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Medicaid/Fee for service

News related to Medicaid/Fee for Service

In Health Bill’s Defeat, Medicaid Comes of Age

MARCH 27, 2017

When it was created more than a half century ago, Medicaid almost escaped notice.

Front-page stories hailed the bigger, more controversial part of the law that President Lyndon B. Johnson signed that July day in 1965 — health insurance for elderly people, or Medicare, which the American Medical Association had bitterly denounced as socialized medicine. The New York Times did not even mention Medicaid, conceived as a small program to cover poor people’s medical bills.

But over the past five decades, Medicaid has surpassed Medicare in the number of Americans it covers. It has grown gradually into a behemoth that provides for the medical needs of one in five Americans — 74 million people — starting for many in the womb, and for others, ending only when they go to their graves.

Medicaid, so central to the country’s health care system, also played a major, though far less appreciated, role in last week’s collapse of the Republican drive to repeal and replace the Affordable Care Act, also known as Obamacare. While President Trump and others largely blamed the conservative Freedom Caucus for that failure, the objections of moderate Republicans to the deep cuts in Medicaid also helped doom the Republican bill.

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SHA looks forward to working with the Department of Human Services' new Office of Housing to achieve more opportunities across populations and to expand the housing stock and supports for those on low incomes living with special needs. Together we hope to problem solve, find creative solutions and work collaboratively toward common goals. — Gail Levinson, Executive Director, SHA


From Liz Shea, Assistant Commissioner, NJDHS, Division of Developmental Disabilities:

Medicaid Fee for Service Implementation
 
Following the release of the Final Rate Report and Rate Schedule on July 18th, the Division has received numerous requests for information and further clarification about the rates and the intended rollout of the Medicaid-based Fee for Service (FFS) System. At this time, it is expected that the Division’s final transition from a contracted reimbursement system to a Medicaid-based fee-for-service (FFS) model will be implemented in 2015.
 
Steps toward that implementation have already begun, and we are developing a FFS Implementation timeline and other materials to assist stakeholders in understanding the various phases of the transition. Visit our Fee for Service Implementation web page, where new information will be posted by the end of August, or email questions or concerns to our dedicated Fee for Service Help Desk at: This email address is being protected from spambots. You need JavaScript enabled to view it. .


Housing
 
Many individuals, families and providers have expressed concern about accessing housing in the Division’s new fee-for-service Medicaid model. In that model, the Division plays a major role in facilitating community-based housing by funding, through its Medicaid waivers, the Medicaid-eligible services that are necessary to support individuals in the community.
 
I am pleased to tell you that, in accordance with national trends and best practices in separating housing and services, and in promoting cross-disability housing, the New Jersey Department of Human Services (DHS) established the DHS Office of Housing (OH), effective July 1, 2014. In collaboration with the divisions of DHS, the OH will develop and implement housing policy for DHS, as well as oversee the day to day housing activities of the Division of Mental Health and Addiction Services and the Division of Developmental Disabilities. In addition, the responsibilities of the Office of Housing, which is being led by Janel Winter, will include:
 
· identifying housing priorities, models and innovations for people served by DHS
· developing and growing partnerships with state agencies including the state housing agency – the Department of Community Affairs, and the state housing finance agency – the Housing & Mortgage Finance Agency, as well as other public and private partners and all stakeholders
· ensuring a pipeline of affordable housing to meet DHS’s Olmstead obligations and other needs
· education and outreach on supportive and affordable housing for people with disabilities.
 
In FY15, in addition to the ongoing crucial responsibility of ensuring sufficient housing to meet DHS’s Olmstead obligations and other needs (including supporting the closure of the Woodbridge Developmental Center), the OH will pursue two key goals:
 
· Development of a plan for compliance with the new CMS Final Rule on HCBS settings
· Development of a clearinghouse for administration of DHS housing subsidies
 
The following resources will also be launched in the coming months:
 
· A Housing web page on the Division’s website
· A dedicated DHS Housing Help Desk at This email address is being protected from spambots. You need JavaScript enabled to view it.
· The Supportive Housing Education Project, which will offer extensive educational and technical assistance resources to individuals and families on mainstream affordable housing resources and ways to pair those resources with DDD’s services available through its Medicaid waivers to create new housing options


Pre-Service Training for Direct Support Professionals
 
In our ongoing effort to improve service quality, the Division is implementing changes to the pre-service training requirements for Direct Support Professionals. Please see the important notice below regarding the Medication Administration training module:
 
Mandatory On-site Competency Assessment
The New Jersey Division of Developmental Disabilities is committed to safe and effective medication administration practices in all settings, and has established new pre-service training guidelines regarding these practices.
 
The Division recognizes that regardless of format – whether classroom or online – the training component alone does not build the necessary skills for the safe administration of medication in community-based settings. Therefore, an on-site competency assessment will be required across the system for all agency staff that are required to administer medications, as follows:  
 
· Effective July 1, 2014

Agencies have the option to either (a) send staff Medication Administration Module classroom training, or (b) complete the Medication Administration module online through the College of Direct Support (CDS). On-site Competency Assessment is mandatory following the completion of CDS online training before agency staff can independently administer medications.
 
· Effective October 1, 2014

On-site Competency Assessment is mandatory following the completion of classroom training before agency staff can independently administer medications.
 
· By June 30, 2015

On-site Competency Assessment is mandatory and must be completed for ALL existing agency staff required to administer medications.

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