[Federal Register Volume 60, Number 190 (Monday, October 2, 1995)]
[Notices]
[Pages 51483-51487]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-24400]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[ORD-079-N]
New and Pending Demonstration Project Proposals Submitted
Pursuant to Section 1115(a) of the Social Security Act: June 1995
AGENCY: Health Care Financing Administration (HCFA).
ACTION: Notice.
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SUMMARY: This notice lists new proposals for Medicaid demonstration
projects submitted to the Department of Health and Human Services
during the month of June 1995 under the authority of section 1115 of
the Social Security Act. This notice also lists proposals that were
approved, disapproved, pending, or withdrawn during this time period.
This notice also lists a new proposal that was submitted to the
Department in March 1995 but was inadvertently
[[Page 51484]]
omitted from the notice of new proposals published in the Federal
Register for that month. (This notice can be accessed on the Internet
at HTTP://WWW.SSA.GOV/HCFA/HCFAHP2.HTML.)
COMMENTS: We will accept written comments on these proposals. We will,
if feasible, acknowledge receipt of all comments, but we will not
provide written responses to comments. We will, however, neither
approve nor disapprove any new proposal for at least 30 days after the
date of this notice to allow time to receive and consider comments.
Direct comments as indicated below.
ADDRESSES: Mail correspondence to: Susan Anderson, Office of Research
and Demonstrations, Health Care Financing Administration, Mail Stop C3-
11-07, 7500 Security Boulevard, Baltimore, MD 21244-1850.
FOR FURTHER INFORMATION CONTACT: Susan Anderson, (410) 786-3996.
SUPPLEMENTARY INFORMATION:
I. Background
Under section 1115 of the Social Security Act (the Act), the
Department of Health and Human Services (HHS) may consider and approve
research and demonstration proposals with a broad range of policy
objectives. These demonstrations can lead to improvements in achieving
the purposes of the Act.
In exercising her discretionary authority, the Secretary has
developed a number of policies and procedures for reviewing proposals.
On September 27, 1994, we published a notice in the Federal Register
(59 FR 49249) that specified (1) the principles that we ordinarily will
consider when approving or disapproving demonstration projects under
the authority in section 1115(a) of the Act; (2) the procedures we
expect States to use in involving the public in the development of
proposed demonstration projects under section 1115; and (3) the
procedures we ordinarily will follow in reviewing demonstration
proposals. We are committed to a thorough and expeditious review of
State requests to conduct such demonstrations.
As part of our procedures, we publish a notice in the Federal
Register with a monthly listing of all new submissions, pending
proposals, approvals, disapprovals, and withdrawn proposals. Proposals
submitted in response to a grant solicitation or other competitive
process are reported as received during the month that such grant or
bid is awarded, so as to prevent interference with the awards process.
II. Listing of New Proposal for the Month of March 1995
The following comprehensive health reform proposal was submitted
during the month of March 1995 but was inadvertently omitted from the
listing of new proposals for that month. This proposal is also included
under the listing of pending comprehensive health reform proposals for
the month of June 1995.
Demonstration Title/State: The Partnership Plan--New York.
Description: New York proposes to move most of the currently
eligible Medicaid population and Home Relief (General Assistance)
populations from a primarily fee-for-service system to a managed care
environment. The State also proposes to establish special needs plans
to serve individuals with HIV/AIDS and certain children with mental
illnesses. The proposed enrollment date for Home Relief and Aid to
Families with Dependent Children (AFDC) recipients is November 1, 1995,
followed by a one year enrollment period for the SSI population
beginning January 1, 1997.
Date Received: March 17, 1995.
State Contact: Richard T. Cody, Deputy Commissioner, Division of
Health and Long Term Care, 40 North Pearl Street, Albany, NY 12243,
(518) 474-9132.
Federal Project Officer: Debbie Van Hoven, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
III. Listing of New, Pending, Approved, and Withdrawn Proposals for the
Month of June 1995
A. Comprehensive Health Reform Programs
1. New Proposals
The following comprehensive health reform proposal was received
during the month of June:
Demonstration Title/State: Kentucky Health Care Partnership--
Kentucky.
Description: Kentucky proposes to enroll all non-institutional
AFDC, AFDC-related, and Aged, Blind, and Disabled Medicaid eligibles
into regional managed care networks operated by a sole-source
contractor. The proposed start date of the demonstration is December 1,
1995.
Date Received: June 19, 1995.
State Contact: Larry A. McCarthy, Director, Program Development and
Budget, Department of Medicaid Services, 275 East Main Street,
Frankfort, KY 40621, (406) 444-4540.
Federal Project Officer: Maria Boulmetis, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
2. Pending Proposals
Demonstration Title/State: Arizona Health Care Cost Containment
System (AHCCCS)--Arizona.
Description: Arizona proposes to expand eligibility under its
current section 1115 AHCCCS program to persons with incomes up to 100
percent of the Federal poverty level.
Date Received: March 17, 1995.
State Contact: Mabel Chen, M.D., Director, Arizona Health Care Cost
Containment System, 801 East Jefferson, Phoenix, AZ 85034, (602) 271-
4422.
Federal Project Officer: Joan Peterson, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: MediPlan Plus--Illinois.
Description: Illinois seeks to develop a managed care delivery
system using a series of networks, either local or statewide, to tailor
its Medicaid delivery system to the needs of local urban neighborhoods
or large rural areas.
Date Received: September 15, 1994.
State Contact: Tom Toberman, Manager, Federal/State Monitoring, 201
South Grand Avenue East, Springfield, IL 62763, (217) 782-2570.
Federal Project Officer: Gina Clemons, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Community Care of Kansas--Kansas.
Description: Kansas proposes to implement a ``managed cooperation
demonstration project'' in four predominantly rural counties, and to
assess the success of a non-competitive managed care model in rural
areas. The demonstration would enroll recipients currently eligible in
the AFDC and AFDC-related eligibility categories, and expand Medicaid
eligibility to children ages 5 and under with family incomes up to 200
percent of the Federal poverty level.
Date Received: March 23, 1995.
State Contact: Karl Hockenbarger, Kansas Department of Social and
Rehabilitation Services, 915 Southwest Harrison Street, Topeka, KS
66612, (913) 296-4719.
Federal Project Officer: Jane Forman, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-21-
04, 7500 Security Boulevard, Baltimore, MD 21244-1850.
[[Page 51485]]
Demonstration Title/State: Louisiana Health Access--Louisiana.
Description: Louisiana proposes to implement a fully capitated
statewide managed care program. A basic benefit package and a
behavioral health and pharmacy wrap-around would be administered
through the managed care plans. The State intends to expand Medicaid
eligibility to persons with incomes up to 250 percent of the Federal
poverty level (FPL); those with incomes above 133 percent of the FPL
would pay all or a portion of premiums.
Date Received: January 3, 1995.
State Contact: Carolyn Maggio, Executive Director, Bureau of
Research and Development, Louisiana Department of Health and Hospitals,
P.O. Box 2870, Baton Rouge, LA 70821-2871, (504) 342-2964.
Federal Project Officer: Gina Clemons, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Missouri.
Description: Missouri proposes to require Medicaid beneficiaries to
enroll in managed care delivery systems, and extend Medicaid
eligibility to persons with incomes below 200 percent of the Federal
poverty level. As part of the program, Missouri would create a fully
capitated managed care pilot program to serve non-institutionalized
persons with permanent disabilities on a voluntary basis.
Date Received: June 30, 1994.
State Contact: Donna Checkett, Director, Division of Medical
Services, Missouri Department of Social Services, P.O. Box 6500,
Jefferson City, MO 65102-6500, (314) 751-6922.
Federal Project Officer: Nancy Goetschius, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: The Granite State Partnership for Access
and Affordability in Health Care--New Hampshire.
Description: New Hampshire proposes to extend Medicaid eligibility
to adults with incomes below the AFDC cash standard and to create a
public insurance product for low income workers. The State also seeks
to implement a number of pilot initiatives to help redesign its health
care delivery system.
Date Received: June 14, 1994.
State Contact: Barry Bodell, New Hampshire Department of Health and
Human Services, Office of the Commissioner, 6 Hazen Drive, Concord, NH
03301-6505, (603) 271-4332.
Federal Project Officer: Maria Boulmetis, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: The Partnership Plan--New York.
Description: New York proposes to move most of the currently
eligible Medicaid population and Home Relief (General Assistance)
populations from a primarily fee-for-service system to a managed care
environment. The State also proposes to establish special needs plans
to serve individuals with HIV/AIDS and certain children with mental
illnesses. The proposed enrollment date for Home Relief and Aid to
Families with Dependent Children (AFDC) recipients is November 1, 1995,
followed by a 1-year enrollment period for the SSI population beginning
January 1, 1997.
Date Received: March 17, 1995.
State Contact: Richard T. Cody, Deputy Commissioner, Division of
Health and Long Term Care, 40 North Pearl Street, Albany, NY 12243,
(518) 474-9132.
Federal Project Officer: Debbie Van Hoven, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: SoonerCare--Oklahoma.
Description: Oklahoma proposes to implement a 5-year statewide
managed care demonstration using both fully and partially capitated
delivery systems. The emphasis of the program is to address access
problems in rural areas by encouraging the development of rural-based
managed care initiatives. The State will employ traditional fully
capitated managed care delivery models for urban areas and will
introduce a series of partial capitation models in the rural areas of
the State. All currently eligible, non-institutionalized Medicaid
beneficiaries will be enrolled during the first 2 years of the project.
Date Received: January 6, 1995.
State Contact: Dr. Garth Splinter, Oklahoma Health Care Authority,
Lincoln Plaza, 4545 North Lincoln Blvd., Suite 124, Oklahoma City, OK
73105, (405) 530-3439.
Federal Project Officer: Helaine I. Fingold, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Health Access Plan Demonstration--
Vermont.
Description: Vermont proposes to integrate Medicaid recipients into
managed care plans and expand coverage to uninsured individuals up to
150 percent of the Federal poverty level. The State also proposes to
provide pharmacy coverage to low-income Medicare beneficiaries.
Date Received: February 24, 1995.
State Contact: Veronica Celani, Health Policy Director, Vermont
Agency of Human Services, 103 State Street, Waterbury, VT 05671, (802)
828-2949.
Federal Project Officer: Sherrie Fried, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
3. Approved Conceptual Proposals (Awards of Waivers Pending)
No conceptual proposals were approved during the month of June.
4. Approved Grant Proposals (Award of Waivers Pending)
No grant proposals were awarded during the month of June.
5. Approved Proposals
No comprehensive health reform proposals were approved during the
month of June.
6. Disapproved Proposals
No comprehensive health reform proposals have been disapproved
since January 1, 1993.
7. Withdrawn Proposals
No comprehensive health reform proposals were withdrawn during the
month of June.
B. Other Section 1115 Demonstration Proposals
1. New Proposals
The following new proposals were received during the month of June.
Demonstration Title/State: Alternatives in Medicaid Home Care
Demonstration--Colorado.
Description: Colorado proposes to conduct a pilot project that
eliminates the restriction on provision of Medicaid home health
services in locations other than the recipient's place of residence.
The proposal would also permit nursing aides to perform functions which
historically have been provided only by skilled nursing staff. Medicaid
recipients participating in the project will be adults (including both
frail elderly clients and younger clients with disabilities) who can
live independently and self-direct their own care. The project would
provide for delegation of specific functions from nurses to certified
nurses aides, pay nurses for
[[Page 51486]]
shorter supervision and monitoring visits, and allow higher payments to
aides performing delegated nursing tasks. Currently, home health agency
nursing and nurse aide services are paid on a per visit basis. Each
visit is approximately 2-4 hours in duration, and recipients must
require skilled, hands-on care.
Date Received: June 3, 1995.
State Contact: Dann Milne, Director, Department of Health Care
Policy and Financing, 1575 Sherman Street, Denver, CO 80203-1714, (303)
866-5912.
Federal Project Officer: Phyllis Nagy, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-21-
06, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Montana Mental Health Access Plan--
Montana.
Description: Montana proposes to provide all mental health services
for current Medicaid eligibles through managed care and to expand
Medicaid eligibility to persons with incomes up to 200 percent of the
Federal poverty level. Newly eligible individuals would receive only
mental health benefits, and would not be eligible for other health
services under the demonstration. A single state-wide contractor would
provide the mental health services and also determine eligibility,
perform inspections, and handle credentialing.
Date Received: June 16, 1995.
State Contact: Nancy Ellery, State Medicaid Director, Department of
Social and Rehabilitation Services, P.O. Box 4210, 111 North Sanders,
Helena, MT 59604-4210, (406) 444-4540.
Federal Project Officer: Nancy Goetschius, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
2. Pending Proposals
Demonstration Title/State: Georgia's Children's Benefit Plan--
Georgia.
Description: Georgia submitted a section 1115 proposal entitled
``Georgia Children's Benefit Plan'' to provide preventive and primary
care services to children aged 1 through 5 living in families with
incomes between 133 percent and 185 percent of the Federal poverty
level. The duration of the project is 5 years with proposed project
dates of July 1, 1995 to June 30, 2000.
Date Received: December 12, 1994.
State Contact: Jacquelyn Foster-Rice, Georgia Department of Medical
Assistance, 2 Peachtree Street Northwest, Atlanta, GA 30303-3159, (404)
651-5785.
Federal Project Officer: Maria Boulmetis, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-18-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: High Cost User Initiative--Maryland.
Description: Maryland proposes to implement an integrated case
management system for high-cost, high-risk Medicaid recipients.
Date Received: July 8, 1994.
State Contact: John Folkemer, Maryland Department of Health and
Mental Hygiene, Office of Medical Assistance Policy, 201 West Preston
Street, Baltimore, MD 21201, (410) 225-5206.
Federal Project Officer: William Clark, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-21-
06, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Family Planning Services Section 1115
Waiver Request--Michigan.
Description: Michigan seeks to extend Medicaid eligibility for
family planning services to all women of childbearing age with incomes
at or below 185 percent of the Federal poverty level, and to provide an
additional benefit package consisting of home visits, outreach services
to identify eligibility, and reinforced support for utilization of
services. The duration of the project is 5 years.
Date Received: March 27, 1995.
State Contact: Gerald Miller, Director, Department of Social
Services, 235 South Grand Avenue, Lansing, MI 48909, (517) 335-5117.
Federal Project Officer: Suzanne Rotwein, Ph.D., Health Care
Financing Administration, Office of Research and Demonstrations, Mail
Stop C3-24-07, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Family Planning Proposal--New Mexico.
Description: New Mexico proposes to extend Medicaid eligibility for
family planning services to all women of childbearing age with incomes
at or below 185 percent of the Federal poverty level.
Date Received: November 1, 1994.
State Contact: Bruce Weydemeyer, Director, Division of Medical
Assistance, P.O. Box 2348, Santa Fe, NM 87504-2348, (505) 827-3106.
Federal Project Officer: Suzanne Rotwein, Ph.D., Health Care
Financing Administration, Office of Research and Demonstrations, Mail
Stop C3-24-07, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: CHOICES--Citizenship, Health,
Opportunities, Interdependence, Choices and Supports--Rhode Island.
Description: Rhode Island proposes to consolidate all current State
and Federal funding streams for adults with developmental disabilities
under one program using managed care/managed competition.
Date Received: April 5, 1994.
State Contact: Susan Babin, Department of Mental Health,
Retardation, and Hospitals, Division of Developmental Disabilities, 600
New London Avenue, Cranston, RI 02920, (401) 464-3234.
Federal Project Officer: Melissa McNiff, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-21-
06, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Family Planning Services Eligibility
Requirements Waiver--South Carolina.
Description: South Carolina proposes to extend Medicaid coverage
for family planning services for 22 additional months to postpartum
women with monthly incomes under 185 percent of the Federal poverty
level. The objectives of the demonstration are to increase the number
of reproductive age women receiving either Title XIX or Title X funded
family planning services following the completion of a pregnancy,
increase the period between pregnancies among mothers eligible for
maternity services under the expanded eligibility provisions of
Medicaid, and estimate the overall savings in Medicaid spending
attributable to providing family planning services to women for 2 years
postpartum. The duration of the proposed project would be 5 years.
Date Received: May 4, 1995.
State Contact: Eugene A. Laurent, Executive Director, State Health
and Human Services Finance Commission, P.O. Box 8206, Columbia, SC
29202-8206, (803) 253-6100.
Federal Project Officer: Suzanne Rotwein, Ph.D., Health Care
Financing Administration, Office of Research and Demonstrations, Mail
Stop C3-24-07, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Demonstration Title/State: Wisconsin.
Description: Wisconsin proposes to limit the amount of exempt funds
that may be set aside as burial and related expenses for SSI-related
Medicaid recipients.
Date Received: March 9, 1994.
State Contact: Jean Sheil, Division of Economic Support, Wisconsin
Department of Health and Social Services, 1 West Wilson Street, Room
650, P.O. Box 7850, Madison, WI 53707, (608) 266-0613.
[[Page 51487]]
Federal Project Officer: J. Donald Sherwood, Health Care Financing
Administration, Office of Research and Demonstrations, Mail Stop C3-16-
26, 7500 Security Boulevard, Baltimore, MD 21244-1850.
3. Approved Conceptual Proposals (Award of Waivers Pending)
No conceptual proposals were awarded during the month of June.
4. Approved Proposals
No proposals were approved during the month of June.
5. Disapproved Proposals
No proposals were disapproved during the month of June.
6. Withdrawn Proposals
No proposals were withdrawn during the month of June.
IV. Requests for Copies of a Proposal
Requests for copies of a specific Medicaid proposal should be made
to the State contact listed for the specific proposal. If further help
or information is needed, inquiries should be directed to HCFA at the
address above.
(Catalog of Federal Domestic Assistance Program, No. 93.779; Health
Financing Research, Demonstrations, and Experiments.)
Dated: September 22, 1995.
Bruce C. Vladek,
Administrator, Health Care Financing Administration.
[FR Doc. 95-24400 Filed 9-29-95; 8:45 am]
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