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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[ORD-076-N]

New and Pending Demonstration Project Proposals Submitted

Pursuant to Section 1115(a) of the Social Security Act: April 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 April 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approved, disapproved, pending, or withdrawn during this time period.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 also 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, 2230 Oak

Meadows, 6325 Security Boulevard, Baltimore, MD 21207.

FOR FURTHER INFORMATION CONTACT: Susan Anderson (410) 966-3996.

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 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, Pending, Approved, and Withdrawn Proposals for the

Month of April 1995

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 [[Page 33222]] awarded, so as to prevent interference with the

awards process.

A. Comprehensive Health Reform Programs

1. New Proposals

No new comprehensive health reform proposals were received during

the month of April.

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 persons 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, Arizona 85034, (602)

271-4422.

Federal Project Officer: Mike Fiore, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

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, (217) 782-2570.

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: 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 recipients currently eligible in

the 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 SW Harrison Street, Topeka, Kansas 66612,

(913) 296-4719.

Federal Project Officer: Jane Forman, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

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 (FPL); those with incomes above 133 percent of the FPL

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,

Post Office 2870, Baton Rouge, Louisiana 70821-2871, (504) 342-2964.

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: 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, Missouri 65102-6500, (314) 751-6922.

Federal Project Officer: Nancy Goetschius, 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, (603) 271-4332.

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: 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 N. Lincoln Blvd., Suite 124, Oklahoma City,

Oklahoma 73105, (405) 530-3439.

Federal Project Officer: Helaine I. Fingold, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland

21207. [[Page 33223]]

Demonstration Title/State: Health Access Plan Demonstration--

Vermont.

Description: Vermont proposes to integrate Medicaid recipients into

managed care plans and expand coverage to uninsured individuals up to

150 percent of the Federal poverty level. The State also proposes to

provide pharmacy coverage to low income Medicare beneficiaries.

Date Received: February 24, 1995.

State Contact: Veronica Celani, Health Policy Director, Vermont

Agency of Human Services, 103 State Street, Waterbury, Vermont 05671,

(802) 828-2949.

Federal Project Officer: Sherrie Fried, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

3. Approved Conceptual Proposals (Awards of Waivers Pending)

No conceptual proposals were approved during the month of April.

4. Approved Grant Proposals (Award of Waivers Pending)

No grant proposals were awarded during the month of April.

5. Approved Proposals

Demonstration Title/State: MassHealth--Massachusetts.

Description: Massachusetts plans to implement a range of strategies

to extend Medicaid coverage of its low-income citizens, including the

employed and the unemployed. The program would employ direct provision

of health services and promote market forces to address the needs of

the uninsured, including providing subsidies to employers and employees

with incomes up to 200 percent of the Federal poverty level.

Date Received: April 15, 1994.

Date Approved: April 24, 1995.

State Contact: Laurie Burgess, Director, Managed Care Program

Development, Division of Medical Assistance, 600 Washington Street,

Boston, Massachusetts 02111, (617) 348-5695.

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 plans to expand its Medicaid managed care

delivery system and to extend Medicaid eligibility to children with

incomes up to 275 percent of the Federal poverty level.

Date Received: July 28, 1994.

Date Approved: April 27, 1995.

State Contact: Maria Gomez, Commissioner, Health Care Services

Delivery, Minnesota Department of Human Services, 444 Lafayette Road N,

St. Paul, Minnesota 55155, (612) 297-4113.

Federal Project Officer: Penny Pine, 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.

7. Withdrawn Proposals

No comprehensive health reform proposals were withdrawn during the

month of April.

B. Other Section 1115 Demonstration Proposals

1. New Proposals

No new proposals were received during the month of April.

2. Pending Proposals

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 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 NW, 201 South Grand Avenue East,

Atlanta, Georgia 30303-3159, (404) 651-5785.

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, (410) 225-5206.

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: Family Planning Services Section 1115

Waiver Request--Michigan.

Description: Michigan seeks to extend Medicaid coverage for family

planning services to all women of childbearing age living in families

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, Michigan 48909, (517) 335-

5117.

Federal Project Officer: Suzanne Rotwein, Ph.D., Health Care

Financing Administration, Office of Research and Demonstrations, 2306

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: 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, (401) 464-3234.

Federal Project Officer: Melissa McNiff, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, [[Page 33224]] 6325 Security Boulevard, Baltimore, Maryland

21207.

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 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, (608) 266-0613.

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 awarded during the month of April.

4. Approved Proposals

Demonstration Title/State: Minnesota Long-Term Care Options

Project--Minnesota.

Description: Minnesota plans 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.

Date Approved: April 27, 1995.

State Contact: Pamela Parker, Minnesota Department of Human

Services, Human Services Building, 444 Lafayette Road North, St. Paul,

Minnesota 55155, (612) 296-2140.

Federal Project Officer: Melissa McNiff, 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 April.

6. Withdrawn Proposals

The following proposal was withdrawn from consideration.

Demonstration Title/State: KIDS CARE--Virginia

Description: Virginia proposed 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.

Date Withdrawn: April 27, 1995.

State Contact: Janet Kennedy, Suite 1300, 600 East Broad Street,

Richmond, Virginia 23219, (804) 371-8855.

Federal Project Officer: Maria Boulmetis, Health Care Financing

Administration, Office of Research and Demonstrations, 2302 Oak

Meadows, 6325 Security Boulevard, Baltimore, Maryland 21207.

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: June 14, 1995.

Bruce C. Vladeck,

Administrator, Health Care Financing Administration.

[FR Doc. 95-15342 Filed 6-26-95; 8:45 am]

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