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DDES Memo Series 2006-03

To: Area Administrators / Human Services Area Coordinators
DDES Bureau Directors
County Departments of Community Programs Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
Licensing Chiefs / Section Chiefs
Tribal Chairpersons / Human Services Facilitators
County Aging Units Directors
County COP Coordinators
County COP-Waiver Coordinators
County LTS Planning Committee Chairpersons
County Fiscal Managers

From: Sinikka Santala, Administrator

Subject: CHANGE IN CIP II

Document Summary - This memo announces that counties may manage CIP II funds as an allocation, like COP-W, instead of on a "slot" basis, EFFECTIVE January 1, 2006.

Background - The Division of Disability and Elder Services for some time has explored ways to simplify waiver program management. Some simplification actions can be done administratively and we are now implementing one of them. Wisconsin provides home and community based services to adults who are elderly or have a physical disability through the county human services system under a single federal home and community-based waiver. There are two state appropriations for this waiver: COP-W and CIP II. COP-W is funded as an allocation to counties, based on the Community Aids formula or as designated by legislative intent. Counties manage these funds by serving eligible people within the total amount of COP-W funding. CIP II funding is awarded to counties as a "slot" based primarily on the number of nursing home beds that have closed in their county. Each "slot" is worth a fixed per diem (currently $41.86 per day). Counties manage CIP II funding by filling each "slot" with an eligible person and may not serve more people than their total number of CIP II slots. In addition the average service costs may not exceed the per diem without approval from the Department.

The distinction to counties between COP-W and CIP II is purely fiscal, as the program standards and quality assurance requirements are identical. It is cumbersome to manage two separate allocations of funds that serve the same populations. Counties have to track the number of CIP II participants and not serve more people than the number of slots allocated. Counties also need to track their CIP II average per diem and not exceed this rate without an approved variance from the Department. If a county's CIP II program spends above the CIP II rate, counties may have to switch a few people back and forth between COP-W and CIP II to lower the CIP II average per diem.

Policy Change - Effective January 1, 2006, counties may use their CIP II funding as an allocation and not be limited to serving the same number of persons as CIP II slots allocated. Counties may serve as many people as possible within their CIP II allocation. In addition, a county will not be required to receive a formal per diem rate variance from the Department as long as the combined average per diem, including administration, of a county's COP-W and CIP II expenditures does not exceed the CIP II per diem (currently $41.86).

Rationale - By removing 'slot" restrictions, some counties may be able to serve more people than their number of allocated CIP II slots, thereby increasing the number of total people served with CIP II. Counties will no longer be held to serving a maximum number of people; they may serve more people than CIP II slots.

This policy will also simplify financial administration of the waivers for counties. Because the per diem upper limit will be established using both COP-W and CIP II per diem, most counties will not need to request a variance to their average per diem. In addition, counties will be able to manage COP-W and CIP-II using the same internal fiscal and other county policies and will not have to track a defined number of CIP II participants.

Cost Effectiveness - Under the policy change described above, counties will not need a variance from the Department if expenditures are within contracted CIP II and COP-W allocations and the combined per diem average (including administration) of both CIP II and COP-W is less than or equal to the CIP II per diem, currently at $41.86.

Because of federal waiver requirements, counties that exceed this per diem will still be required to request a variance from the Department, as discussed in the Medicaid Waiver Manual.

REGIONAL CONTACT: Human Services Area Coordinators

CENTRAL CONTACT: Lisa Kelly
Bureau of Long-Term Support
P. O. Box 7851
Madison, WI 53707-7851
(608) 267-3659
kellylm@wisconsin.gov

MEMO WEB SITE: http://www.dhs.wisconsin.gov/partners/local.htm

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