FSSA lays out providers, tier-system transition from attendant care to Structured Family Caregiving

Family caregivers of medically complex children will soon no longer be able to provide attendant care — meaning they have to transition to other Medicaid programs. The Family and Social Services Administration provided updates this week on one of the main programs families can shift to in July.

FSSA requested approval from the Centers for Medicare and Medicaid Services to implement two changes to the Structured Family Caregiving program.

The first change would allow foster parents to provide Structured Family Caregiving. The second change would give caregivers of Medicaid members in the program access to skilled respite, or short-term relief provided by a skilled care worker.

Heather Dane, the chief program officer of FSSA’s Bureau of Disabilities Services, said Structured Family Caregiving already provides non-skilled respite, but families reached out asking for the change.

“We’ve heard you,” Dane said. “And we’re in agreement and have submitted that to CMS for their feedback and for their approval.”

Dane said any additional information on the changes will be provided through the state’s Medicaid strategies web page.

READ MORE: Families raise concerns on attendant care issue, present recommendations to governor

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FSSA also provided updates on how it will determine what tier of Structured Family Caregiving members will be on.

The attendant care program paid providers about $34 an hour, regardless of the assessed need. The providers would then pay Legally Responsible Individuals a portion of that.

Structured Family Caregiving pays caregivers per day using a three-tiered system based on an evaluation of the Medicaid member. The daily rate for level one is about $77, level two is about $100 and level three is about $133.

For those transitioning from attendant care to Structured Family Caregiving, Dane said their tier will be determined by the amount of authorized attendant care hours they had as of May 1.

Members approved for one to 20 hours a week will be one level one. Those approved for 21 to 40 hours will be level two. Level three will include anyone who was approved for more than 41 hours.

Dane said FSSA is working to complete those assessments by May 30.

“So if you choose to go to structured family care, your care manager will have everything they need to put you in the appropriate level on that July 1st date,” Dane said.

After the transition, any new Structured Family Caregiving recipients will be evaluated with FSSA’s current tool with information included specific to the pediatric population. Dane said the agency is developing an evaluation tool specifically for the pediatric population that will launch July 1, 2025.

FSSA also announced it published a statewide list of Structured Family Caregiving providers.

Dane said these providers will not be able to provide services before July 1.

“This is an opportunity for you to start calling those providers, asking the questions, interviewing them so that they can be ready and you can be ready,” Dane said.

FSSA is hosting webinars every other Wednesday until July 1 to provide updates for Medicaid members under the age of 59 currently on the Aged and Disabled waiver. FSSA said the webinars will be recorded and made available to those who cannot attend via the Medicaid strategies web page.

Dane said there will be new information and updates shared during each webinar.

• Individual and Family Bi-Weekly Webinar for Aged and Disabled or TBI Waiver
  May 15, 2024, 3-3:30 EST
  Microsoft Teams link
• Individual and Family Bi-Weekly Webinar for Aged and Disabled or TBI Waiver
  May 29, 2024, 3-3:30 EST
  Microsoft Teams link
• Individual and Family Bi-Weekly Webinar for Aged and Disabled or TBI Waiver
  June 12, 2024, 3-3:30 EST
  Microsoft Teams link
• Individual and Family Bi-Weekly Webinar for Aged and Disabled or TBI Waiver
  June 26, 2024, 3-3:30 EST
  Microsoft Teams link

Abigail is our health reporter. Contact them at aruhman@wboi.org.