Common use of Waiver Services/State Plan Amendments Clause in Contracts

Waiver Services/State Plan Amendments. a. HIV/AIDS WAIVER PROGRAM The Contractor must arrange for and provide services to persons with AIDS or symptomatic HIV the same as those provided under the Department's AIDS Waiver Program. Individuals enrolled in the Department's AIDS Waiver Program who would not otherwise be eligible for MA, are included in HealthChoices. The Contractor shall be responsible for tracking these Members in accordance with federal reporting requirements. A full description of the AIDS Waiver Program can be found in the HealthChoices Proposers' Library. b. HIV/AIDS TARGETED CASE MANAGEMENT (TCM) PROGRAM The Contractor must ensure the provision of TCM services for persons with AIDS or symptomatic HIV, including access to needed medical and social services using the existing TCM program standards of practice followed by the Department or comparable standards approved by the Department. In addition, individuals within the PH-MCO who provide the TCM services must meet the same qualifications as those under the Department's TCM Program. A full description of the TCM Program including practice standards for case managers, can be found in the HealthChoices Proposers' Library. c. MICHAEL DALLAS WAIVER (MDW) PROGRAM MA Consumers who are currently receiving home and community based services through the MDW, will be enrolled in the HealthChoices Program but all waiver services will be covered under the MA FFS delivery system. All other non-waiver services will be covered under the HealthChoices PH-MCO. MA Consumers currently receiving home and community based services through the MDW Program and deemed MA eligible solely through the MDW will be exempt from the HealthChoices Program. d. HEALTHY BEGINNINGS PLUS (HBP) PROGRAM The Contractor must provide services that meet or exceed HBP standards in effect as defined in current MA Bulletins. The Contractor must also assure that the coordinated prenatal activities of the HBP Program continue by utilizing enrolled HBP Providers or developing comparable resources. Such comparable programs will be subject to review and approval by the Department based on the likelihood that such programs will be of greater effectiveness in meeting the goals of the HBP Program. The Contractor must provide a full description of its plan to provide prenatal care for pregnant women and infants in fulfillment of the HBP Program objectives for review and advance written approval by the Department. This plan must include comprehensive postpartum care. e. PENNSYLVANIA DEPARTMENT OF AGING (PDA)