can be confusing, this list of topics can get you straight to what you want to see. Click the link to go directly to the corresponding manual in the table.

 


The following table will attempt to explain what each document is (memo, explanation letter, mark up with changes, or new manual), what it contains, and possibly some documents to assist you. Remember, the list of topics above can assist you in finding what you need much faster.

Document Title Document Description Assisting docs/info
Interested Persons and Providers Letter for DDS Standards for Certification, Investigation and Monitoring; State Plan Amendment 2017-011; Child Health Management Services provider manual update; and Developmental Day Treatment Clinic Services provider manual update IPLtrSPA17-011.doc memo
(SPA011 – 1 of 15)
State Plan Amendment 2017-011 Attachment 3.1A 1i SPA17-011-31A1i.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
SERVICES PROVIDED, CATEGORICALLY NEEDY (page as it will appear in new manual)
(SPA011 – 2 of 15) Page 1i
State Plan Amendment 2017-011 Attachment 3.1A 1i with tracked changes SPA17-011-31A1i-markup.doc SAME MANUAL PAGE: mark up that shows changes
(SPA011 – 3 of 15) Page 1i
State Plan Amendment 2017-011 Attachment 3.1A 4A SPA17-011-31A4A.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
SERVICES PROVIDED, CATEGORICALLY NEEDY (page as it wil appear in new manual)
(SPA011 – 4 of 15) Page 4a
State Plan Amendment 2017-011 Attachment 3.1A 4A with tracked changes SPA17-011-31A4A-markup.doc SAME MANUAL PAGE: mark up that shows changes
(SPA011 – 5 of 15) Page 4a
State Plan Amendment 2017-011 Attachment 3-1B 2h SPA17-011-31B2h.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
SERVICES PROVIDED, MEDICALLY NEEDY (page as it wil appear in new manual)
(SPA011 – 6 of 15) Page 2h
State Plan Amendment 2017-011 Attachment 3-1B 2h SPA17-011-31B2h-markup.doc SAME MANUAL PAGE: mark up that shows changes
(SPA011 – 7 of 15) Page 2h
State Plan Amendment 2017-011 SPA17-011-31B4b.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
SERVICES PROVIDED, MEDICALLY NEEDY (page as it wil appear in new manual)
(SPA011 – 8 of 15) Page 4b
State Plan Amendment 2017-011 SPA17-011-31B4b-markup.doc SAME MANUAL PAGE: mark up that shows changes 1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact
(SPA011 – 9 of 15) Page 4b
DDS Standards for Certification, Investigation and Monitoring – Redline DDS-Stnds-Redline.doc DDS STANDARDS for Certification, Investigation, an Monitoring for Center-Based Community Services  1. Summary DDTCS-CHMS 2. Info
(SPA011 – 10 of 15) entire manual, mark up that shows changes
DDS Standards for Certification, Investigation and Monitoring DDS-Stnds-Clean.doc DDS STANDARDS for Certification, Investigation, an Monitoring for Center-Based Community Services
(SPA011 – 11 of 15) entire manual, as it will appear
CHMS-2-17 Provider Manual Update Transmittal Letter CHMS-2-17.doc letter that explains which parts of the CHMS manual have been changed
(SPA011 – 12 of 15)
CHMS-2-17 Provider Manual Update CHMS-2-17up.doc CHMS Manual mark up with changes. 1. Summary DDTCS-CHMS 2. Info
(SPA011 – 13 of 15)
DDTCS-2-17 Provider Manual Update Transmittal Letter DDTCS-2-17.doc letter that explains which parts of the DDTCS manual have been changed
(SPA011 – 14 of 15)
DDTCS-2-17 Provider Manual Update DDTCS-2-17up.doc DDTCS Manual mark up with changes. 1. Summary DDTCS-CHMS 2. Info
(SPA011 – 15 of 15)
Interested Persons and Providers Letter for State Plan Amendment 2017-010, Outpatient Behavioral Health Services and Inpatient Psychiatric Provider Manual Updates and Residential Community Reintegration Program Certification IPLtrSPA17-010.doc memo
(SPA010 – 1 of 8)
State Plan Amendment 2017-010 Attachment 3.1 A SPA010-Attach3-1A.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
SERVICES PROVIDED, CATEGORICALLY NEEDY (page as it will appear in new manual – NO MARK UP AVAILABLE)
(SPA010 – 2 of 8) Page 6c17a
State Plan Amendment 2017-010 Attachment 3.1 B SPA010-Attach3-1B.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
SERVICES PROVIDED, MEDICALLY NEEDY (page as it will appear in new manual – NO MARK UP AVAILABLE)
(SPA010 – 3 of 8) Page 5f17a
Residential Community Integration Program Certification ResCommReintCert.doc Residential Community Integration Program Certification
(SPA010 – 4 of 8) entire manual as it will appear NO MARK UP AVAILABLE
Inpatient Psychiatric (INPPSYCH-1-17) Provider Manual Update Transmittal Letter INPPSYCH-1-17.doc Letter that shows the changes to Manual Update for Inpatient Psychiatric Services for Under Age 21
(SPA010 – 5 of 8)
INPPSYCH-1-17 Provider Manual Update INPPSYCH-1-17up.doc Manual Update for Inpatient Psychiatric Services for Under Age 21
(SPA010 – 6 of 8) entire manual as it will appear NO MARK UP AVAILABLE
Outpatient Behavioral Health Services (OBHS-1-17) Provider Manual Update Transmittal Letter OBHS-1-17.doc Letter that shows the changes to Manual Update for Outpatient Behavioral Health Services
(SPA010 – 7 of 8)
OBHS-1-17 Provider Manual Update OBHS-1-17up.doc Manual Update for Outpatient Behavioral Health Services
(SPA010 – 8 of 8) entire manual, mark up that shows changes
Interested Persons and Providers Letter for Independent Assessment Manual IPLtrAR_IA.doc memo
(AR_IA – 1 of 2)
AR Independent Assessment Manual AR_IA_July_17.doc New manual for Independent Assessment 1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact
(AR_IA – 2 of 2)
Interested Persons and Providers Letter for DDS Policy 1076 -Appeals IPLtrDDS1076.doc memo
(1076 – 1 of 3)
DDS Policy 1076 with Tracked Changes DDS1076-Appeals-markup.doc DDS Policy APPEALS Manual
(1076 – 2 of 3) entire manual, mark up that shows changes 1. Summary Appeals
2. Info Policy 1076 Appeals
DDS Policy 1076 -Clean DDS1076-Appeals-clean.doc DDS Policy APPEALS Manual
(1076 – 3 of 3) entire manual, as it will appear
Interested Persons and Providers Letter for DDS Policy 1086 IPLtrDDS1086.doc memo
(DDS1086 – 1 of 3)
DDS Policy 1086 with tracked changes DDS1086-HDC-markup.doc DDS Human Development Center Admission and Discharge Rules Policy Manual
(DDS1086 – 2 of 3) entire manual, mark up that shows changes 1. 1086 HDC Rules Summary

2. 1086 Info

DDS Policy 1086 DDS1086-HDC.doc DDS Human Development Center Admission and Discharge Rules Policy Manual
(DDS1086 – 3 of 3) entire manual, as it will appear
Interested Persons and Providers Letter for Medical Services Policy Manual Sections E-600 through E-670 and Appendix R IPLtrABLE.doc memo
(ABLE – 1 of 2)
Medical Services Policy Manual Sections E-600 through E-670 and Appendix R ABLE.pdf Able Act Policy Manual: Eligibility Factors, Contributions, Withdrawals, Expenses, Exclusions,
(ABLE – 2 of 2) entire manual, as it will appear – NO MARK UP AVAILABLE
Interested Persons and Providers Letter for Community and Employment (CES) 1915 (c) Waiver, DDSCES-1-17 Provider Manual Update and Certification Standards for CES Providers IPLtrDDSCES.doc memo C Waiver
(CES – 1 of 5)
DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards DDSCESCertStand-markup.doc DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards
(CES – 2 of 5) entire manual, mark up that shows changes 1. Summary of Changes

2. Info – CES Waiver

DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards DDSCESCertStand.doc DDS Community and Employment Supports (CES) Waiver Minimum Certification Standards
(CES – 3 of 5) entire manual, as it will appear
Developmental Disabilities Services Community and Employment Supports (DDSCES1-17) Provider Manual Update Transmittal Letter DDSCES-1-17.doc Letter that shows the changes to Manual Update for Arkansas Medicaid Health Care Providers – DDS Community and Employment Supports (CES)
(CES – 4 of 5)
DDSCES-1-17 Provider Manual DDSCES-1-17up.doc Manual Update for Arkansas Medicaid Health Care Providers – DDS Community and Employment Supports (CES)
(CES – 5 of 5) entire manual, mark up that shows changes 1. Summary of Changes
2. Info – CES Waiver
Interested Persons and Providers Letter for Provider-Led Arkansas Shared Savings Entity (PASSE) Waiver and New Provider Manual IPLtrPASSE.doc memo
(PASSE 1 of 5)
Provider-led Arkansas Shared Savings Entity Program – Phase I PASSEWvr.pdf PASSE Program Information B Waiver
1. Summary of PASSE
2. Info & Financial Impact
(PASSE 2 of 5)
Provider-led Arkansas Shared Savings Entity Spreadsheet SpreadsheetPASSEWvr.pdf PASSE Information – Enrollment Projections, Costs
(PASSE 3 of 5)
PASSE-New-17 Provider Manual Update Transmittal Letter PASSE-New-17.doc letter that explains Provider-Led Arkansas Shared Savings Entity (PASSE) Program manual
(PASSE 4 of 5)
PASSE-New-17 Provider Manual Update PASSE-New-17up.doc New PASSE Manual
(PASSE 5 of 5) entire manual, mark up 1. Summary of PASSE
2. Info & Financial Impact
Interested Persons and Providers Letter for Independent Assessment for Personal Care and Criminal Background Check Requirements for Providers IPLtrIA.doc memo
(IA – 1 of 22)
State Plan Amendment 2017-009 with Tracked Changes SPA17-009-markup.doc STATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT: AMOUNT, DURATION AND SCOPE OF
SERVICES PROVIDED, CATEGORICALLY NEEDY (mark up that shows changes
(IA – 2 of 22) Page 10aa
State Plan Amendment 2017-009 SPA17-009.doc SAME MANUAL PAGE: as it will appear
(IA – 2 of 22) Page 10aa
ARChoices in Home Care Home and Community-Based 2176 Waiver (ARCHOICES-1-17) Provider Manual Update Transmittal Letter ARCHOICES-1-17.doc letter that explains changes to ARChoices In Homecare Home and Community-Based 2176 Waiver Manual
(IA – 3 of 22)
ARCHOICES-1-17 Provider Manual Update ARCHOICES-1-17up.doc ARChoices In Homecare Home and Community-Based 2176 Waiver Manual
(IA – 4 of 22) entire manual, mark up that shows changes
Child Health Services/Early and Periodic Screening, Diagnosis, and Treatment (EPSDT-1-17) Provider Manual Update Transmittal Letter EPSDT-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – EPSDT Manual
(IA – 5 of 22)
EPSDT-1-17 Provider Manual Update EPSDT-1-17up.doc Arkansas Medicaid Health Care Providers – EPSDT Manual change
(IA – 6 of 22) Section II, mark up that shows changes IA required for certain home health clients
1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact
Home Health (HOMEHLTH-1-17) Provider Manual Update Transmittal Letter HOMEHLTH-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – Home Health Manual
(IA – 7 of 22)
HOMEHLTH-1-17 Provider Manual Update HOMEHLTH-1-17up.doc Arkansas Medicaid Health Care Providers – Home Health Manual change
(IA – 8 of 22) Section II, mark up that shows changes background check changes
Hospice (HOSPICE-1-17) Provider Manual Update Transmittal Letter HOSPICE-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – Hospice Service manual
(IA – 9 of 22)
HOSPICE-1-17 Provider Manual Update HOSPICE-1-17up.doc Arkansas Medicaid Health Care Providers – Hospice Service manual changes
(IA – 10 of 22) Section II, mark up that shows changes background check, IAs for personal care
1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact
IndependentChoices (INCHOICE-1-17) Provider Manual Update Transmittal Letter INCHOICE-1-17.doc letter that expains changes to Arkansas Medicaid Health Care Providers – IndependentChoices Manual
(IA – 11 of 22)
INCHOICE-1-17 Provider Manual Update INCHOICE-1-17up.doc Arkansas Medicaid Health Care Providers – IndependentChoices Manual changes
(IA – 12 of 22) Section II, mark up that shows changes various changes included background checks
Personal Care (PERSCARE-1-17) Provider Manual Update Transmittal Letter PERSCARE-1-17.doc letter that explains changes to Arkansas Medicaid Health Care Providers – Personal Care manual
(IA – 13 of 22)
PERSCARE-1-17 Provider Manual Update PERSCARE-1-17up.doc Arkansas Medicaid Health Care Providers – Personal Care Manual changes
(IA – 14 of 22) Section II, mark up that shows changes
Private Duty Nursing Services (PDN-1-17) Provider Manual Update Transmittal Letter PDN-1-17.doc letter that explains changes to the Arkansas Medicaid Health Care Providers – Private Duty Nursing Services manual
(IA – 15 of 22)
PDN-1-17 Provider Manual Update PDN-1-17up.doc Arkansas Medicaid Health Care Providers – Private Duty Nursing Services Manual changes
(IA – 15 of 22) Section II, mark up that shows changes background checks
Physician (PHYSICN-3-17) Provider Manual Update Transmittal Letter PHYSICN-3-17.doc letter that explains changes to the Physician/ Independent Lab/CRNA/Radiation Therapy Center manual
(IA – 17 of 22)
PHYSICN-3-17 Provider Manual Update PHYSICN-3-17up.doc Physician/ Independent Lab/CRNA/Radiation Therapy Center manual changes
(IA – 18 of 22) Section II, mark up that shows changes IA requirement
1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact
Rural Health Clinic (RURLHLTH-1-17) Provider Manual Update Transmittal Letter RURLHLTH-1-17.doc letter that explains changes to the Rural Health Clinic Services manual
(IA – 19 of 22)
RURLHLTH-1-17 Provider Manual Update RURLHLTH-1-17up.doc Rural Health Clinic Services manual changes
(IA – 20 of 22) Section II, mark up that shows changes IA requirement
1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact
Section I (SecI-3-17) All Provider Manuals Update Transmittal Letter SecI-3-17.doc letter that explains the changes to the Arkansas Medicaid Health Care Providers – All Providers manual
(IA – 21 of 22)
SecI-3-17 All Provider Manuals Update SecI-3-17up.doc Arkansas Medicaid Health Care Providers – All Providers manual
(IA – 22 of 22) Section II, mark up that shows changes IA requirement
1. IA Public Notice
2. IA Manual Summary
3. IA fiscal Impact