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Idaho State Transition Plan, Coming Into Compliance with HCBS Setting Requirements

The comment period for the Draft Statewide Transition Plan is now over.  Comments will be reviewed, summarized, and added to the transition Plan and changes made as appropriate.  The state expects to publish version two of the plan early in 2015.  That publication and the subsequent comment period will be announced on this webpage.

Draft State Transition Plan

Purpose

The purpose of this posting is to provide public notice and receive public comments for consideration regarding Idaho Medicaid’s Draft Home and Community Based Services Settings Transition Plan. The full Transition Plan can be found by selecting the link in the right hand column titled: Idaho State Transition Plan.

Transition Plan

The Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) published regulations in the Federal Register on January 16, 2014, which became effective on March 17, 2014, implementing new requirements for Medicaid’s 1915(c), 1915(i), and 1915(k) Home and Community-Based Services (HCBS) waivers. These regulations require the state to submit a transition plan for all the state’s 1915(c) waiver and 1915(i) HCBS state plan programs. This plan sets forth the actions Idaho will take to operate all applicable HCBS programs in compliance with the final rules. It is  Idaho’s effort to comply/demonstrate compliance with the regulations around Home and Community Based (HCB) setting requirements. Idaho will be submitting its transition plan to CMS. The federal regulations are 42 CFR 441.301(c)(4)-(6). More information can be found on the CMS website.
Copies may be obtained by printing the Transition Plan from this webpage or  copies may also be picked up from any Regional Medicaid Office or at the Medicaid Central Office located at 3232 Elder St., Boise ID.

Transition Plan Summary

Idaho completed a preliminary analysis of its residential HCBS settings in late summer of 2014. This analysis identified areas where the new regulations on residential settings are supported in Idaho as well as areas that will need to be strengthened in order to align Idaho’s HCBS programs with the regulations.  Actions necessary for Idaho to come into full compliance have been proposed in the Transition Plan along with a timeline for doing so. 

States must also make a determination that services provided in non-residential settings do not have the characteristics of an institutional setting as described by CMS.  The Transition Plan describes Idaho’s work to date in relationship to this requirement as well as its plans for completing that assessment. 

The plan further outlines Idaho’s intentions for coming into full compliance with all non-residential setting requirements. 

Home and Community Based Settings: Final Rule, Community Settings

The Centers for Medicare and Medicaid Services (CMS) issued a final rule for home and community based settings (HCBS) effective March 17, 2014. The purpose of the regulation is to ensure that individuals receive Medicaid HCBS in settings that are integrated in and support full access to the greater community and that the individual’s role in service planning is optimized. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services in the community to the same degree as individuals who do not receive HCBS. Idaho Medicaid is currently completing an analysis of the regulation to determine the impact to participants and providers.

CMS expects all states to develop a HCBS transition plan that provides an assessment of potential gaps in compliance with the new regulation, as well as strategies and timelines for becoming compliant with the rule’s requirements. CMS further requires that states seek input from the public in the development of this transition plan. When available, Idaho will post the draft transition plan for comment on this website for 30 days. The plan will also be distributed to provider associations, consumer advocacy organizations, and other potentially interested stakeholders for feedback.

Additionally, stakeholder meetings will be provided via a series of WebEx presentations in the upcoming months. Stakeholders are encouraged to attend and provide comments during this time.

All comments will be reviewed. The state will incorporate appropriate suggestions and summarize the modifications made to the transition plan in response to the public comment. A summary of public comments, including comments that agree and disagree with the state’s determination about whether types of settings meet the HCBS requirements, will be included.    

Resource on Home and Community Based Advocacy

Please take a moment to access a great resource (HCBS Advocacy) for learning more about the HCBS setting regulations and how they are expected to impact both providers and individuals receiving home and community based services. 

Under the State Resources tab you will find information on each state’s current efforts to comply with the new HCBS setting regulations.  Under the National Resources tab you will find helpful national-level advocacy resources. They include a variety of tools to assist with advocating for people who may access HCBS. This website contains a host of additional information any stakeholder should be interested in reading.

Ask The Program

We are interested in receiving your comments, recommendations, and questions as we work to develop a plan to transition to full compliance with the new HCBS setting requirements. All comments will be reviewed. The state will incorporate appropriate suggestions into the transition plan. A summary of public comments, including comments that agree/disagree with the state’s determination about whether types of settings meet the HCBS requirements, will be included in the Final Transition Plan. 

Email the program