ROBERT L. EHRLICH, JR., Governor

Ch. 4

15-141.

(A)     (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(2)      "COMMUNITY CARE ORGANIZATION" MEANS AN ORGANIZATION
APPROVED BY THE DEPARTMENT THAT ARRANGES FOR HEALTH CARE SERVICES
WITH THE GOAL OF PROMOTING THE DELIVERY OF SERVICES IN THE MOST
APPROPRIATE, COST-EFFECTIVE SETTING.

(3)      "COMMUNITY CHOICE PROGRAM" MEANS A PROGRAM THAT
DELIVERS SERVICES IN ACCORDANCE WITH THE WAIVER DEVELOPED UNDER THIS
SECTION.

(B)     (1) ON OR BEFORE NOVEMBER 1, 2004, THE DEPARTMENT SHALL APPLY
FOR A WAIVER UNDER THE FEDERAL SOCIAL SECURITY ACT.

(2)      AS PERMITTED BY FEDERAL LAW OR WAIVER, THE SECRETARY MAY
ESTABLISH A PROGRAM UNDER WHICH MEDICAID PROGRAM RECIPIENTS ARE
REQUIRED TO ENROLL IN COMMUNITY CARE ORGANIZATIONS.

(3)      CONSISTENT WITH THE FEDERAL WAIVER UNDER PARAGRAPH (1) OF
THIS SUBSECTION, IF THE SECRETARY ESTABLISHES A PROGRAM UNDER
PARAGRAPH (2) OF THIS SUBSECTION, THE PROGRAM MAY NOT OPERATE IN MORE
THAN TWO AREAS OF THE STATE.

(C) ANY WAIVER DEVELOPED UNDER THIS SECTION SHALL INCLUDE THE
FOLLOWING GOALS AND OBJECTIVES:

(1)      INCREASING PARTICIPANT SATISFACTION;

(2)      ALLOWING PARTICIPANTS TO AGE IN PLACE;

(3)      REDUCING MEDICAID EXPENDITURES BY ENCOURAGING THE MOST
APPROPRIATE UTILIZATION OF HIGH QUALITY SERVICES; AND

(4)      ENHANCING COMPLIANCE WITH THE FEDERAL AMERICANS WITH
DISABILITIES ACT BY OFFERING COST-EFFECTIVE COMMUNITY-BASED SERVICES IN
THE MOST APPROPRIATE HIGH QUALITY AND LEAST RESTRICTIVE SETTING.

(D) (1) THE BENEFITS PROVIDED BY THE COMMUNITY CHOICE PROGRAM
SHALL INCLUDE THOSE SERVICES AVAILABLE UNDER THE MEDICAID STATE PLAN
AND SERVICES COVERED UNDER HOME AND COMMUNITY-BASED SERVICES
WAIVERS.

(2)      EXCEPT WHEN SERVICES ARE LIMITED OR EXCLUDED FROM THE
COMMUNITY CHOICE PROGRAM BY THE SECRETARY, THE COMMUNITY CARE
ORGANIZATION SHALL PROVIDE ALL THE SERVICES ESTABLISHED IN REGULATION
AND REQUIRED BY THE SECRETARY.

(3)      THE SECRETARY MAY EXCLUDE SPECIFIC POPULATIONS.