DDES Memo Series
July 18, 2005
STATE OF WISCONSIN
Department of Health and Family Services
Division of Disability and Elder Services
Area Administrators/Human Services Area Coordinators
DHCF Bureau/Office Directors
County Departments of Community Program Directors
County Departments of Developmental Disabilities Services Directors
County Departments of Human Services Directors
County Departments of Social Services Directors
County LTS/COP Coordinators
County Developmental Disabilities Services Coordinators
DDES Section Chiefs
County/Tribal Aging Directors
Tribal Chairpersons/Human Services Facilitators
Program - AFH Activities (supercedes
describes how counties may obtain reimbursement for 50% of the cost of a
limited number of activities related to the administration of Adult Family
Homes (AFH) paid by Medicaid. The
Department invites counties to apply for federal matching funds under the
Medicaid Administrative Pass-Through (MAPT) program for adult family home
administrative functions only.
The Division of Disability and Elder Services and county based
long-term care programs share the interest of developing a range of
community based living arrangements for individuals with disabilities and
older people. Adult Family Homes are widely used by consumers as the
preferred living arrangement. However, the development of Adult Family
Homes requires staff time on behalf of counties. This memo provides
information on how counties can claim Medicaid funding for certain
The Medicaid Pass-Through Program (MAPT) is an administrative program
to arrange for the pass-through to counties of the federal share (50%) of
certain administrative and quality assurance functions reimbursable
through Medicaid administrative funds. MAPT may be accessed to pay for
activities performed or purchased by county agencies which are not
reimbursable through Medicaid provider rates but which are necessary for
the proper administration of Medicaid funds.
The MAPT program was made available to counties in 1990. However, new
county applicants were not accepted after February 15, 1991. This memo
re-opens the MAPT program for adult family home (AFH) administrative
functions only and invites counties to submit applications for federal
reimbursement for approved AFH activities. The Department is pleased to
offer this expansion of the MAPT program as a resource for counties to
develop community living options for people who are elderly and people who
have a disability. The availability of a 50% federal match on AFH
development activities will assist counties in creating additional
community living capacity as they partner with the Department on
relocation initiatives from nursing homes and ICFs-MR.
MAPT Reimbursable Functions
At this time, MAPT applications from any county will be considered for
adult family home (AFH) provider development activities that are directly
associated with the recruitment, development, and enrollment of AFHs.
- RFP's: Developing, issuing and evaluating requests for proposals for
- Contracting: Developing, executing, and monitoring contracts for
agencies providing AFH services to MA-Waiver recipients.
- Recruitment: County staff expenses involved in recruiting,
developing, and initiating AFH providers outside the county agency for
provision of Medicaid services to Medicaid-eligible recipients. For
example, county staff expenses associated with development or
enlistment of an Adult Family Home facility for waiver recipients are
reimbursable, but non-administrative expenses such as furnishings,
purchase of buildings, land, or equipment for an AFH, etc., are not
- Certification: Surveying and certifying providers as meeting
Medicaid AFH provider standards, such as certifying adult family homes
that serve Medicaid Waiver recipients residing in AFHs. Developing
provider standards or provider survey instruments, conducting provider
surveys, issuing certification notices, providing consultation and
orientation as to the certification standards, and similar
administrative functions are MAPT reimbursable. Quality assurance
activities that are currently administered by The Management Group (TMG)
or Bureau of Quality Assurance (BQA) are not eligible for MAPT
Counties may access Medicaid Administrative Pass-Through (MAPT) funds
for adult family home administrative functions with participants in any or
all of the following programs: COP-Waiver, CIP II, CIP 1A, CIP 1B or BIW.
Due to the Wisconsin Medicaid Cost Reporting (WIMCR) initiative,
activities related to the following Medicaid covered services provided by
county agencies must not be included in MAPT claiming:
- Case management services.
- Child/adolescent day treatment.
- Community support program services.
- Home health services.
- Medical day treatment services.
- Mental health crisis intervention services.
- Outpatient mental health and substance abuse services, including
evaluation, psychotherapy, and substance abuse counseling and
intensive in-home mental health services for children under
- Outpatient mental health and substance abuse services provided in
the home and community (The non-federal share of this service is
provided by the county).
- Personal care services.
- Prenatal care coordination services.
- Substance abuse day treatment.
Time Studies and Documentation of Activity
For MAPT funds used to match county staff salary and benefit expenses,
the staff will be required to conduct time studies documenting that costs
were incurred for allowable Medicaid activities. For CY05, time studies
are conducted on a quarterly basis. For CY06, we are anticipating that
counties will be required to complete 100% time reporting. Counties will
also be required to document how the MAPT funds were used.
Counties must provide 50% of the cost of allowable expenses through an
acceptable Medicaid match source. Acceptable sources include:
(a) COP Funds and, on a one-time basis, COP carryover (available for
COP-W only), and approved COP High Cost funds that are not used to match
another Medicaid program or federal grant;
(b) Community Aids Funds not used to provide match for another Medicaid
service (i.e., Medicaid case management or federal grants);
(c) County Property Tax Funds including funds used to provide match or
overmatch for Community Aids but which are not used to provide match for
another Medicaid program or federal grant;
(d) Other allowable matching funds include any other state-funded
allocation not already used to match Medicaid. With Department approval,
funds may include a federal grant, private or public donations.
Reporting of Expenses
MAPT expenditures will be reported monthly through CARS. Three separate
CARS lines are available to report such expenses: one for the federal
amount and two for the match (Community Aids/County Match and/or COP).
CARS #388 - Federal Pass-Through Amount: Report 50% of MAPT
reimbursable expenses on this CARS line. Do not report this amount
anywhere else on any CARS line. Do not report this cost on the HSRS waiver
CARS #389 - Community Aids/County Match: Report the match
portion of MAPT reimbursable expenses (up to 50% cost) for which Community
Aids or county match/overmatch is the source of the match. This CARS line
is an informational line and costs reported on this line will
automatically roll to CARS line #561 for payment purposes. Therefore, do
not report MAPT match expenses directly onto CARS line #561.
CARS #390 - COP Match for MAPT: Report the match portion of MAPT
reimbursable expenses (up to 50%) for which COP is the source of the
match. This CARS line is an informational line and costs reported on this
line will automatically roll to the general COP CARS line #367 for payment
purposes. Therefore, do not report MAPT match expenses directly onto CARS
line #367. Expenditures of COP Match are not to be reported on HSRS but
will be included when claiming COP administrative funds on the COP hard
copy reconciliation format.
Any county agency responsible for administering any of the above
mentioned waiver programs identified may apply for MAPT funds.
Applications for CY05 are due August 1, 2005. Please include
A (MAPT Vendor Related Allocation Formula) and
B (Request for Medicaid Administrative Funds) including any related
position descriptions. If you are seeking MAPT reimbursement for
contracted services related to recruiting, monitoring, developing and
initiating AFH providers, include a copy of the latest contract and any
service agreement. Send materials to Lisa Kelly at the address below.
REGIONAL OFFICE CONTACT:
Human Services Area Coordinators - Adult Services
CENTRAL OFFICE CONTACT:
Bureau of Long Term Support
P. O. Box 7851
Madison, WI 53707-7851
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