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TEAMKY Demonstration

Approval Period: January 1, 2025 through December 31, 2029

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d. A description of the process for developing care plans based on assessment of need.

i. Plan to initiate care plans and closed-loop referrals to social services and community providers based on the outcomes of screening.

ii. Description of how the state will ensure that HRSN screening and service delivery are provided to beneficiaries in ways that are culturally responsive and/or trauma informed, as appropriate.

26. Updates to the Protocol for Assessment of Beneficiary Eligibility and Needs and Provider Qualifications for HRSN Services.

a. The state may choose to cover a subset of the HRSN services and/or beneficiary qualifying criteria specified in Attachments K and N. Certain changes to the state’s service offerings and eligibility criteria, within what CMS has approved in Attachment K and N, do not require additional CMS approval. The state must follow the following process to notify CMS of any such HRSN service or qualifying criteria change. i. The state must follow the same beneficiary notification procedures as apply in the case of changes to coverage and/or beneficiary service qualification criteria for state plan services, including with respect to beneficiaries who currently qualify for and/or are receiving services who may receive a lesser amount, duration, or scope of coverage as a result of the changes. ii. The state must provide public notice. iii. The state must submit a letter to CMS no less than 30 days prior to implementation describing the changes, which will be incorporated in the demonstration’s administrative record. b. In addition to the requirements in a. above, if the state seeks to implement additional clinical and social risk factors than what were included in approved Attachment N, the state must follow the process below to update the protocol: i. The state must provide a budget neutrality analysis demonstrating the state’s expected cost for the additional population(s). The state may only add additional clinical and social risk factors through the protocol process described in this STC if CMS determines the criteria are allowable and doing so would not require an increase to the amount of the state’s HRSN expenditure authority in Table 10. ii. The state must receive CMS approval for the updated protocol prior to implementation of changes under this STC 26.b. iii. The state is limited to submitting to CMS one update to its protocol per demonstration year as part of this process outlined in this STC. 26.