Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.12-010 - Living Choices Assisted Living 1915(c) HCBS Waiver Slot Increase

Universal Citation: AR Admin Rules 016.06.12-010

Current through Register Vol. 49, No. 9, September, 2024

Summary for Living Choices Assisted Living (LCAL) 1915(c) HCBS Waiver Slot Increase

The Living Choices Assisted Living (LCAL) 1915(c) Home and Community Based Services waiver is administered by the Department of Human Services, Division of Medical Services. A.C.A. § 20-10-1704 requires the Living Choices Assisted Living waiver to serve a minimum of one thousand (1,000) persons. To comply with A.C.A § 20-10-1704, the number of unduplicated participants served in the Living Choices Assisted Living waiver will be increased from eight hundred (800) to one thousand (1,000) effective June 15, 2012.

Appendix J: Cost Neutrality Demonstration

J-1: Composite Overview and Demonstration of Cost-Neutrality Formula

Composite Overview. Complete the fields in Cols. 3, 5 and 6 in the following table for each waiver year. The fields in Cols. 4, 7 and 8 are auto-calculated based on entries in Cols 3, 5, and 6. The fields in Col. 2 are auto-calculated using the Factor D data from the J-2d Estimate of Factor D tables. Col. 2 fields will be populated ONLY when the Estimate of Factor D tables in J-2d have been completed.

Leve l(s) of Care: Nursing Facility

Col. 1

Col. 2

Col. 3

Col. 4

Col. 5

Col. 6

Col. 7

Col. 8

Year

Factor D

Factor D'

Total: D+D'

Factor G

Factor G'

Total: G+G'

Difference (Col 7 less Column4)

1

16115.99

1775,41

17891.40

.i4399,0S

3113,82

37512.90

19621.50

2

16571.21

1847,49

18418.70

35795,6X

3240,24

39035.92

20617.22

3

17068.65

1922,50

18991.15

.17248,99

3371,79

40620.78

21629.63

4

17580.00

2()(K),55

19580.55

.18761..30

3508.69

42269.99

22689.44

5

18107.92

2081.77

20189.69

40.335.00

3651.14

43986.14

23796.45

J-2: Derivation of Estimates (1 of 9)

a. Number Of Unduplicated Participants Served. Enter the total number of unduplicated participants from Item B-3-a who will be served each year that the waiver is in operation. When the waiver serves individuals under more than one level of care, specify the number of unduplicated participants for each level of care:

Table: J-2-a: Unduplicated Participants

Wai v e r Ye ar

Total Number Unduplicated Number of Participants (from Item B-3-a)

Distribution of Unduplicated Participants by Level of Care (if applicable)

Level of Care:

Nursing Facility

Ye a r 1

800

800

Ye a r 2

1000

1000

Ye a r 3

1000

looo

Ye a r 4

1000

1000

Ye a r 5

1000

1000

b. Average Length of Stay. Describe the basis of the estimate of the average length of stay on the waiver by participants in item J-2-a.

The average length of stay on the waiver is estimated to be 240 days. This average was calculated as days of eligibility from the MMIS segments, using the! Medicaid DSS (BusinessObjects). These numbers were determined by reporting the total days of waiver service (based on service eiigibility days within |

c. Derivation of Estimates for Each Factor. Provide a narrative description for the derivation of the estimates of the following factors.

i. Factor D Derivation. The estimates of Factor D for each waiver year are located in Item J-2-d. The basis for these estimates is as follows:

Factor D is derived from current reporting of expenditures from the Medicaid DSS (BusinessObjects) and consideration of previous waiver estimates of utilization and growth rates.

ii. Factor D' Derivation. The estimates of Factor D' for each waiver year are included in Item J-1. The basis of these estimates is as follows:

Factor D' was computed based on what was done in prior years. Using the market basket forecasts and the related DDS report of all waiver eligible recipients annual expenditures were extracted from the decision support system (DSS) component of the MMIS. Note; Costs indicated for State iii. Factor G Derivation. The estimates of Factor G for each waiver year are included in Item J-1. The basis of these estimates is as follows:

Factor G is computed based on the average annual expenditures for nursing home recipients that were extracted from the decision support system (DSS) component of the MMIS. Using the average annual expenditures for nursing home recipients and the market basket forecasts for the next 5 iv. Factor G' Derivation. The estimates of Factor G' for each waiver year are included in Item J-1. The basis of these estimates is as follows:

Factor G' was derived using the same methodology as in prior years It was computed based on the average annual expenditures for nursing home recipients that were extracted from the decision support system (DSS) component of the MMIS. Using the average annual expenditures for nursing

Compo ne nt manage me nt f or waive r s e rv ic e s . If the service(s) below includes two or more discrete services that are reimbursed separately, or is a bundled service, each component of the service must be listed. Select "manage components" to add these components.

Waiver Services

Extended Medicaid State Plan Prescription Drugs

Living Choices Assisted Living Services

Pharmacist Consultant Services

d. Estimate of Factor D.

i. Non- Co ncurre nt Wa iv e r. Complete the following table for each waiver year. Enter data into the Unit, # Users, Avg. Units Per User, and Avg. Cost/Unit fields for all the Waiver Service/Component items. Select Save and Calculate to automatically calculate and populate the Component Costs and Total Costs fields. All fields in this table must be completed in order to populate the Factor D fields in the J-1 Composite Overview table.

Wa iv e r Ye a r: Ye a r 1

Waiver Service/ Component

Unit

# Users

Avg. Units Per User

Avg. Cost/ Unit

Component Cost

Total Cost

Exte nde d Me dicaid State Plan Pre scription Drugs Total:

257697.00

Extended Medicaid State Plan Prescription Drugs

1 Month 1

100

9.00

286.33

257697.00

Living Choices Assisted Living Services To t al:

12527918.30

Tie r Le ve l 1

1 Day

2661

230.00

62.98

3853116.40

Tie r Le ve l 2

|l Day

241

230.00

1 67.06'

3717135.80

Tie r Le ve l 3

I Day

216'

230.00

72.76

3614716.80

Tie r Le ve l 4

|lDay

77

230.00

75.83

1342949.30

Pharmacist Consultant Services Total:

107180.00

Pharmacist Consultant Services

|lDay 1

100

230,00

4,66

107180.00

GRAND TOTAL:

12892795.30

Total Estimated Unduplicated Participants:

800

Factor D (Divide total by number of participants):

16115.99

Average Length of Stay on the Waiver:

240

d. Estimate of Factor D.

i. Non- Co ncurre nt Wa iv e r. Complete the following table for each waiver year. Enter data into the Unit, # Users, Avg. Units Per User, and Avg. Cost/Unit fields for all the Waiver Service/Component items. Select Save and Calculate to automatically calculate and populate the Component Costs and Total Costs fields. All fields in this table must be completed in order to populate the Factor D fields in the J-1 Composite Overview table.

Wa iv e r Ye a r: Ye a r 2

Waiver Service/ Component

Unit

# Users

Avg. Units Per User

Avg. Cost/ Unit

Component Cost

Total Cost

Exte nde d Me dicaid State Plan Pre scription Drugs Total:

331785.00

Extended Medicaid State Plan Prescription Drugs

1 Month

' 125

9.00

294.92

331785.00

Living Choices Assisted Living Services To t al:

16129023.70

Tie r Le ve l 1

1 Day 1

333

230.00

64.87

4968393.30

Tie r Le ve l 2

IDay

301

230.00

69 .OS

4782408.40

Tie r Le ve l 3

IDay

270

230.00

74.94

4653774.00

Tie r Le ve l 4

I Day

96

230.00

78.10

1724448.00

GRAND TOTAL:

16571208.70

Total Estimated Unduplicated Participants:

1000

Factor D (Divide total by number of participants):

16571.21

Average Length of Stay on the Waiver:

240

Waiver Service/ Component

Unit

# Users

Avg. Units Per User

Avg. Cost/ Unit

Component Cost

Total Cost

Pharmacist Consultant Services Total:

110400.00

Pharmacist Consultant Services

1 n.iy 1

1001

230.00

[ 4. SO

110400.00

GRAND TOTAL:

16571208.70

Total Estimated Unduplicated Participants:

1000

Factor D (Divide total by number of participants):

16571.21

Average Length of Stay on the Waiver:

d. Estimate of Factor D.

i. Non- Co ncurre nt Wa iv e r. Complete the following table for each waiver year. Enter data into the Unit, # Users, Avg. Units Per User, and Avg. Cost/Unit fields for all the Waiver Service/Component items. Select Save and Calculate to automatically calculate and populate the Component Costs and Total Costs fields. All fields in this table must be completed in order to populate the Factor D fields in the J-1 Composite Overview table.

Wa iv e r Ye a r: Ye a r 3

Waiver Service/ Component

Unit

# Users

Avg. Units Per User

Avg. Cost/ Unit

Component Cost

Total Cost

Exte nde d Me dicaid State Plan Pre scription Drugs Total:

341741.25

Extended Medicaid State Plan Prescription Drugs

1 kfonth

125

9.00

303.77

341741.25

Living Choices Assisted Living Services To t al:

16613293.30

Tie r Le ve l 1

IDay

333

230.00

66.82

5117743.80

Tie r Le ve l 2

1 Day

301

230.00

71.15

4925714.50

Tie r Le ve l 3

1 Day

270

230.00'

77.19

4793499.00

Tie r Le ve l 4

1 Day 1

96

230.001

80.45

1776336.00

Pharmacist Consultant Services Total:

113620.00

Pharmacist Consultant Services

; ixn

100

230.00

4.94

113620.00

GRAND TOTAL:

17068654.55

Total Estimated Unduplicated Participants:

1000

Factor D (Divide total by number of participants):

17068.65

Average Length of Stay on the Waiver:

240

d. Estimate of Factor D.

i. Non- Co ncurre nt Wa iv e r. Complete the following table for each waiver year. Enter data into the Unit, # Users, Avg. Units Per User, and Avg. Cost/Unit fields for all the Waiver

Service/Component items. Select Save and Calculate to automatically calculate and populate the Component Costs and Total Costs fields. All fields in this table must be completed in order to populate the Factor D fields in the J-1 Composite Overview table.

Wa iv e r Ye a r: Ye a r 4

Waiver Service/ Component

Unit

# Users

Avg. Units Per User

Avg. Cost/ Unit

Component Cost

Total Cost

Exte nde d Me dicaid State Plan Pre scription Drugs Total:

351990.00

Extended Medicaid State Plan Prescription Drugs

1 Month _]

125

9.001

312.881

351990.00

Living Choices Assisted Living Services To t al:

17111218.00

Tie r Le ve l 1

1 D.iy 1

3331

230.00

68.82

5270923.80

Tie r Le ve l 2

IDay

301

1 230.00,

73.28'

5073174.40

Tie r Le ve l 3

IDay

270

230.00

79.51

4937571.00

Tie r Le ve l 4

IDsy

96'

230.00

82.86

1829548.80

Pharmacist Consultant Services Total:

117070.00

Pharmacist Consultant Services

1 n.iy

100

230.00

5.09

117070.00

GRAND TOTAL:

17580278.00

Total Estimated Unduplicated Participants:

1000

Factor D (Divide total by number of participants):

17580.00

Average Length of Stay on the Waiver:

240

d. Estimate of Factor D.

i. Non- Co ncurre nt Wa iv e r. Complete the following table for each waiver year. Enter data into the Unit, # Users, Avg. Units Per User, and Avg. Cost/Unit fields for all the Waiver Service/Component items. Select Save and Calculate to automatically calculate and populate the Component Costs and Total Costs fields. All fields in this table must be completed in order to populate the Factor D fields in the J-1 Composite Overview table.

Wa iv e r Ye a r: Ye a r 5

Waiver Service/ Component

Unit

# Users

Avg. Units Per User

Avg. Cost/ Unit

Component Cost

Total Cost

Exte nde d Me dicaid State Plan Pre scription Drugs Total:

362553.75

Extended Medicaid State Plan Prescription Drugs

' 1 Month

1 125

9.00

[ 322.27]

362553.75

Living Choices Assisted Living Services To t al:

17624842.50

Tie r Le ve l 1

|lDay

333,

230.00'

70.89

5429465.10

GRAND TOTAL:

18107916.25

Total Estimated Unduplicated Participants:

1000

Factor D (Divide total by number of participants):

18107.92

Average Length of Stay on the Waiver:

240|

Waiver Service/ Component

Unit

# Users

Avg. Units Per User

Avg. Cost/ Unit

Component Cost

Total Cost

Tie r Le ve l 2

IDay 1

301

230.00

1 75.481

5225480.40

Tie r Le ve l 3

' 1 Day

270

230.00

81.89

5085369.00

Tie r Le ve l 4

I Day 1

96

230.00

85.35

1884528.00

Pharmacist Consultant Services Total:

120520.00

Pharmacist Consultant Services

1 Day

100

230.00

5.24

120520.00

GRAND TOTAL:

18107916.25

Total Estimated Unduplicated Participants:

1000

Factor D (Divide total by number of participants):

18107.92

Average Length of Stay on the Waiver:

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