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29 <br /> 1 Lindsey Shewmaker said it is unknown at this time, but the federal government has a lot <br /> 2 of discretion over what happens with waivers. She said the 1115 waivers just got approved by the <br /> 3 General Assembly, but they can be terminated. <br /> 4 Vice-Chair Hamilton asked for a description of the waivers so everyone could understand <br /> 5 them more fully. <br /> 6 Lindsey Shewmaker said she could get that information to the Board because they can be <br /> 7 very complex and have a lot of pieces. <br /> 8 Commissioner Fowler read part of the statutory wording for 15B waivers. <br /> 9 Chair Bedford said the overall purpose of those has been to keep people with disabilities <br /> 10 out of institutions and provide different services. She said that has over 17,000 people on the <br /> 11 waiting list in North Carolina. <br /> 12 Lindsey Shewmaker said the waivers allow changes based on the state's desires to move <br /> 13 in a different way from the federal government policy. <br /> 14 Commissioner Portie-Ascott asked if the waivers are cut immediately or if they would have <br /> 15 time to prepare. <br /> 16 Lindsey Shewmaker said there is a lot of discretion and complete unknowns. She said <br /> 17 they really do not know. <br /> 18 Chair Bedford said that the budget reconciliation process doesn't need the 60 votes in the <br /> 19 senate and that could also have an impact. <br /> 20 Commissioner Carter asked about the impact of the evaluation audits if they were <br /> 21 implemented every year rather than done every 3 years. <br /> 22 Lindsey Shewmaker described the administrative burden for audits. She said during the <br /> 23 audit, they will pull ten approvals and ten denials and those are sent to staff to make sure all <br /> 24 documents are uploaded for the auditor. She said it takes the auditor a full month for the twenty <br /> 25 cases. She said if there are any issues they have 30 days to rebut the findings. She said that it <br /> 26 takes staff supervisors 4-5 hours a month. She said it is more stressful than anything else because <br /> 27 if they make an error, the county is financially responsible for those errors. She said the audits <br /> 28 demand perfection. <br /> 29 <br /> 30 Slide #13 <br /> Optional .d ,d Services <br /> and Groups * Carolina <br /> (ExpansionServices Groups <br /> • Prescription drugs * Adults 18-64 up to 1330/a FPL <br /> • Personal care services(PCs) * Non-M Aged,Blind,Disabled . . .0%FPL <br /> Dependent• Adult dental and optical services - <br /> • Inpatient psychiatric services . Pregnant women 134%-196%FPL <br /> • Non-mandatory practitioner services - Children 0-17 134%-211%FPL <br /> • Health clinics * Family Planning 134%-195%FPL <br /> e Medically needy <br /> - Working disabled <br /> - Recipients of State-County Special,Assistance <br /> - Participants in the Breast and Cervica(Cancer <br /> Program <br /> t'74 <br /> 31 u� t <br />