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IDD Extraordinary Funding COVID Update

Date: 01/05/21

Joint MCO Bulletin

The information within this bulletin is specific to providers of IDD Residential and/or Day Habilitation services (T2016 and T2021). 

The MCOs had received permission from KDADS and enacted temporary changes to the policy and process for requesting Extraordinary Funding for Residential and/or Day Habilitation services.

This bulletin replaces the previous bulletin about the temporary changes, and provides an update on requesting Extraordinary Funding for individuals with IDD who need to quarantine due to exposure to COVID-19.  The updated information is included within the section on new requests, and is in italics.

Annual Renewal of Extraordinary Funding

For all Extraordinary Funding (EF) renewals for authorizations that expire on or before Oct. 31, 2020, the provider has the option to continue receiving extraordinary funding for the service(s) without submitting the required renewal request packet.  The provider may either submit the packet for review and receive the customary determination and authorization; or may receive an additional 180 days of EF authorization before the request packet is due. This includes both types of Extraordinary Funding, super tier and individualized rates.

The MCO will automatically extend the authorization for Extraordinary Funding if the annual request packet is not received. Unless otherwise notified, providers will be required to submit the annual renewal request packet for authorizations for Extraordinary Funding that expire November 1 or after, including those that were extended.

If a member who receives an individualized rate changes the provider of service, the new provider has two options.  The provider can either accept the super tier rate and have it authorized for 180 days, or the provider may submit the financial part of the EF uniform packet to identify the individualized rate requested, and have it reviewed and approved for 180 days.

New Requests for Extraordinary Funding

An additional category has been added to the reasons for which MCOs may consider a new request for Extraordinary Funding.  The new category includes persons who have tested positive for COVID-19 and/or need to be quarantined due to direct exposure to COVID-19, and for whom additional staffing support is required.

For persons who qualify under the new category as having direct exposure to COVID-19, the provider may receive super tier funding for up to a total of 14 days for the quarantine. To qualify, the provider must submit documentation of confirmed exposure of the individual to someone who has COVID-19, along with a statement of the additional staffing support that is being put into place to support the individual during quarantine. 

For individuals who qualify as having COVID-19, the provider only needs to submit information confirming the positive test and quarantine of the individual. The provider will then need to submit subsequent documentation of when the quarantine and/or extra supports end.

All other new Extraordinary Funding requests will be handled per State EF policy and require all necessary forms to be considered. 

The new criteria for requesting Extraordinary Funding for an individual who has direct exposure to a person with COVID-19, or who has tested positive for COVID-19 will remain in place until KDADS rescinds Appendix K in its entirety.