95-7848. New and Pending Demonstration Project Proposals Submitted Pursuant to Section 1115(a) of the Social Security Act: January 1995

[Federal Register Volume 60, Number 61 (Thursday, March 30, 1995)]
[Notices]
[Pages 16481-16486]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-7848]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[ORD-073-N]


New and Pending Demonstration Project Proposals Submitted 
Pursuant to Section 1115(a) of the Social Security Act: January 1995

AGENCY: Health Care Financing Administration (HCFA), HHS.

ACTION: Notice.

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SUMMARY: This notice lists new proposals for demonstration projects 
submitted to the Department of Health and Human Services during the 
month of January 1995 under the authority of section 1115 of the Social 
Security Act. This notice also lists approved, disapproved and pending 
proposals.

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, 2230 Oak 
Meadows, 6325 Security Boulevard, Baltimore, MD 21207.

FOR FURTHER INFORMATION CONTACT:
Susan Anderson, [phone].

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.

II. Listing of New and Pending Proposals for the Month of January 1995

    As part of our procedures, we are publishing a monthly notice in 
the Federal Register of all new submissions, pending proposals, 
approvals, and disapprovals. Proposals submitted in response to a grant 
solicitation or other competitive process will be reported as received 
during the month that such grant or bid is awarded, so as to prevent 
interference with the awards process. We have added a new category in 
this notice entitled ``Approved Grant Proposals'' to identify grant and 
cooperative agreement awards for development of demonstration projects 
that may involve section 1115 authority.

A. Comprehensive Health Reform Programs

1. New Proposals
    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 eligibility 
of persons with incomes up to 250 percent of the Federal poverty level 
(FPL), with persons with incomes above 133 percent of the FPL paying 
all or a portion of premiums. To fund the demonstration, the State is 
seeking a waiver of Federal Medical Assistance Payments (FMAP) 
requirements, which would effectively create a block grant whereby the 
Federal share of the demonstration would be fixed over the course of 
the demonstration and the State would assume the cost of increases as 
they occurred.
    Date Received: January 3, 1995.
    State Contact: Carolyn Maggio, Executive Director, Bureau of 
Research and Development, Louisiana Department of Health and Hospitals, 
Post Office 2870, Baton Rouge, Louisiana 70821-2871, [phone].
    Federal Project Officer: Gina Clemons, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    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 individuals 
will be enrolled during the first two years of the project.
    Date Received: January 6, 1995.
    State Contact: Dr. Garth Splinter, Oklahoma Health Care Authority, 
Lincoln Plaza, 4545 N. Lincoln Blvd., Suite 124, Oklahoma City, 
Oklahoma 73105.
    Federal Project Officer: Helaine I. Fingold, Health Care Financing 
[[Page 16482]] Administration, Office of Research and Demonstrations, 
2302 Oak Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
2. Pending Proposals:
    Demonstration Title/State: The Diamond State Health Plan--Delaware.
    Description: Delaware proposes to expand eligibility for Medicaid 
to persons with incomes up to 100 percent of the Federal poverty level 
and require that the Medicaid population enroll in managed care 
delivery systems. The State's current section 1115 demonstration 
project, the Delaware Health Care Partnership for Children, would be 
incorporated into the statewide program as an optional provider for 
eligible children.
    Date Received: July 29, 1994.
    State Contact: Kay Holmes, DSHP Coordinator, DHSS Medicaid Unit, 
Biggs Building, P.O. Box 906, New Castle, Delaware 19720, (302) 577-
4900.
    Federal Project Officer: Rosana Hernandez, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    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, Illinois 62763, [phone].
    Federal Project Officer: Gina Clemons, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: MassHealth--Massachusetts.
    Description: Massachusetts proposes a range of strategies that 
would extend Medicaid coverage to its low-income and uninsured 
citizens, including the employed, the short-term unemployed, and the 
long-term unemployed. The proposed program would employ direct 
provision of health services as well as indirect strategies that would 
promote market forces to address the needs of the uninsured, by 
providing subsidies to employers and low-income employees with incomes 
up to 200 percent of the Federal poverty level.
    Date Received: April 15, 1994.
    State Contact: Laurie Burgess, Director, Managed Care Program 
Development, Division of Medical Assistance, 600 Washington Street, 
Boston, Massachusetts 02111, [phone].
    Federal Project Officer: Ed Hutton, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: MinnesotaCare--Minnesota.
    Description: Minnesota proposes to expand its use of managed care 
service delivery and to extend Medicaid eligibility to families and 
children with incomes up to 275 percent of the Federal poverty level. 
The State would also integrate Medicaid with other public entities that 
deliver health services.
    Date Received: July 28, 1994.
    State Contact: Maria Gomez, Commissioner, Health Care Services 
Delivery, Minnesota Department of Human Services, 444 Lafayette Road N, 
St. Paul, Minnesota 55155, [phone].
    Federal Project Officer: Penny Pine, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Missouri.
    Description: Missouri proposes to require that beneficiaries 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, Missouri 65102-6500, [phone].
    Federal Project Officer: Suzanne Rotwein, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    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, New 
Hampshire 03301-6505, [phone].
    Federal Project Officer: Maria Boulmetis, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
3. Approved Conceptual Proposals (Award of Waivers Pending)
    No conceptual proposals were approved during the month of January.
4. Approved Grant Proposals (Award of Waivers Pending)
    No grant proposals were awarded in the month of January. The 
following are proposals awarded since January 1, 1993:
    Demonstration Title/State: MAINE-NET: Medicaid and Medicare Managed 
Care for the Elderly and Physically Disabled in Maine--Maine.
    Description: This project is designed to demonstrate integrated 
models for the financing and delivery of managed health care and social 
services for elderly and physically disabled persons on Medicare and/or 
Medicaid in Maine. The project seeks to promote the development of 
regional service delivery networks or health plans, particularly in 
rural areas of the State, that would be responsible for the management, 
coordination and integration of services, including multi-disciplinary 
approaches to care planning and service delivery. The demonstration 
will provide a comprehensive package of primary, acute, and long term 
care (institutional and noninstitutional) services as part of a prepaid 
capitated health plan for the target populations. The project is in the 
early developmental stage.
    Date Received: March 25, 1994.
    State Contact: Carreen Wright, State of Maine Department of Human 
Services, State House Station #11, Augusta, Maine 04333.
    Federal Project Office: Kay Lewandowski, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, Baltimore, Maryland 21207.

    Demonstration Title/State: Project Demonstrating and Evaluating 
Alternative Methods to Assure and Enhance the Quality of Long Term Care 
Services for Persons with Developmental Disabilities through 
Performance-Based Contracts with Service Providers--Minnesota 
[[Page 16483]] 
    Description: The purpose of this project is to determine whether 
and how well the implementation of new approaches to quality assurance, 
with outcome-based definitions and measures of quality, will replace 
the input and process measures of quality, and in the process 
contribute to improving quality of life for persons with developmental 
disabilities. The Minnesota Department of Human Services will seek 
Federal authority to waive necessary provisions of intermediate care 
facilities for the mentally retarded (ICFs/MR) regulations to permit 
alternative quality assurance mechanisms in selected demonstration, 
residential, and support service programs. The Department will enter 
into performance-based contracts with counties, and participating ICF/
MR providers. Desirable outcomes include, among others, the enhancement 
of consumer choice and autonomy, employment, and integration into the 
community. This project is in the developmental stage.
    Date Received: March 25, 1994.
    State Contact: Helen M. Yates, Minnesota Department of Human 
Services, Health Care Administration, 44 Lafayette Road, St. Paul, 
Minnesota 55155-3853.
    Federal Project Officer: Samuel M. Brown, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
5. Approved Proposals
    Demonstration Title/State: OhioCare--Ohio.
    Description: Ohio will expand Medicaid eligibility to include 
uninsured persons with incomes up to 100 percent of the Federal poverty 
level. New and current eligibles in this statewide program will receive 
services through managed care. Certain special health related services, 
such as mental health and drug and alcohol addiction services, will 
also be provided through managed care.
    Date Received: March 2, 1994.
    Date Awarded: January 17, 1995.
    Implementation Date: (Proposed) January 1, 1996.
    State Contact: Kathi Glynn, Director, Ohio Medicaid, 30 East Broad 
Street, Columbus, Ohio 43266, [phone].
    Federal Project Officer: David Walsh, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
6. Disapproved Proposals
    No comprehensive health reform proposals have been disapproved 
since January 1, 1993.

B. Other Section 1115 Demonstration Proposals

1. New Proposals
    No new proposals were received during the month of January.
2. Pending Proposals
    Demonstration Title/State: Georgia's Children's Benefit Plan.
    Description: The State of Georgia submitted a Section 1115 proposal 
entitled ``Georgia Children's Benefit Plan'' that provides preventive 
and primary care services for children 1 through 5 years of age who are 
between 133 and 185 percent of the Federal poverty level. The duration 
of the waiver 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 NW, 201 South Grand Avenue East, 
Atlanta, Georgia 30303-3159, [phone].
    Federal Project Officer: Maria Boulmetis, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    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, Maryland 21201, [phone].
    Federal Project Officer: Rosana Hernandez, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Minnesota Long-Term Care Options 
Project--Minnesota.
    Description: The State proposes to integrate long-term care and 
acute care services under combined Medicare and Medicaid capitation 
payments for elderly dual eligibles.
    Date Received: April 18, 1994.
    State Contact: Pamela Parker, Minnesota Department of Human 
Services, Human Services Building, 444 Lafayette Road North, St. Paul, 
Minnesota 55155, [phone].
    Federal Project Officer: Melissa McNiff, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    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, New Mexico 87504-2348, (505) 827-
3106.
    Federal Project Officer: Alisa Adamo, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Pay-in Spenddown Pilot--Ohio.
    Description: Ohio proposes to implement a one-county pilot program 
to simplify Medicaid eligibility administration. It would allow the 
medically needy to pay in spenddown amounts in order to qualify for 
Medicaid.
    Date Received: April 28, 1994.
    State Contact: Jeanne Carroll, Ohio Department of Human Services, 
30 East Broad Street, Columbus, Ohio 43266, [phone].
    Federal Project Officer: David Walsh, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    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, Rhode Island 02920, [phone].
    Federal Project Officer: Melissa McNiff, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

     [[Page 16484]] Demonstration Title/State: Virginia.
    Description: Virginia proposes to expand Medicaid eligibility to 
children in the State-funded KIDS CARE program, and provide them with a 
limited Medicaid benefit restricted to ambulatory services.
    Date Received: May 18, 1994.
    State Contact: Janet Kennedy, Suite 1300, 600 East Broad Street, 
Richmond, Virginia 23219, [phone].
    Federal Project Officer: Maria Boulmetis, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Family Planning Demonstration--
Washington.
    Description: The State proposes to provide family planning services 
to low-income women for an additional 10 months postpartum, which will 
extend total coverage for such services to one year.
    Date Received: April 21, 1994.
    State Contact: Claudia Lewis, Medical Assistance Administration, 
Division of Client Services, P.O. Box 45530, Olympia, Washington 98504-
5530, [phone].
    Federal Project Officer: Maria Boulmetis, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Wisconsin.
    Description: The State 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, Wisconsin 53707, [phone].
    Federal Project Officer: J. Donald Sherwood, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
3. Approved Conceptual Proposals (Award of Waivers Pending)
    No conceptual proposals were approved during the month of January.
4. Approved Proposals
    The following projects were inadvertently omitted from the list of 
pending proposals published in the Federal Register on January 23, 1995 
(60 FR 4418).
    Demonstration Title/State: The Multistate Nursing Home Case-Mix and 
Quality Demonstration--Kansas.
    Description: This demonstration tests a combined Medicare and 
Medicaid nursing home payment and quality monitoring system. The system 
significantly enhances the quality assurance process in SNFs. Data for 
measuring quality of care will come from an expanded version of the 
standardized resident assessment instrument currently used by States 
for all nursing home residents. The same tool that is used in care 
planning, which measures residents' needs, strengths, and preferences, 
will be used to determine Medicare and Medicaid payment. In the 
developmental phase of the demonstration, data from the assessment 
instruments were used to create 30 facility-level quality indicators. 
Under the demonstration, these indicators will help facilities 
benchmark their own performance and help Medicare and Medicaid target 
nursing home surveys.
    Date Received: Winter 1989.
    Date Awarded: January 1995.
    Implementation Date: (Proposed) Summer 1995.
    State Contact: Evelyn McCormick, R.N., Case Mix Demonstration 
Project Director, Department of Social And Rehabilitation Services 
Docking State Office Building, Room 628 South, 915 Southwest Harrison, 
Topeka, Kansas 66612-1570, [phone].
    Federal Project Officer: Elizabeth Cornelius, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: The Multistate Nursing Home Case-Mix and 
Quality Demonstration--Maine.
    Description: This demonstration tests a combined Medicare and 
Medicaid nursing home payment and quality monitoring system. The system 
significantly enhances the quality assurance process in SNFs. Data for 
measuring quality of care will come from an expanded version of the 
standardized resident assessment instrument currently used by States 
for all nursing home residents. The same tool that is used in care 
planning, which measures residents' needs, strengths, and preferences, 
will be used to determine Medicare and Medicaid payment. In the 
developmental phase of the demonstration, data from the assessment 
instruments were used to create 30 facility-level quality indicators. 
Under the demonstration, these indicators will help facilities 
benchmark their own performance and help Medicare and Medicaid target 
nursing home surveys.
    Date Received: Winter 1989.
    Date Awarded: January 1995.
    Implementation Date: (Proposed) Summer 1995.
    State Contact: Alison Moore, R.N., M.B.A., Case Mix Demonstration 
Project Director, Bureau of Medical Services, Maine Department of Human 
Services, State House Station 11, Augusta, Maine 04333, [phone].
    Federal Project Officer: Elizabeth Cornelius, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: The Multistate Nursing Home Case-Mix and 
Quality Demonstration--Mississippi.
    Description: This demonstration tests a combined Medicare and 
Medicaid nursing home payment and quality monitoring system. The system 
significantly enhances the quality assurance process in SNFs. Data for 
measuring quality of care will come from an expanded version of the 
standardized resident assessment instrument currently used by States 
for all nursing home residents. The same tool that is used in care 
planning, which measures residents' needs, strengths, and preferences, 
will be used to determine Medicare and Medicaid payment. In the 
developmental phase of the demonstration, data from the assessment 
instruments were used to create 30 facility-level quality indicators. 
Under the demonstration, these indicators will help facilities 
benchmark their own performance and help Medicare and Medicaid target 
nursing home surveys.
    Date Received: Winter 1989.
    Date Awarded: January 1995.
    Implementation Date: (Proposed) Summer 1995.
    State Contact: Jamie Collier, Case Mix Demonstration Project 
Director Division of Medicaid, Robert E. Lee Building, Suite 801, 239 
North Lamar Street, Jackson, Mississippi, [phone].
    Federal Project Officer: Elizabeth Cornelius, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: The Multistate Nursing Home Case-Mix and 
Quality Demonstration--New York.
    Description: This demonstration tests a combined Medicare and 
Medicaid nursing home payment and quality monitoring system. The system 
[[Page 16485]] significantly enhances the quality assurance process in 
SNFs. Data for measuring quality of care will come from an expanded 
version of the standardized resident assessment instrument currently 
used by States for all nursing home residents. The same tool that is 
used in care planning, which measures residents' needs, strengths, and 
preferences, will be used to determine Medicare and Medicaid payment. 
In the developmental phase of the demonstration, data from the 
assessment instruments were used to create 30 facility-level quality 
indicators. Under the demonstration, these indicators will help 
facilities benchmark their own performance and help Medicare and 
Medicaid target nursing home surveys.
    Date Received: Winter 1989.
    Date Awarded: January 1995.
    Implementation Date: (Proposed) Summer 1995.
    State Contact: David H. Wilcox, CPA, Case Mix Demonstration Project 
Director, Bureau of Health Economics, 1143 Corning Tower, Empire State 
Plaza, Albany, New York 12237-0722, [phone].
    Federal Project Officer: Elizabeth Cornelius, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: The Multistate Nursing Home Case-Mix and 
Quality Demonstration--South Dakota.
    Description: This demonstration tests a combined Medicare and 
Medicaid nursing home payment and quality monitoring system. The system 
significantly enhances the quality assurance process in SNFs. Data for 
measuring quality of care will come from an expanded version of the 
standardized resident assessment instrument currently used by States 
for all nursing home residents. The same tool that is used in care 
planning, which measures residents' needs, strengths, and preferences, 
will be used to determine Medicare and Medicaid payment. In the 
developmental phase of the demonstration, data from the assessment 
instruments were used to create 30 facility-level quality indicators. 
Under the demonstration, these indicators will help facilities 
benchmark their own performance and help Medicare and Medicaid target 
nursing home surveys.
    Date Received: Winter 1989.
    Date Awarded: January 1995.
    Implementation Date: (Proposed) Summer 1995.
    State Contact: Carol Job, R.N., Case Mix Demonstration Project 
Director, Department of Social Services and Aging, 700 Governors Drive, 
Pierre, South Dakota 57501-2291, [phone].
    Federal Project Officer: Elizabeth Cornelius, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: The Multistate Nursing Home Case-Mix and 
Quality Demonstration--Texas.
    Description: This demonstration tests a combined Medicare and 
Medicaid nursing home payment and quality monitoring system. The system 
significantly enhances the quality assurance process in SNFs. Data for 
measuring quality of care will come from an expanded version of the 
standardized resident assessment instrument currently used by States 
for all nursing home residents. The same tool that is used in care 
planning, which measures residents' needs, strengths, and preferences, 
will be used to determine Medicare and Medicaid payment. In the 
developmental phase of the demonstration, data from the assessment 
instruments were used to create 30 facility-level quality indicators. 
Under the demonstration, these indicators will help facilities 
benchmark their own performance and help Medicare and Medicaid target 
nursing home surveys.
    Date Received: Winter 1989.
    Date Awarded: January 1995.
    Implementation Date: (Proposed) Summer 1995.
    State Contact: Sue Wilson, Case Mix Demonstration Project Director 
Rate Analysis Department, Texas Department of Human Services P.O. Box 
149030, Mailcode W-425, Austin, Texas 78714-9030 [phone]
    Federal Project Officer: Elizabeth Cornelius, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    The following proposal was approved in January 1995.
    Demonstration Title/State: Demonstration Project for Family 
Planning and Reproductive Services--Maryland.
    Description: Maryland will extend Medicaid eligibility for family 
planning and preventive reproductive services for a 5-year period to 
women who are Medicaid eligible due to their pregnancy and remain 
Medicaid eligible 60-days post-partum.
    Date Received: June 11, 1994.
    Date Awarded: January 18, 1995.
    Implementation Date: Not yet determined
    State Contact: Jane Forman, Department of Health and Mental Hygiene 
Room 137, 201 West Preston Street, Baltimore, Maryland 21201, (410) 
225-6538
    Federal Project Officer: Alisa Adamo, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    The following are projects approved since January 1, 1993, in 
addition to those published in the Federal Register on January 23, 1995 
(60 FR 4418).
    Demonstration Title/State: Medicaid Direct Purchase Vaccine Program 
(MDPVP)--Arkansas.
    Description: The MDPVP streamlines the reimbursement process for 
vaccines, by allowing States to directly reimburse manufacturers for 
vaccines. Vaccine manufacturers send a shipment of vaccines on 
consignment at no cost to each private physician who treats children on 
Medicaid. Physicians then bill Medicaid for the office visit when they 
inoculate children, but not for the cost of the vaccine. The Medicaid 
program will reimburse the manufacturer directly at a discounted rate, 
according to the number of vaccines administered. The manufacturer will 
then send replacement quantities of the vaccines to the private 
physicians.
    Date Received: March 1993.
    Date Awarded: June 1993.
    Implementation Date: Not Yet Determined.
    State Contact: Judy Kerr, Arkansas Department of Human Services, 
Division of Economic and Medical Services, Donaghey Plaza South, P.O. 
Box 1437 Little Rock, Arkansas 72203-1437, [phone].
    Federal Project Officer: Alisa Adamo, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Improving Access to Care for Pregnant 
Substance Abusers--Massachusetts.
    Description: This demonstration seeks to increase the number of 
Medicaid-eligible pregnant substance abusers who receive coordinated 
perinatal care services, substance abuse treatment, and other relevant 
services to promote better health outcomes for themselves and their 
offspring.
    Date Received: 1991.
    Date Awarded: July 1, 1993.
    Implementation Date: July 1993.
    State Contact: Milton Argeriou, Ph.D. Project Director, MOTHERS 
Project, 200 [[Page 16486]] Lincoln Street, Suite 303, Boston, 
Massachusetts 02111, [phone].
    Federal Project Officer: Debbie Van Hoven, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Improving Access to Care for Pregnant 
Substance Abusers--New York.
    Description: This demonstration seeks to increase the number of 
Medicaid-eligible pregnant substance abusers who receive coordinated 
perinatal care services, substance abuse treatment, and other relevant 
services to promote better health outcomes for themselves and their 
offspring.
    Date Received: 1991.
    Date Awarded: July 1, 1993.
    Implementation Date: July 1993.
    State Contact: Mr. Stuart Lefkowich, Assistant Commissioner, Bureau 
of Primary Care, Division of Health and Long Term Care, New York State 
Department of Social Services, 40 North Pearl Street, Albany, New York 
12243-0001, [phone]
    Federal Project Officer: Sherrie Fried, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Health Access Plan--South Carolina.
    Description: This project tests the effects on individuals' access 
to and cost of health care of eliminating categorical eligibility 
requirements and of raising the financial eligibility limits to 150 
percent of the Federal poverty level.
    Date Received: Spring 1991.
    Date Awarded: February 1993.
    Implementation Date: March 1993.
    State Contact: Bruce Bondo, Health and Human Services Finance 
Commission, 1801 Main Street, Columbia, South Carolina 29201, (803) 
253-6177.
    Federal Project Officer: Jamie Hadley, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Improving Access to Care for Pregnant 
Substance Abusers--South Carolina.
    Description: This demonstration seeks to increase the number of 
Medicaid-eligible pregnant substance abusers who receive coordinated 
perinatal care services, substance abuse treatment, and other relevant 
services to promote better health outcomes for themselves and their 
offspring.
    Date Received: 1991.
    Date Awarded: July 1, 1993.
    Implementation Date: July 1993.
    State Contact: Bunny W. Jones, State Health and Human Services 
Finance Commission, Department of High Risk and Maternal Care, P.O. Box 
8206, Columbia, South Carolina 29202-8206, [phone].
    Federal Project Officer: Debbie Van Hoven, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Health Access Plan--Washington.
    Description: This project tests the effects of eliminating 
categorical eligibility requirements and raising the financial 
eligibility limits to 200 percent of the Federal poverty level on 
individuals' access to and cost of health care.
    Date Received: Spring 1991.
    Date Awarded: February 1993.
    Implementation Date: March 1993.
    State Contact: Rochelle Salsman, Department of Health and Social 
Services, Medical Assistance Administration, Office of Recipient 
Services, 617 8th Avenue, SE., 4th Floor, P.O. Box 45530, Olympia, 
Washington 98504, [phone].
    Federal Project Officer: Jamie Hadley, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

    Demonstration Title/State: Improving Access to Care for Pregnant 
Substance Abusers--Washington.
    Description: This demonstration seeks to increase the number of 
Medicaid-eligible pregnant substance abusers who receive coordinated 
perinatal care services, substance abuse treatment, and other relevant 
services to promote better health outcomes for themselves and their 
offspring.
    Date Received: 1991.
    Date Awarded: July 1, 1993.
    Implementation Date: July 1993.
    State Contact: Kathy L. Apodaca, First Steps Plus Project, Medical 
Assistance Administration, Washington State Department of Health, P.O. 
Box 45730, Olympia, Washington 98504, [phone].
    Federal Project Officer: Alisa Adamo, Health Care Financing 
Administration, Office of Research and Demonstrations, 2302 Oak 
Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.
5. Disapproved Proposals
    No proposals were disapproved during the month of January.

III. 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: March 21, 1995.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 95-7848 Filed 3-29-95; 8:45 am]
BILLING CODE 4120-01-P