Policy/Initiative Type: Medicaid

West Virginia Statewide Transition Plan

“The Centers for Medicare & Medicaid Services (CMS) recently released new regulations and guidance on the delivery of home and community-based services (HCBS) offered through Medicaid waiver programs. Through this new rule, CMS intends to ensure that individuals receiving HCBS through Medicaid waivers have full access to integrated, community living including receiving services in the most integrated setting possible. To increase understanding of the rule for individuals receiving services, family members and providers, the West Virginia Bureau for Medical Services will post information and relevant materials on this webpage.

To fully implement the new rule from CMS, West Virginia must submit a transition plan for the each Medicaid waiver offering HCBS to ensure compliance of the new rule. The Bureau for Medical Services is solicited comments on the draft Transition Plans.  There is one transition plan for each waiver. The transition plans will be combined into one Statewide Transition Plan. Comments from the public will be used to complete the final Statewide Transition Plan to submit to CMS.”

Links:

West Virginia Statewide Transition Plan

Colorado Adult IDD Waiver Redesign Stakeholder Review (PDF)

“Adult Intellectual and Developmental Disabilities Waiver Redesign Stakeholders provide guidance and advice to the Department on the development and implementation of a redesigned waiver to support adults with intellectual and developmental disabilities.
The redesigned waiver will offer an array of services and supports that are flexible to the needs and preferences of the individuals who receive them, are available when and where they are needed, and incorporate the following principles:
• Freedom of choice over living arrangements, social, community, and recreational opportunities
• Individual authority over supports and services
• Support to organize services in ways that are meaningful to the individual receiving services
• Health and safety assurances
• Opportunity for community contribution
• Responsible use of public dollars”

Links:

Colorado Adult IDD Waiver Redesign Stakeholder Review (PDF)

California DDS Fact Sheet: Home and Community Based Setting Rule

“The purpose of the rules is to ensure that individuals receive services in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services to the same degree as individuals who do not receive regional center services. It means that settings need to focus on the nature and quality of individuals’ experiences and not just about the buildings where the services are delivered. Individuals have an active role in the development of their plan, the planning process is person-centered, and the plan reflects the individual’s service and supports and what is important to them.”

Links:

California DDS Fact Sheet: Home and Community Based Setting Rule

Colorado HCBS Settings Final Rule Provider Transition Plan (PTP) User Manual

Developed to Assist Providers in Completing the PTP on the Google Cloud/G-Suite Platform
“In order to demonstrate to CMS that Colorado has attained statewide compliance with the HCBS Settings Final Rule, the Department needs providers to complete a PTP for each setting where individuals live or receive HCBS. This includes:

  • Adult day service programs (basic and specialized)
  • Alternative care facilities (ACFs)
  • Child Residential Habilitation Program (CHRP) settings, including foster care homes, kinship foster care, non-certified kinship care, specialized group facilities (SGFs), including group homes and group centers, and residential child care facilities (RCCFs)
  • Day habilitation programs, including Specialized Habilitation, Supported Community Connections (SCC), and prevocational services
  • Day treatment facilities
  • Group homes
  • Individual Residential Services and Supports (IRSS) settings, including host homes and Personal Care Agencies (PCAs)
  • Group supported employment programs
  • Supported Living Program (SLP) facilities
  • Transitional Living Program (TLP) facilities.”

 

Links:

Colorado HCBS Settings Final Rule PTP User Manual (PDF)

“New Hampshire Granite Advantage Health Care Program 1115 Demonstration”

~~“In this extension package, changes have been made to the STCs and related authorities to align with New Hampshire State Legislature Senate Bill 313, requiring the state to request waivers under section 1115 needed to implement the Granite Advantage Health Care Program, which will serve beneficiaries through the state’s Medicaid managed care delivery system rather than through the New Hampshire Health Protection Program (NHHPP) Premium Assistance program, which assisted beneficiaries in covering premiums to purchase qualified health plan coverage through the Health Insurance Exchange.  Separately, on September 13, 2018, CMS approved New Hampshire’s state plan amendment to effectuate mandatory enrollment of the new adult group population into Medicaid managed care.  By transitioning all beneficiaries into a single Medicaid managed care delivery system, the state intends to streamline administration of beneficiary services and reduce administrative costs.  Consistent with the STCs for this extension, the state must ensure the availability of adequate resources for implementation and monitoring of the demonstration.  Approval of this demonstration extension does not imply approval of any particular state financing approach and the state must comply with all general financial requirements under Title XIX.”

Links:

“New Hampshire Granite Advantage Health Care Program 1115 Demonstration”
Secondary Link

SOUTH DAKOTA HOME AND COMMUNITY BASED SERVICES STATEWIDE TRANSITION PLAN

~~“Home and community based services (HCBS) in South Dakota have been historically provided through four1915(c) HCBS Waivers.  Each waiver targets a specific population and provides a menu of services to meet the needs of the target population. South Dakota has structured its waivers to meet the needs of individuals who live in rural and frontier areas. As the state Medicaid agency, the Department of Social Services provides oversight to all of South Dakota’s Medicaid waivers.”

Links:

SOUTH DAKOTA HOME AND COMMUNITY BASED SERVICES STATEWIDE TRANSITION PLAN

Home- and Community-Based Services (HCBS)2018 Provider Quality Management Self- Assessment

~~“This form is required for entities enrolled to provide services in Section B under the following waivers/programs:• Health   and Disability   • Elderly Waiver • Brain Injury Waiver (BI) • Waiver (HD)AIDS/HIV Waiver • Children’s Mental Health Waiver (CMH) • Physical Disability   Waiver (PD)• Intellectual Disability   Waiver (ID)• HCBS Habilitation Services (Hab)
Each provider is required to submit one, six-section self-assessment by December 1, 2018. This form is to be completed and submitted via fillable PDF as directed on the Provider Quality Management Self-Assessment1 webpage."
 

Links:

Home- and Community-Based Services (HCBS)2018 Provider Quality Management Self- Assessment

2018 Revised Texas Promoting Independence Plan

~~“Funding for Reduction in Community-based Services Interest Lists  Texas has five 1915(c) Medicaid waiver programs and one Home and Community-Based Services (HCBS) program in the 1115 waiver, which serve people who have a physical, IDD or a related condition.20 Community-based services and supports delivered via Medicaid waiver programs are in high demand and interest consistently outweighs available resources. Interest list numbers reflect individuals who have demonstrated interest in a waiver, but have not yet been assessed for financial or functional eligibility. Individuals may not be found eligible for the program after being assessed. Some service needs may be met through other programs, such as CFC or GR or Title XX funded services, until the individual’s name reaches the top of the interest list.”

Links:

2018 Revised Texas Promoting Independence Plan

Home and Community Based Care Settings Rule: New Hampshire Statewide Transition Plan

~~“New Hampshire has drafted a Statewide Transition Plan to show how it will establish compliance with these new regulations. New Hampshire’s draft Statewide Transition Plan includes several sections: 1) Inventory – review of existing state standards, policies, regulations, and statute to determine state level changes that are needed to align with the federal requirements, 2) Assessment – Development, implementation and validation of assessments completed by providers and participants including remediation plans and the role of the Advisory Task Force, 3) Ongoing Monitoring and Compliance. “

 

Links:

Home and Community Based Care Settings Rule: New Hampshire Statewide Transition Plan
Current Draft:
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