1915(c) and 1915(i) Home and Community-Based (HCB) Setting Transition Plan
On Jan. 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule, effective March 17, 2014, which amends the requirements for qualities of home and community-based (HCB) settings. These requirements reflect CMS’s intent that individuals receive services and supports in settings that are integrated in and support full access to the greater community. The final rule requires the use of a person-centered planning process to develop a participant/beneficiary’s annual Plan for Services and Supports (PSS). A summary of the requirements included in the final rule is provided below. The complete set of federal regulations for the final regulations can be found on the Home and Community Based Services webpage on the CMS website.
Initial Approval of Statewide Transition Plan
The Centers for Medicare and Medicaid Services (CMS) granted the Division of Medicaid initial approval of its Statewide Transition Plan (STP) on May 25, 2017, to bring settings into compliance with the federal home and community based services (HCBS) regulations found at 42 C.F.R. §§441.30l(c)(4)(5) and Section 441.710(a)(l )(2). Initial approval was granted because DOM has completed its systemic assessment; included the outcomes of this assessment in the STP; clearly outlined remediation strategies to rectify issues that the systemic assessment uncovered, such as legislative/regulatory changes and changes to vendor agreements and provider applications; and is actively working on those remediation strategies.
In order to receive final approval of Mississippi’s STP, DOM will need to complete the following remaining steps and submit an updated STP with this information included:
- Complete comprehensive site-specific assessments of all home and community-based settings, implement necessary strategies for validating the assessment results, and include the outcomes of these activities within the STP;
- Draft remediation strategies and a corresponding timeline that will resolve issues that the site-specific settings assessment process and subsequent validation strategies identified by the end of the home and community-based settings rule transition period (March 17, 2022);
- Outline 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;
- Develop a process for communicating with beneficiaries that 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
- Establish ongoing monitoring and quality assurance processes that will ensure all settings providing HCBS continue to remain fully compliant with the rule in the future.
Previous versions of the Statewide Transition Plan
- Version 5: Feb. 6, 2017 Statewide Transition Plan submitted for initial approval
- Version 4: Nov. 28, 2016 Statewide Transition Plan
- Version 3: Sept. 16, 2015 Statewide Transition Plan
- Version 2: March 10, 2015 Statewide Transition Plan
- Version 1: Sept. 27, 2014 Statewide Transition Plan