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Multiple DOH and CMS Updates on the Federal HCBS Settings Rule and How It Affects You

The Centers for Medicare and Medicaid Services (CMS) issued new guidance last week regarding the implementation of the federal home and community-based settings (HCBS) rule. The guidance, which can be accessed here, focuses on the heightened scrutiny process and in some cases supplements or replaces previous guidance. One notable clarification is that CMS presumes, as we had advocated, that a person’s private home is compliant. LeadingAge and LeadingAge NY are analyzing the guidance to determine what impact it will have on our membership. CMS is holding a webinar for State Medicaid Directors on March 28th regarding the new guidance; we hope to have more information after that discussion. Please let us know if you would like more information about the webinar.

LeadingAge NY and the Adult Day Health Care Council (ADHCC) met with the Department of Health (DOH) this week to discuss the implementation process and its impact on our members. We voiced concerns regarding the heightened scrutiny process and how it may impact adult day health care settings and assisted living programs. The Department stressed the nature of the programming as a key consideration in the heightened scrutiny process. Specifically, they noted bi-directional community integration as critical – that is, bringing the community into the setting as well as facilitating access to the community outside of the setting. Such community integration should be guided by a person-centered plan that encourages resident choice and autonomy. LeadingAge NY and ADHCC also raised concern about the resources needed and the cost of implementation to implement aspects of the rule; CMS has not included any additional funds to address these costs. The Department is still in the process of finalizing their process for heightened scrutiny and is working to incorporate the recent guidance. We will continue to discuss these issues with DOH as the process unfolds.

As noted above, one of the key components of the HCBS settings rule is person-centered care, and DOH will be providing training and tools to assist providers. To this end, DOH is hosting a webinar on April 8, 2019 from 10 a.m. to 12 p.m. entitled HCBS Person-Centered Planning - Lessons From the Field. The webinar will feature three HCBS provider exemplars in person-centered care delivery. The providers will share how they use best and promising practices within an Adult Care Facility, Adult Day Health Care Center, and Social Adult Day Program. There will be time at the end of the webinar for questions and answers. You may register for the webinar here.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828