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DDES Memo Series 2005-12

July 18, 2005

STATE OF WISCONSIN
Department of Health and Family Services
Division of Disability and Elder Services

To: 
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

From: 
Sinikka Santala
Administrator

Re: MAPT Program - AFH Activities (supercedes DCS 90-04)

Document Summary  

This memo 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.

Purpose

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 administrative costs.

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. Examples include:

  • RFP's: Developing, issuing and evaluating requests for proposals for AFH providers.
  • 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 permissible.
  • 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 reimbursement.

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 HealthCheck.
  • 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.

Matching Funds

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 module.

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.

Application Process

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 Attachment A (MAPT Vendor Related Allocation Formula) and Attachment 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: 
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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