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CMS Releases Planned Construction and Person-Centered Planning Requirements in HCBS Settings Requirements Compliance Toolkit

May 31, 2016

CMS has recently released a new section of its Settings Requirements Compliance toolkit, titled Frequently Asked Questions on Planned Construction and Person-Centered Planning Requirements. The resource addresses a number of questions that people have had, about how person-centered planning may impact the requirements of the final rule on home and community-based services (HCBS). This guidance may have significant impact on health care, residential, and supported employment service providers. 

The resource advises that, when assessing planned construction of a setting, it is impossible for CMS to determine in advance whether the setting will be fully compliant with the HCBS rule until it is fully constructed and individuals with disabilities have moved in. As noted in the Final Rule, all presumptively institutional settings in which individuals receive HCBS-funded services must pass a “heightened scrutiny” review by CMS in order for CMS to be able to determine whether the setting overcomes the presumption and is compliant with the Final HCBS Settings Rule. CMS also gives further guidance as to which settings may require heightened scrutiny. CMS notes that some unique exceptions may apply, such as settings that were newly operational in a congested area at the time the final rules were released. It advises individuals in the process of constructing a new setting to contact CMS early in the planning stage to discuss any concerns they have about ensuring the setting’s compliance with the HCBS Settings rule. 

With regard to person-centered planning, CMS explains the process for making individualized exceptions to certain HCBS rule requirements. The HCBS Settings rule allows exceptions to some of its requirements if they are (1) set forth in an individual’s person-centered plan, and (2) limited to that individual and not applied to all individuals in the setting. However, CMS stresses that these modifications are allowable only on an individualized basis and only when non-restrictive alternatives have already been tried and failed to support the safety and well-being of the person. The modifications should be directly proportional to the need of the person. 

For further information, view the HCBS’ Settings Requirements Compliance Toolkit.