Home Services Program 2024

The Home Services Program (HSP) was established in December 1979, to prevent the premature or unnecessary institutionalization of individuals with disabilities by providing services in the home that do not exceed the cost of comparable services in a nursing facility. The program is dedicated to promoting customer independence, their choice, and their control of services. The program's goals support the desires and abilities of individuals with disabilities by enabling them:

• to remain at home rather than in a nursing facility with real choices and options for quality care,
• to retain control over the services they receive, and
• to live self-directed lives that enable them to actively participate at home and in the community.

HSP is designed to allow eligible individuals in need of long-term care and who meet the criteria for disability as defined by the Social Security Act, to receive any or all the following services to remain in their homes:

FY 24 Highlights

• A total of 35,629 customers were served in the program at an average monthly cost of $2,222.
• HSP increased rates for agency providers to ensure these rates are competitive with market standards ensuring HSP customers have access to a robust network of agency provider agencies. Rates were increased by 4.3% for Homemaker services and 10% for Adult Day Services to ensure provider capacity exists to meet the thousands of HSP customer who rely on these services.
• Identified and initiated the recovery of more than $1.64 million in overpayment for a total of 821 cases. Through restitution and repayment agreements, the State will largely be made whole for these overpayments.
• Terminated a total of 53 providers in connection with provider fraud, or due to the abuse, neglect or exploitation of a person with a disability as determined through an Adult Protective Services investigation. BHCS Vision for FY24
• Worked together with Service Employees International Union (SEIU) to negotiate a new Collective Bargaining agreement for the year 2023-2027.

Looking Ahead for FY25

In FY 2025, our goal is to ensure the continued growth of the Home Services Program to help individuals achieve and maintain their independence, to maintain timeliness of required assessments, to achieve long-term integration of select pandemic era policies and further invest in modernizing the program.

IMPACT Revalidation

CMS/HFS requires all state Operating agencies to revalidate all actively enrolled Medicaid providers at least every five years. This requirement is for all Medicaid providers, including Individual providers, Homemaker/Home health and other agencies.

HSP will send two mail / email notifications to Individual providers and agencies reminding their upcoming Revalidation due date. The first notice will be sent 90 calendar days prior to the Revalidation Cycle end date and the second notice will be distributed 45 calendar days prior to the Revalidation Cycle end date. Providers providing multiple services (PA, LPN, CNA, RN) must revalidate each of their enrollment Separately.

Providers who fail to send documentation for revalidation prior to the Revalidation due date will end dated in IMPACT and they will become ineligible to work and for payment after this date.

HSP has taken this project forward by automating the entire process as much as possible to complete the revalidations on time. The first round of 90-day / 45-day letters have been sent out to providers reminding them of their due dates and seek completed documentation for Revalidation.

Background screening will also be done for the providers as per the CBA Screening policy that are very similar to new enrollments.

EVV (Electronic Visit Verification)

Current contract with existing HSP EVV Vendor is coming to an end. HSP is working with DHS and State procurement on an RFP Contract. HSP is on their final steps to finalize the RFP before it can be published on BidBuy for vendors to bid.

Sandata Mobile connect (SMC) is a mobile application that can be used by providers to clock-in and clock-out to track their time providing services to a HSP customer. In order to make HSP providers more electronic, HSP will take action to encourage SMC application across all providers. To start with we are planning to send out promotional fliers to encourage them to opt-in to use the mobile application.

As a Medicaid operating agency (OA) HSP has to send visits data of all Individual providers/Agency providers to HFS (State Medicaid Agency) Aggregator. HSP is currently working with HFS to finalize and Agency compliance policy to enforce agencies to send visits data to HSP's aggregator in regular frequencies.

BHCS Program Spending

Type of Services	Number of Customers	Total Spending
Personal Assistant	32,634	$886,539,296
CNA	120	$2,894,659
LPN	29	$1,050,373
RN	25	$823,962
Homemaker	2,451	$50,016,464
Maintenance Home Health	19	$135,196
Home-Delivered Meals	639	$1,351,801
Electronic Home Response (duplicated Count)	1,832	$360,840
Adult Day Care (duplicated count)	37	$441,552
Brain Injury Services (duplicated count)	23	$181,490
Home Remodeling	157	$1,785,522
Assistive Equipment	39	$74,752
Background Checks	308	$11,160
Case Management Services	2,767	$3,489,830
Other Misc. Services (duplicated count)	286	$32,800
Prescreening	1,152	$166,551
Total (with Prescreening)	35,629	$949,356,249

BHCS Operational Spending Overview

Category	FY24 Spending
Program Administration	$30,770,661
Other Provider Costs & Benefits	$141,105,338
Total Waiver Services	$949,356,249
Persons with Disabilities	$836,642,163
Persons with Brain Injury	$89,051,768
Persons with HIV/AIDS	$23,662,318
Total Spending	$1,121,232,248
Percent Administration to Total Spending	2.74%