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June 30, 2016

HOME AND COMMUNITY BASED SERVICES

Idaho State Transition Plan, Coming Into Compliance with HCBS Setting Requirements
Public Notice and Request for Comment

Post Date: June 3, 2016
Comments will be accepted through: July 4, 2016
Contact: Michele Turbert, Medicaid 208-364-1946

Purpose

The purpose of this posting is to provide public notice and receive public comments for consideration regarding version four of Idaho Medicaid’s 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, v4.

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 updated transition plan to CMS in July, 2016.

Copies of this version may be obtained by printing the Transition Plan v4 from this webpage. Copies may also be picked up from any Regional Medicaid Office or at the Medicaid Central Office located at 3232 Elder St., Boise ID.

Public Comment Submission Process

The state of Idaho’s Department of Health and Welfare, Division of Medicaid is seeking public input on the transition plan. Please take the time to comment on the transition plan and whether or not you believe it includes sufficient activities for the state of Idaho to comply with the new HCBS regulations.

Comments should be submitted by July 4, 2016. Comments and input regarding the transition plan may be submitted in the following ways:

  1. On this webpage in the right hand column you will see an “Ask the Program” section. There you can use the Email the program tab to email your comments directly to the program.
  2. By e-mail:  HCBSSettings@dhw.idaho.gov
  3. By written comments sent to:

    HCBS
    Division of Medicaid, Attn. Transition Plan
    PO Box 83720
    Boise, ID  83720-0009

  4. By FAX: (208) 332-7286 (please include: Attention HCBS)
  5. By calling toll free to leave a voicemail message: 1 (855) 249-5024

All comments will be tracked and summarized. The summary of comments in addition to a summary of modifications made in response to the public comments will be added to the Statewide Transition Plan. In cases where the state’s determination differs from public comment, the additional evidence and rationale the state used to confirm the determination will be added to the Transition Plan as well. The Transition Plan will then be submitted to CMS.  Once it is submitted to CMS, the updated Transition Plan will be reposted on the HCBS webpage listed above.

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 identified in the Transition Plan along with a timeline for completing those actions.  

The plan further outlines the process Idaho will use to assess the HCB residential settings to ensure they are integrated in and support full access of individuals to the greater community. 

States must also make a determination that settings where HCB services are provided 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. 

Idaho has now completed its systemic assessment of the state’s compliance with the HCBS regulations. The state will complete its’ systemic remediation activities by July 1, 2017. Site specific assessments and remediation will be initiated in January of 2017.  The plan outlines this process as well as Idaho’s plan for transitioning impacted participants to compliant settings where necessary. All outstanding milestones and corresponding timelines are identified in the plan.  

Home and Community Based Services Rules

Medicaid Home and Community-Based Services (HCBS) proposed rules that were published on October 7, 2015 have been heard by the Idaho Legislature’s Health and Welfare committees.  On Monday January 25, 2016 the Medicaid HCBS rules passed unanimously in the Idaho Senate and also passed unanimously in the Idaho House of Representatives on Friday, January 29, 2016. The final Medicaid HCBS rules will be published on and become effective on July 1, 2016.  These rules are necessary for the state of Idaho to move into full compliance with the Federal law passed by the Centers for Medicare and Medicaid Services (CMS). 

The Medicaid HCBS rules will be used to ensure that individuals receiving Medicaid HCBS are integrated in and supported to gain full access to their community. Idaho Medicaid is currently working with stakeholders to establish a toolkit that will benefit Idaho providers of Medicaid HCBS services to come into compliance with the HCBS IDAPA rules.

Home and Community Based Settings 

 

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. 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.

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.

Idaho has completed its’ fourth version of the state plan. 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. To access the updated Idaho Transition Plan, please go to Resources in the right hand column, Idaho Transition Plan – Version 4.

 

Ask The Program

We are interested in receiving your comments, recommendations, and questions as we work to move to full compliance with the new HCBS setting requirements. The State’s Transition Plan - Version 4 is posted here under Resources.  If you have any questions or comments about the plan or the new requirements (see Final Regulation under Resources) please send us an email and we will get back to you as soon as possible.

Email the program