Comprehensive Medicaid Waiver Renewal

Public Comment Sought for Medicaid-funded Services

June 21, 2016

Overview

On June 10, 2016, the New Jersey Department of Human Services’ (DHS) Division of Medical Assistance and Health Services (DMAHS) submitted its draft renewal application for the New Jersey FamilyCare 1115 Comprehensive Waiver Demonstration to the federal Centers for Medicare and Medicaid Services (CMS). The waiver was approved by CMS in October 2012 and is set to expire in June 2017.

Deadline:  August 12, 2016

As part of the process, New Jersey is providing a 30-day stakeholder review and comment period, which runs through July 10, 2016.  UPDATE:  At the request of acting Commissioner Elizabeth Connolly, "in order to ensure that everyone’s voices are heard and submitted comments reviewed, CMS has allowed the state to extend the 30-day public input period another 30 days to August 12." 

What is the Renewal Application?  

The renewal document outlines the “contract” between DHS and CMS and allows for federal reimbursement to the state for services delivered through Medicaid, a state- and federally-funded public health insurance program that provides medical and health services to individuals with low income and/or disabilities.  In New Jersey, the program is called NJ FamilyCare. The proposal makes more funds available to meet the needs of the autism community and other populations that NJ FamilyCare (Medicaid) serves. 

Specifically, the state intends to:

  1. Increase access to services and supports for individuals with autism and those with a dual diagnosis of intellectual or developmental disabilities and mental illness
  2. Further streamline NJ FamilyCare (Medicaid) eligibility and enrollment processes, and
  3. Initiate or expand services with nationally recognized best practices and implement strategies to streamline processes and create efficiencies that continue to rebalance resources.  

Why is commenting on this document important?

NJ FamilyCare (Medicaid) pays for many publicly funded services for children and adults with developmental disabilities. This document offers a general outline of how services and supports for individuals with intellectual and developmental disabilities can be enhanced and/or increased.  These services include:  the Community Care Waiver, the Supports Program, and coverage of medically necessary services for children with autism via Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT), and more.

As state officials draft this application, community input is needed to inform the development of the policies and procedures for these services to ensure that the community’s needs will be addressed in a family-friendly, efficient, and effective manner. 

Proposals most relevant for our community and for which it is critical that your voice be heard are:

  1. Moving the Community Care Waiver (CCW) from a separate waiver category to this Comprehensive Medicaid Waiver (page 12)
  2. Supports Program for adults with Developmental Disabilities
  3. Pilot program for Adults with I/DD and Co-occurring Behavioral Health Needs (page 12)
  4. NJ FamilyCare (Medicaid) coverage of medically necessary services, including Applied Behavior Analysis treatment for children with autism (pages 12-14)

Now is the time to make recommendations for what services should be available and how these services will be administered. Here are some questions to get you started:

  • Are the treatment needs of children and adults with autism being met by the CCW, Supports Program, and NJ FamilyCare? 
  • How could these programs improve or expand to meet individuals’ needs?
  • What services would ensure the safety, treatment, and basic quality of life needs of individuals with autism are met?

Submit your comments

The Department of Human Services is encouraging interested parties are being encouraged to submit constructive thoughts by email, fax or mail.  DHS is open to your ideas and suggestions and may incorporate any viable, cost-neutral recommendations that can advance a patient-centered system of care that ensures access to quality, comprehensive health care for participants. 

Autism New Jersey has prepared comments that our members and stakeholders may wish to review and consider before submitting their own. Feel free to copy any/all content. Please consider crediting us with a preface such as, “Consistent with Autism New Jersey’s position, …”  You could agree with components or the entire comment. When the state summarizes all of the comments for CMS and their own purposes, consistent messages will help our community’s voices will be heard loud and clear.

 

Your submissions can be sent via:  

Email: dmahs.cmwcomments@dhs.state.nj.us

Fax: 609-588-7343

Mail:
Margaret Rose
Division of Medical Assistance and Health Services
Office of Legal and Regulatory Affairs
P.O. Box 712
Trenton, NJ 08625-0712


Expanding Access to ABA Via Medicaid

"NJ FamilyCare (Medicaid) coverage of ABA treatment for children with autism and intellectual disability is a moral and federal imperative that will offer thousands of children from low-income homes the opportunity to make tremendous gains in communication, social, academic, and life skills as well as markedly improve their prognosis as adults."

AUTISM NEW JERSEY
500 Horizon Drive, Suite 530 Robbinsville, NJ 08691
Phone: 609.588.8200; 800.4.AUTISM | Fax: 609.588.8858
Email: information@autismnj.org

Instagram