Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of...

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Colorado Department of Health Care Policy and Financing 1 Colorado Medicaid Home Modification Benefit May 2013

Transcript of Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of...

Page 1: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

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Colorado Medicaid

Home Modification Benefit

May 2013

Page 2: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

Improving health care access

and outcomes for the people we serve while demonstrating sound

stewardship of financial resources

Our Mission:

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Page 3: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

Medicaid Home Modification Benefit

What is Medicaid?

What is the Home Modification Benefit?

What are our commonalities?

How can take advantage of this benefit?

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Medicaid provides free or low-cost health coverage for children, families, elderly and people with disabilities

Programs vary by state Must cover mandatory benefits

Can provide optional benefits

Waivers give states flexibility to develop alternatives for specific populations or needs

Moving toward more community options

What is Medicaid?

Page 5: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

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Medicaid

Adults without Dependent

Children Families Elderly

Individuals with Disabilities

Long-Term Services and Supports

Qualify for applicable

waivers

Home Modification

Benefit

Page 6: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

→ Provides additional Medicaid benefits to specific populations

→ Clients must meet financial, medical and program criteria

→ Clients must receive services in their homes or communities

→ Clients can only receive services from one waiver at a time

Home and Community Based Services (HCBS) Waiver Program

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Community Mental Health Supports Waiver

Persons with Brain Injury

Persons who are Elderly, Blind and Disabled

Persons with Spinal Cord Injury

Persons Living with AIDS

Persons with Developmental Disabilities

Supported Living Services Waiver

Adult HCBS Waivers in Colorado

Page 8: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

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Questions

Page 9: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

Purpose

Provide a safe and accessible home environment which allows persons living with a disability to safely reside in their home

Modifications • Installing or

building ramps

• Installing grab-bars

• Widening doorways

• Modifying

• Bathrooms

• Kitchens

• And more…

Medical Need Home modifications must:

• Be necessary for health and safety of client

• Enable client to function more independently in home

• Prevent institutionalization

• Be required due to client’s illness, impairment or disability as determined by Case Management Agency

Home Modification Benefit

Page 10: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

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$10,000 lifetime cap per client

Can be split among different projects

Medicaid is payer of last resort

How much is the benefit?

Page 11: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

Living with a physical disability

Needs accessible bathroom

Enrolled in Elderly, Blind and Disabled waiver

Currently renting

Michael

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Page 12: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

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Michael works with Case Manager to submit request

Case Manager requests landlord

approval

Occupational Therapist visits

Michael to determine need

Case Manager requests bids

based on therapist evaluation

Home Modification provider submits

bid to Case Manager

Case Manager submits bid for State approval

Case Manager notified of the approved bid

Case Manager notifies Home Modification

provider

Work begins

Client Perspective

Page 13: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

Sue owns a home remodel business

Many of her clients are part of the elderly or disabled population

This program gives her an additional opportunity to continue to help people in her community

Becoming a Provider

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Enroll as Medicaid Provider

Connect with local Case Management

Agency

Receive notification from

CMA when there is a request

Conduct site visit with client

Submit bid to Case Manager

Case Manager submits bid for State approval

Case Manager notifies approved

provider

Home Modification provider secures

necessary permits Work begins

Provider Perspective

Page 15: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

I know someone who might benefit from this program? What if…

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Page 16: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

What are our commonalities?

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Type of Work

Funding

Clients

Providers

Who oversees programs

Differences and Similarities

Page 18: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

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Expand your business to new populations

Provide services to a vulnerable population in your community

Take advantage of additional funding source

Becoming a Home Modification Provider

Page 19: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

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Colorado.gov/hcpf

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Questions

Page 21: Colorado Medicaid Home Modification Benefit...Home Modification Benefit Colorado Department of Health Care Policy and Financing 10 $10,000 lifetime cap per client Can be split among

Colorado Department of Health Care Policy and Financing

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Thank You!

Nick Clark

Long-Term Services Supports Division Health Care Policy and Financing

[email protected] 303-866-2436

mailto:[email protected]

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