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HCBS Transition Plans Update

May 31, 2017

Kansas Releases Revised HCBS Transition Plan

On March 20, 2017, Kansas revised its HCBS Transition Plan. Kansas chose to make changes in the direction of the state’s implementation process. The state increased stakeholder participation, revised its compliance timelines, and incorporated the public comments it received into the Transition Plan.

Employment-related provisions of Kansas’ HCBS Transition Plan include: (1) specific targeting of employment services and day services as areas in need of improvement in Kansas’ intellectual and developmental disabilities (I/DD) waiver; (2) updating its Transition Steps Timeline for day services and non-integrated employment service settings to better reflect CMS’ policy that prevocational and day services be time-limited and in the most integrated setting; (3) pursuing robust accountability measures to ensure employment-related aspects of the Final Rule are enforced; and (4) starting up a new workgroup that will analyze whether there are any pay rate structures that create disincentives for employment services, with a projected completion date in May 2018. The state will then determine how it can incentivize employment in the long-term for its beneficiaries. Kansas also intends to remove aspects of its service reimbursement structure that penalize providers for successfully moving a beneficiary into full-time employment. Kansas’ Transition Plan now includes all of the recommendations made by Kansas’ employment-related workgroups and Kansas’ responses to the workgroup’s recommendations.

For more information on the robust employment-related changes made to Kansas’ HCBS Transition Plan, read the Transition Plan.

Missouri Receives Initial Approval for Its HCBS Transition Plan

On March 29, 2017, Missouri received initial approval from CMS for its HCBS Transition Plan. CMS granted approval because the state had completed its systemic assessment, outlined remediation strategies to rectify issues that the systemic assessment revealed, and is now pursuing that remediation.

Employment-related provisions of Missouri’s HCBS Transition Plan include: (1) holding providers responsible, through Missouri’s quality-of-service reviews, for ensuring that their beneficiaries live truly self-determined lives; (2) identifying gainful self-chosen employment as one of the key components of self-determination; (3) updating waiver renewal applications and waiver service definitions that better align services like individualized skill development and employment services towards the goal of competitive integrated employment; and (4) incorporating the requirements of the Final Rule, including the employment-related provisions, into all training materials and manuals given to HCBS providers.

For more information, read the initial approval letter for Missouri and Missouri’s HCBS Transition Plan.