CMS Approves Tennessee’s HCBS Transition Plan, Including Supported Employment Provisions
On April 13, 2016, the Center for Medicare and Medicaid Services (CMS) granted final approval for Tennessee’s Statewide Transition Plan, designed to bring the state into compliance with CMS’ final rules on home and community-based services (HCBS). CMS has granted approval of Tennessee’s plan, according to CMS’ announcement, finding that Tennessee has completed its systemic and site-specific assessments and clearly identified remediation strategies for fixing the issues it uncovered in both. CMS also said that it approved the plan because Tennessee has created a very comprehensive heightened scrutiny procedure, which will allow the state to review whether settings that have been identified as institutional or isolating in nature have overcome those characteristics and comport with the rule, or a plan for relocating beneficiaries if a setting cannot come into compliance.
Tennessee’s Transition Plan states that it has aligned all waiver incentives and systems of reimbursement toward supporting integrated employment at a competitive wage and community living as the preferred outcome for all those receiving HCBS. For example, Tennessee’s Department of Intellectual and Developmental Disabilities (DIDD) conducted a self-assessment and found that, while its policies were compliant with the final HCBS rules, its provider manuals and training requirements for providers needed to be updated. DIDD has now submitted its provider manuals to TennCare for review. They now include both compliance with HCBS-specific rules and exploration of supported employment and community volunteer options as requirements for service providers. Tennessee presumes that its sheltered workshops and day habilitation settings are out of compliance with the final rule and will require major modifications in order to comply. Tennessee has also built in Individual Experience Assessments as an important component of its evaluations of a setting’s effectiveness.