Using Concurrent Authorities
Concurrent 1915(a) and (c) authorities
This approach uses the statutory authority in 1915(a) to enter into a voluntary contract with an entity to provide state plan services to beneficiaries who are eligible to receive them. A state may use this authority to contract for a narrow or broad range of services offered under the state plan, including personal care assistance, nursing facility services, and therapies. The program must have voluntary enrollment, and all eligible contractors must be allowed to participate. However, the state may establish qualifications for contractors to ensure that they are able to meet the needs of the target population. 1915(a) also allows the use of “in lieu of” services to provide flexible services that are not otherwise defined in the benefit package.
By itself, Section 1915(a) may be used to establish a voluntary MLTSS program that includes the full range of state plan services. However, 1915(a) does not include authority for expanded financial eligibility to 300% of the SSI level. For this reason, you may want to include a 1915(c) waiver concurrently with the 1915(a) contracting authority. Tables 5.E and 5.F illustrate this dynamic.
Table 5.E. Section 1915(a) authority by itself
Table 5.F. Section 1915(a) and 1915(c) concurrently
