New York State HCBS Settings Transition Plan

~~“DOH operates the following 1915(c), waivers in addition to overseeing our sister agencies and offices that operate other 1915(c) waivers as the State's Medicaid agency.
•Long Term Home Health Care Program Waiver2
•Nursing Home Transition and Diversion (NHTD) Waiver
•Traumatic Brain Injury (TBI) Waiver
•Care at Home Waivers I and II

In addition, as noted above, New York State offers significant home and community-based LTSS through our Medicaid state plan, as well as under the NY Partnership Plan 1115 Demonstration Waiver. The rule does not apply to state plan services outside of 1915(i) and 1915(k) authorities. However, CMS has indicated that it expects New York State to address the application of the HCB Settings rule to all HCBS provided through its 1115 Demonstration in this Statewide Transition Plan. Finally, New York State implemented the Community First Choice Option (CFCO) – 1915(k), with an effective date of July 1, 2015, with the understanding that such services would not be provided in congregate or provider-owned settings until these options are assessed and remediated, if necessary, through the Statewide Transition Plan period.”

Links:

Medicaid in Montana 2019 Report Presented to the 2019 Montana State Legislature

~~“Waivers –HCBS Individuals with Developmental Disabilities
The waiver offers 30 separate services, provided in a variety of residential and work settings. Waiver participants live in a variety of circumstances, including family homes, group homes, apartments, foster homes and assisted living situations. Work service options covered by this waiver include day supports and activities, and supported employment (including individual and group supports). A variety of other services and supports are available, including extended State Plan services.“

Links:

Medicaid in Montana 2019 Report Presented to the 2019 Montana State Legislature

Washington Long-term Services and Supports Program Administration

“Long-term care (LTC) programs provide services for the aged and disabled in need of institutional care. Some individuals who receive LTC services are able to continue living in their home or in an alternate living facility (ALF) on a Home and Community based (HCB) Waiver authorized by Home and Community Services (HCS) or the Development Disabilities Administration (DDA). LTSS programs that are not considered “institutional” programs are Medicaid Personal Care (MPC) and Community First Choice (CFC).”

Links:

Washington Long-term Services and Supports

West Virginia DHHR to Add 200 Slots to IDD Waiver Program (2019)

“The West Virginia Department of Health and Human Resources (DHHR), Bureau for Medical Services today announced the Intellectual/Developmental Disabilities (IDD) Waiver Program will release 200 slots to accommodate individuals on the wait list. The new slots are a result of the cost savings and efficiencies of the program.

“The Intellectual/Developmental Disabilities Waiver is important to many residents and their families as it provides an alternative to institutional care,” said Cindy Beane, Commissioner for DHHR’s Bureau for Medical Services. “These additional slots allow DHHR to continue serving this vulnerable population.”

The IDD Waiver Program assists individuals who have intellectual and/or developmental disabilities in achieving the highest level of independence and self-sufficiency possible. Individuals must be determined medically and financially eligible for services.

In addition to the 200 slots to be released in January 2019, the program released 62 new slots and 106 rollover slots in July 2018.”

Links:

West Virginia DHHR to Add 200 Slots to IDD Waiver Program

Long Term Care 1915(c) Waiver Provider Orientation

~~“The Office of Long Term Care is responsible for ensuring that all providers of 1915(c) home and community based waiver services for the following waivers meet credentialing requirements as documented in the CMS approved waiver applications.
• Elderly & Disabled Waiver
• Assisted Living Waiver
• Independent Living Waiver
• Traumatic Brain Injury/Spinal Cord Injury Waiver
Agencies may currently apply to enroll as providers of Personal Care services, In-Home Respite services or Adult Day Care services under the Elderly & Disabled (E&D) Waiver or Assisted Living services under the Assisted Living (AL) Waiver.”

Links:

Long Term Care 1915(c) Waiver Provider Orientation

Medicaid in Montana 2019 Report Presented to the 2019 Montana State Legislature

~~“Waivers –HCBS Individuals with Developmental Disabilities
The waiver offers 30 separate services, provided in a variety of residential and work settings. Waiver participants live in a variety of circumstances, including family homes, group homes, apartments, foster homes and assisted living situations. Work s ervice options covered by this waiver include day supports and activities, and supported employment (including individual and group supports). A variety of other services and supports are available, including extended State Plan services. “

Links:

Medicaid in Montana 2019 Report Presented to the 2019 Montana State Legislature

Important Change to Children’s 1915(c)Waiver Programs

~~“The following waivers will be combined into one new Children’s waiver:
•Office of Mental Health (OMH) Serious Emotional Disturbance (SED) waiver
•Office for People with Developmental Disabilities (OPWDD) Care at Home waiver
•Office of Children and Families (OCFS) Bridges to Health (B2H) SED waiver, B2HDevelopmental Disability (DD) waiver, and B2H Medically Fragile waiver”

Links:

Important Change to Children’s 1915(c)Waiver Programs

North Dakota Statewide Transition Plan

“Final approval is granted due to the state completing the following activities:

Conducted a comprehensive site-specific assessment and validation of all settings serving individuals receiving Medicaid-funded HCBS, and included in the STP the outcomes of these activities and proposed remediation strategies to rectify any issues uncovered through the site specific assessment and validation processes by the end of the transition period.
Outlined a detailed plan for identifying settings that are presumed to have institutional characteristics, including qualities that isolate HCBS beneficiaries, as well as the proposed process for evaluating these settings and preparing for submission to CMS for review under heightened scrutiny;
Developed a process for communicating with beneficiaries who are currently receiving services in settings that the state has determined cannot or will not come into compliance with the home and community-based settings criteria by March 17 ,2022; and
Established ongoing monitoring and quality assurance processes that will ensure all settings providing HCBS continue to remain fully compliant with the rule in the future.”

Links:

North Dakota Statewide Transition Plan (PDF)
North Dakota Statewide Transition Plan (secondary link)

Building Capacity for Transformation

~~“CMS Approves Request to Amend New Hampshire's Building Capacity for Transformation Waiver
The Centers for Medicare & Medicaid Services (CMS) has approved New Hampshire's request to amend to its section l l l 5(a) demonstration titled, "Building Capacity for Transformation" (BCT) (Project Number l l-W-00301/1). With this approval, the state will replace one existing Designated State Health Program (DSHP) authorized in the Special Terms and Conditions (STC) with three different ones- there are no changes to the DSHP spending limits that were already approved/established- it only replaces the DSHPs for which the state may currently draw federal financial participation (FFP). The BCT demonstration will remain in effect through December 31 , 2020.”

Links:

Building Capacity for Transformation

Community First Choice Option (CFCO) LOCAL DISTRICT SOCIAL SERVICE OFFICES

~~“Overview
• Community First Choice Option (CFCO) became available to all states under the Affordable Care Act of 2010
• This option provides a 6 percent increase in federal matching payments to states to expand and enhance Medicaid State Plan (State Plan) home– and community–based attendant services to individuals in need of long–term care for Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs) and health–related tasks
• The LDSS will now be required to administer the CFCO through adherence to the State Plan, 42 CFR Part 441, and State–issued guidance, which will ensure statewide consistency when authorizing or reauthorizing CFCO services
• All services must be provided statewide in a manner that provides such services in the most integrated setting appropriate to the individual´s needs, and without regard to the individual´s age, type or nature of disability, severity of disability, or the form of home and community–based attendant services and supports that the individual requires to lead an independent life”

Links:

Community First Choice Option (CFCO) LOCAL DISTRICT SOCIAL SERVICE OFFICES

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