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Supported Living Services (SLS) Waiver Exception Review �Case Manager Training�

February 2025

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Housekeeping

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Questions?

Corinna Barrack, HCBS Benefits Specialist

corinna.barrack@ state.co.us

Get the Slides

Available on �SLS Exceptions Website

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Agenda

Supported Living Services (SLS) Exception Reviews

What is an SLS exception?
Who is eligible?
Process for case managers
Completing a review
Example of a review
Resources

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Supported Living Services Exceptions

The 2021 Long Bill SB 21-205 allowed for an increase in flexibilities within the SLS waiver for Members who are likely on the DD waiver waitlist
The exception gives access to services beyond the established limits and Service Plan Authorization Limits (SPAL) funding to eligible SLS waiver Members

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Who May Be Eligible?

Members on the SLS waiver who are at risk for an emergency DD waiver enrollment; and,
Members who have less than 10% of SPAL funding remaining; or,
The needed service units are not available because of current service unit limitation(s).

Members can meet requirements A, B, and C; A and B; or A and C to be eligible for a request.

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SLS Exception Process

Case manager works with the Member to determine SLS exception, Support Level Review (SLR), or Support Intensity Scale (SIS) reassessment to meet individual needs

Case Managers completes the SLS Exception form. *All requests must be for future dates of service.

Case manager submits all required documentation to Telligen

Telligen reviews and issues an outcome letter

If approved, Case manager attaches this letter to the PAR in PDF format + submits PAR

*PAR approval within 5-10 business days

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There is a Waiver Options Flowchart that can assist you in making these decisions with the member and/or guardian.

Case managers complete the SLS exception form; requests can not be retro dated. Please always use the version on the website to ensure that you’re using the most up to date form. It is recommended that case managers review this form internally with a supervisor or identified colleague who has experience with this process.

Case manager submits all required documentation to Telligen in Qualitrac. Required documentation includes the PAR and any other member specific documentation such as LTHH PAR and rights modifications.

Telligen will issue an outcome which can be an approval, partial approval, or denial. Please be aware that SLS exceptions are not subject to Notice of actions. If an approval or partial approval is received, the case manager should next attach the outcome letter to the PAR in the bridge (we'll show you how to do this shortly). Please submit the PAR and do not leave it as 'work in progress'. This indicates to the system that the PAR is ready for approval and will be approved within 5-10 business days.

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Attaching A Document to the Bridge

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SLS Exception Form Information

SLS exception requests must be the right option to meet the Member’s needs
The form must be completed in its entirety
Services requested must meet service definitions
Requests will not be retroactively dated and can only be approved for a maximum of up to one year; or until the next annual review
Services are approved for what is outlined in the SLS exception letter
SLS exceptions are not a replacement for long term residential services
SLS exceptions are not for Service Plan Authorization Limit (SPAL) prorations

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Waiver Options Flowchart can be a supportive tool to use in discussion with the Member and/or guardian. As an example, you’re working with a parent who has shared that the Member had a recent change that is resulting in additional services and supports needed that would exceed their SPAL. Using the waiver options flow chart, you can identify if an SLR or SIS reassessment would be the best option. If the Member is needing residential support, another option may be looking into a housing voucher.

The form must be completed in its entirety and cannot be retrodated. Case managers should ensure that unit cost and calculations are correct. Describe that service requested clearly and include scope and frequency. Providing justification for how these services will prevent an emergency DD request is required. Remember, the reviewers don’t know the Member like you do, and providing details will be necessary for an accurate review. This is another area that can be helpful for a supervisor or identified colleague with experience who can help review. Ensuring accuracy prior to form submission can prevent any unnecessary requests for information or denials.

Requests are approved for 1 year or until the next CSR. As reviews are not continuous, Case Managers can submit new requests anytime during the active SLS exception certification period.

Services are approved for what is outlined in the SLS exception letter. For example, if a Member receives approval for additional SCC units, and later needs to add in hippotherapy, the approved SCC units cannot be reduced to accommodate service. The exception is granted for specific services justified to meet a need rather than an increased SPAL to spend on services overall.

This process should not be used to replace long term residential services. For example, if a Member is displaced and a request is submitted for 6 months of Respite, this is not an option for the SLS waiver or exceptions process. Case Managers would need to seek support in other areas including housing options or potentially an emergency DD enrollment request. This process is intended to support the Member remaining on the SLS waiver.

SLS exceptions are not to be utilized for a SPAL proration. For example, a Member changes waivers in the middle of a certification period and the utilized services exceed the proration of the SPAL. These situations come directly to the Department for review and would not meet the criteria of the exceptions process.

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SLS Example

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SLS Example Continued

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SLS Example Continued

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SLS Example Continued

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SLS Example Continued

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SLS Example Continued

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SLS Example Continued

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SLS Example Continued

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SLS Example Continued

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SLS Exception Resources

Form
Trainings
Flow chart

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Contact

Corinna Barrack, HCBS Benefits Specialist

corinna.barrack@state.co.us

General HCBS Questions

hcpf_hcbs_questions@state.co.us

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Thank you!

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