Notices for Week of: NOVEMBER 30, 2006
PROPOSED STATE RULES
By law, public notice of proposed rules must be given by publication in newspapers of record. The purpose of these notices is to give the public a chance to respond to the proposals. The public notices for administrative rules are now also available online at http://vermont-archives.org/aparules/ovnotices.htm The law requires an agency to hold a public hearing on a proposed rule, if requested to do so in writing by 25 persons or an association having at least 25 members.
To make special arrangements for individuals with disabilities or special needs please call or write the contact person listed below as soon as possible
To obtain further information concerning any scheduled hearing(s), obtain copies of proposed rule(s) or submit comments regarding proposed rule(s), please call or write the contact person listed below. You may also submit comments in writing to the Legislative Committee on Administrative Rules, State House, Montpelier, Vermont 05602 (828-2231).
Global Commitment to Health Grievance and Appeal Rules.
Vermont Proposed Rule: 06P034
AGENCY: Human Services
CONCISE SUMMARY: This rule outlines a grievance and appeal procedure required under the federally approved Global Commitment to Health 1115 Medicaid waiver program. In the new State and Federal Medicaid structure, the Office of Vermont Health Access (OVHA) is a public Managed Care Organization, thus must meet federal rules for Medicaid managed care organizations. Federal requirements for resolving service disagreements between beneficiaries and MCO employees, representative of the MCO, and state designated agencies are contained in this proposal. The overall goals of the grievance and appeal process are to resolve disputes fairly, to provide expeditious resolution of disputes, to enhance beneficiary and public confidence in the equity and integrity of the service system, to ensure beneficiary access to clinically justified covered benefits, and to allow for the independent review of MCO staff decisions concerning appealable actions.
TYPE OF PERSONS AFFECTED: All Medicaid beneficiaries, Medicaid providers, all departments in the Agency of Human Services that receive Medicaid funding, Designated Agencies, Specialized Service Agencies, Human Services Board, and all advocacy organizations that assist Medicaid beneficiaries.
COST BENEFIT ANALYSIS: This rule will affect all beneficiaries served by a State health care program in Vermont. Departments and agencies that provide services funded through the Global Commitment to Health 1115(a) waiver will also be affected as they will be required to have designated individuals available to hear appeals, research and respond to grievances, and track and report both grievances and appeals. Although this process will require staffing, the rule will have a neutral economic impact because the individuals that are currently designated to the lengthy fair hearing process will be reassigned to the initial, more expeditious Global Commitment process. Beneficiaries will benefit from the common procedures and more timely responses generated from the uniform Global Commitment process. While the expected volume of grievances and appeals is unknown, the volume of appeals will likely be consistent with the volume of fair hearings that are currently filed with the Human Services Board.
SCHEDULED HEARINGS: January 4, 2007 from 3:00 to 6:00 p.m. at the Central Vermont Medical Center boardroom, 130 Fisher Road Barre, Vermont 05641.
DEADLINE FOR PUBLIC COMMENT: January 11, 2007
FOR FURTHER INFORMATION, CONTACT: Matthew Palmer, 312 Hurricane Lane, Suite 201, Williston, VT 05495; Phone: 802-879-2377; Email: mattp@ahs.state.vt.us.
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Attendant Services Program Regulations
Vermont Proposed Rule: 06P035
AGENCY: Human Services, Dept. of Disabilities, Aging and Independent Living (DAIL)
CONCISE SUMMARY: This rule implements the grievance and appeal process required under the federally-approved Global Commitment to Health 1115 Medicaid Waiver program. As a Medicaid program, the Attendant Services Program (ASP) is part of Global Commitment and operates as a service of the Managed Care Organization (MCO), Office of Vermont Health Access. The ASP regulations are being amended to add a grievance process and make the existing appeals process conform to the Global Commitment Grievance and Appeal requirements. The overall goals of the grievance and appeal processes are to resolve disputes fairly, to enhance participant and public confidence in the equity and integrity of the service system, to ensure eligible participants access to the ASP program and to allow for the independent review of MCO staff decisions concerning appealable actions.
TYPE OF PERSONS AFFECTED: All Medicaid beneficiaries, including participants in the Attendant Services Programs, Medicaid providers, all departments in the Agency of Human Services that receive Medicaid funding, designated agencies, specialized service agencies, the Human Services Board, and all advocacy organizations that assist Medicaid beneficiaries will be affected by this rule.
COST BENEFIT ANALYSIS: The rule will affect all participants in the Attendant Services Program. The Department also will be affected as it will be required to have designated individuals available to hear appeals, research and respond to grievances, and track and report both grievances and appeals. Although this process will require staffing, the rule will have a neutral economic impact because most of the appeals process has been in place since the ASP programs began, and because the individuals who are currently designated to the lengthy fair hearing process will be focused on the initial, more expeditious, Global Commitment process. While the expected volume of grievances and appeals is unknown, the volume of appeals likely will be consistent with the volume of fair hearings that currently are filed with the Human Services Board.
SCHEDULED HEARINGS: January 4, 2007 from 3:00 to 6:00 p.m. at the Central Vermont Medical Center boardroom, 130 Fisher Road, Barre, Vermont 05641
DEADLINE FOR PUBLIC COMMENT: January 11, 2007
FOR FURTHER INFORMATION, CONTACT: Lorraine Wargo, Director, Individual Support Unit, Division of Disability and Aging Services Department of Disabilities, Aging and Independent Living (DAIL) 103 South Main Street, Waterbury, VT 05671-1601 802-241-3186.
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Choices for Care: 1115 Long-Term Care Medicaid Waiver Regulations.
Vermont Proposed Rule: 06P036
AGENCY: Human Services, Dept. of Disabilities, Aging and Independent Living (DAIL)
CONCISE SUMMARY: This rule amends the appeal section of the existing Choices for Care 1115 Medicaid Waiver Program regulations to give participants in the Choices for Care Medicaid waiver a grievance to give participants in the Choices for Care Medicaid waiver a grievance and appeal process that is the same as the grievance and appeal processes in other programs within the Agency of Human Services. The overall goals of the grievance and appeal process are to resolve disputes fairly, to provide expeditious resolution of disputes, to enhance beneficiary and public confidence in the equity and integrity of the service system, to ensure participant access to services for which they are eligible and to allow for the independent review of decisions concerning appealable actions.
TYPE OF PERSONS AFFECTED: This rule will affect all participants in the Choices for Care 1115 Medicaid Waiver program, as well as the providers under that program. The Department also will be affected as it will be required not only to hear appeals, as it currently does, but also to research and respond to grievances, and to track and report both grievances and appeals. Although this process will require staffing, the rule will have a little economic impact. There will be some increased administrative costs to the Department. Participants will benefit from the common procedures and more timely responses generated from the uniform Global Commitment process. Although the expected volume of grievances is unknown, the volume of appeals likely will remain consistent with the volume of fair hearings that currently are filed with the Human Services Board.
COST BENEFIT ANALYSIS: The proposed appeals process will give participants in the Choices for Care 1115 Medicaid Waiver a more defined appeals process, as well as a grievance process, one that is the same as those in other Agency programs. The appeal process itself will not change to any great extent for Choices for Care participants. The Department will have some added administrative tasks and associated costs related to both the appeal and grievance procedures, as well as some additional paperwork. In addition, Medicaid beneficiaries, Medicaid providers, departments in the agency of Human Services, the Human Services Board and all advocacy organizations that assist Medicaid beneficiaries will be affected.
SCHEDULED HEARINGS: January 4, 2007 from 3:00 to 6:00 p.m. at the Central Vermont Medical Center boardroom, 130 Fisher Road, Barre, Vermont 05641
DEADLINE FOR PUBLIC COMMENT: January 11, 2007.
FOR FURTHER INFORMATION, CONTACT: Lorraine Wargo, Director Individual Support Unit, Division of Disability and Aging Services Department of Disabilities, Aging and Independent Living 103 South Main Street, Waterbury, VT 05371-1601 802-241-3186
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Regulations Implementing the Developmental Disabilities Act of 1996
Vermont Proposed Rule: 06P037
AGENCY: Human Services, Dept. of Disabilities, Aging and Independent Living (DAIL)
CONCISE SUMMARY: This rule implements the grievance and appeal process required under the federally-approved Global Commitment to Health 1115 Medicaid Waiver program. As a Medicaid program, the services provided under the Developmental Disabilities Act are part of Global Commitment and operate as a service of the Managed Care Organization (MCO), Office of Vermont Health Access. The DD Act regulations are being amended to add a grievance process and make the existing appeals process conform to the Global Commitment Grievance and Appeal requirements. The overall goals of the grievance and appeal processes are to resolve disputes fairly, to enhance participant and public confidence in the equity and integrity of the service system, to ensure eligible participants access to the developmental disabilities services system and to allow for the independent review of MCO staff decisions concerning appealable actions.
TYPE OF PERSONS AFFECTED: All Medicaid beneficiaries, Medicaid providers, all departments in the Agency of Human Services that receive Medicaid funding, designated agencies, specialized service agencies, the Human Services Board, and all advocacy organizations that assist Medicaid beneficiaries will be affected by this rule.
COST BENEFIT ANALYSIS: The rule will affect all recipients of services under the Developmental Disabilities Act, as well as the designated agencies and he specialized services agencies. The Department also will be affected as it will be required to have designated individuals available to hear appeals, research and respond to grievances, and track and report both grievances and appeals. Although this process will require staffing, the rule will have minimal economic impact because most of the appeals process has been in place since the DD Act programs began, and because the individuals who are currently designated to the lengthy fair hearing process will be focused on the initial, more expeditious, Global Commitment process. While the expected volume of grievances and appeals is unknown, the volume of appeals likely will be consistent with the volume of fair hearings that currently are filed with the Human Services Board.
SCHEDULED HEARINGS: January 4, 2007 from 3:00 to 6:00 p.m. at the Central Vermont Medical Center boardroom, 130 Fisher Road, Barre, Vermont 05641.
DEADLINE FOR PUBLIC COMMENT: January 11, 2007.
FOR FURTHER INFORMATION, CONTACT: Lorraine Wargo, Director Individual Support Unit, Division of Disability and Aging Services Department of Disabilities, Aging and Independent Living 103 South Main Street, Waterbury, VT 05671-1601 802-241-3186.
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- If you have general questions about the rulemaking process, please contact
- Louise Corliss by e-mail at or by phone 802-828-2863
