The Michigan Department of Health and Human Services (MDHHS) submitted a request to the federal centers for Medicare and Medicaid Services (MCS) asking for approval to allow changes to its Home and Community-Based Services waiver program during the pandemic.
Michigan residents enrolled in Medicaid programs designed to provide services within their homes and communities, rather than in an institutional setting, would be protected from COVID-19 exposure under the request, MDHHS said.
“These essential changes will ensure beneficiaries have access to food, medicine, and care providers, while also minimizing potentially dangerous face-to-face interactions during the COVID-19 pandemic,” said Kate Massey, senior deputy director for the MDHHS Medical Services Administration and Michigan Medicaid director. “Michigan Medicaid is committed to doing whatever we can to continue to provide health care services to Medicaid enrollees during the pandemic while protecting them from exposure.”
MDHHS said the programs serve a variety of populations and include beneficiaries with intellectual or developmental disabilities, physical disabilities, and mental illness.
Michigan’s Home and Community-Based Services waiver programs are:
- MI Choice, which allows eligible adults to receive Medicaid-covered services like those provided by nursing homes while staying in their own home or in another community residential setting.
- MI Health Link, which offers adults age 21 and older enrolled in both Medicaid and Medicare a broad range of medical and behavioral health services, pharmacy, home and community-based services and nursing home care, all in a single program designed to meet individual needs. MI Health Link is for people who live in Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren or Wayne counties, or any county in the Upper Peninsula.
- Children’s Waiver Program, which provides for Medicaid to pay for services for children who are under age 18, have a documented developmental disability and need medical or behavioral supports and services at home.
- Habilitation Supports Waiver, which provides in a home or community-based setting the level of care of an intermediate care facility for people with intellectual and/or developmental disabilities.
- Waiver for Children with Serious Emotional Disturbances, which provides services for children with serious emotional disturbance who meet the criteria for admission to the state’s inpatient psychiatric hospital and are at risk of hospitalization without waiver services.
According to the MDHHS, the request is intended to ensure the primary and emergency medical and support needs of more than 22,000 participating beneficiaries are met without removing them from stable care settings or increasing their risk of exposure to COVID-19.
Michigan has requested the federal government allow all the state’s Home and Community-Based Service waiver programs to:
- Increase payment rates to direct care workers.
- Expand home-delivered meal services.
- Promote expanded use of telehealth services.
- Buy items necessary for social distancing, including personal protective equipment, disinfection supplies, additional cell phone minutes for telehealth visits, and grocery delivery services
- Cover transportation on behalf of a vulnerable person to better facilitate social distancing and self-isolation.
- Relax some provider training requirements to assure continued access.
- Temporarily modify services or service limitations to address health and welfare issues presented by the coronavirus emergency.
Additionally, MDHHS has requested that CMS allow the Children’s Waiver Program, Habilitation Supports Waiver and Waiver for Children with Serious Emotional Disturbances to:
- Temporarily expand settings where services may be provided, such as in hotels, shelters, schools or churches.
- Temporarily allow for payment for services to support beneficiaries in an acute care hospital or short-term institutional stay.
- Temporarily include retainer payments for some providers to address pandemic-related issues.
According to MDHHS, states are only allowed to request these types of amendments to the waivers during emergency situations.
Flexibilities granted by the federal government can extend through the duration of the emergency.