Three Updates on the HCBS Settings Rule
As you know from previous Intelligence articles, the Centers for Medicare and Medicaid Services (CMS) published the final rule related to Home and Community-Based Services (HBCS) settings for Medicaid-funded Long Term Services and Supports (LTSS) provided in non-institutional residential settings. This rule implements a number of changes to home and community-based waivers and has far-reaching implications for other Medicaid providers. There are three updates this week.
First, the Department of Health (DOH) scheduled a webinar on July 7 to review the HCBS rule and their Transition Plan to be in compliance. The materials from the July 7 webinar include:
- HCBS Setting Rule presentation 7.7.14 (PDF, 443KB)
- 7.7.14 recorded session (WMV)
Second, we contacted DOH after hearing from our members the HCBS Setting Rule webinar scheduled for July 7 was full. DOH did add a second webinar scheduled for 1 p.m. on Mon., July 28. According to DOH this webinar is a rebroadcast of the webinar hosted on July 7. Attendance is limited to the first 300 participants. If you missed the first webinar there is still time to register for the webinar on Mon., July 28.
As per DOH, please click here to register for the event.
Third, on June 6, 2014, the Secretary of Health and Human Services (HHS) issued important guidance on implementing Section 2402(a) of the Affordable Care Act. This requires the Secretary to ensure all states develop systems for delivery of HCBS and supports that are designed to respond to the changing needs of beneficiaries, maximize independence, support self-direction, and achieve a more consistent and coordinated approach to the administration of policies and procedures across programs providing HCBS.
According to the announcement a first step in implementing Section 2402(a), the Secretary issued guidance on Person-Centered Planning (PCP) and Self-Direction (SD). The guidance issued is consistent with the final rule from CMS on Medicaid HCBS and meets the requirement in section 2402(a) for a more consistent administration of policies and procedures across programs.
The guidance provides an overview of PCP, defines PCP, provides approaches for implementation, process, and defines the 16 attributes of PCP. As per the guidance, “to support the PCP process, some states are utilizing or developing a standardized comprehensive functional assessment process to determine eligibility for various programs through a 'no wrong door' approach." However, it further states the PCP process often results in quality-of-life goals that exceed the ability of any set of program-specific services and supports to fully meet them. Therefore, the PCP process must not be limited by program specific functional assessments and several initiatives support a standardized functional assessment process including what has been outlined in the Balancing Incentive Program (BIP).
Another component that was outlined in the guidance included the standards for SD. This also includes defining SD and the required elements.
Contact: Cheryl Udell, cudell@leadingageny.org, 518-867-8871