[Federal Register Volume 60, Number 195 (Tuesday, October 10, 1995)]
[Notices]
[Pages 52684-52688]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 95-24947]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Care Financing Administration
[ORD-080-N]


New and Pending Demonstration Project Proposals Submitted 
Pursuant to Section 1115(a) of the Social Security Act; July 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 July 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approved, disapproved, pending, or withdrawn during this time period.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 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 

[[Page 52685]]
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, Pending, Approved, and Withdrawn Proposals for the 
Month of July 1995

A. Comprehensive Health Reform Programs

1. New Proposals
    The following comprehensive health reform proposals were received 
during the month of July:
    Demonstration Title/State: Better Access for You (BAY) Health Plan 
Demonstration--Alabama.
    Description: Alabama proposes to create a mandatory managed care 
delivery system in Mobile County for non-institutionalized Medicaid 
beneficiaries and an expansion population of low-income women and 
children. The network, called the Bay Health Network, would be 
administered by the PrimeHealth Organization, which is owned by the 
University of South Alabama Foundation. The State also proposes to 
expand family planning benefits for pregnant women whose income is less 
than 133 percent of the Federal poverty level.
    Date Received: July 10, 1995.
    State Contact: Vicki Huff, Director, Managed Care Division, Alabama 
Medicaid Agency P.O. Box 5624, Montgomery, AL 36103-5624, (334) 242-
5011

    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: Section 1115 Demonstration Waiver for 
Medicaid Expansion--Utah.
    Description: Utah proposes to expand eligibility for Medicaid to 
all individuals with incomes up to 100 percent of the Federal poverty 
level (subject to limited cost sharing) and to enroll all Medicaid 
beneficiaries in managed care plans. The State also proposes to 
streamline eligibility and administrative processes and to develop a 
subsidized small employer health insurance plan.
    Date Received: July 5, 1995.
    State Contact:

Michael Deily, Acting Division Director, Utah Department of Health, 
Division of Health Care Financing, 288 North 1460 West, P.O. Box 
142901, Salt Lake City, UT 84114-2901, (801) 538-6406.

    Federal Project Officer:

David Walsh, 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 individuals 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 persons currently eligible in the 
Aid to Families with Dependent Children (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.

    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-eligible 
individuals in 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.

    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; those with 

[[Page 52686]]
incomes above 133 percent of the Federal poverty level 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 AFDC 
recipients is November 1, 1995, followed by a 1-year enrollment period 
for the supplemental security income (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.
3. Approved Conceptual Proposals (Awards of Waivers Pending)
    No conceptual proposals were approved during the month of July.
4. Approved Grant Proposals (Award of Waivers Pending)
    No grant proposals were awarded during the month of July.
5. Approved Proposals
    The following proposal was approved during the month of July.
    Demonstration Title/State: Health Access Plan Demonstration--
Vermont.
    Description: Vermont will integrate Medicaid beneficiaries into 
managed care plans and expand coverage to uninsured individuals up to 
150 percent of the Federal poverty level. The State will also provide a 
prescription drug benefit to low-income Medicare beneficiaries.
    Date Received: February 24, 1995.
    Date Approved: July 28, 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.
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 July.

B. Other Section 1115 Demonstration Proposals

1. New Proposals
    No new proposals were received during the month of July.
2. Pending Proposals:
    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 beneficiary's place of residence. 
The proposal would also permit nursing aides to perform functions that 
historically have been provided only by skilled nursing staff. Medicaid 
beneficiaries 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 shorter supervision and 
monitoring visits, and allow higher payments to aides performing 
delegated nursing tasks. Currently, home health 

[[Page 52687]]
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: 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 beneficiaries.
    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: Montana Mental Health Access Plan--
Montana.
    Description: Montana proposes to provide all mental health services 
for current Medicaid-eligible individuals 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 statewide 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.

    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 beneficiaries.
    Date Received: March 9, 1994.
    State Contact:

Jean Sheil, Division of Economic Support, Wisconsin Department of 
Health and 

[[Page 52688]]
Social Services, 1 West Wilson Street, Room 650, P.O. Box 7850, 
Madison, WI 53707, (608) 266-0613.

    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 July.
4. Approved Proposals
    No proposals were approved during the month of July.
5. Disapproved Proposals
    No proposals were disapproved during the month of July.
6. Withdrawn Proposals
    No proposals were withdrawn during the month of July.

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 29, 1995.
Bruce C. Vladeck,
Administrator, Health Care Financing Administration.
[FR Doc. 95-24947 Filed 10-6-95; 8:45 am]
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