Posted for public comment: September 11, 2015
Comments accepted through midnight: October 12, 2015
Contact: Michele Turbert, Project Manager, Medicaid 208-364-1946
The purpose of this posting is to provide public notice and receive public comments for consideration regarding Idaho Medicaid’s Home and Community Based Services Settings Transition Plan (v3). The full Transition Plan can be found by selecting the link in the right hand column titled: Idaho State Transition Plan, (v3). Copies may be obtained by printing the Transition Plan 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.
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. Idaho submitted its draft Transition Plan (v2) to CMS in March, 2015. Comments from CMS have been received and are posted on this webpage. Changes to the Transition Plan (v3) have been made based on those comments.
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. Comments should be submitted by midnight October 12, 2015. Comments regarding the Transition Plan may be submitted in the following ways:
a. 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.
b. By e-mail: HCBSSettings@dhw.idaho.gov
c. By written comments sent to:
Division of Medicaid, Attn. Transition Plan
PO Box 83720
Boise, ID 83720-0009
d. By FAX: (208) 332-7286 (please include: Attention HCBS)
e. 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 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 re-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 has now completed a preliminary analysis of its residential and non-residential HCBS settings. This analysis identified areas where the new HCBS requirements are supported in Idaho as well as areas that will need to be strengthened in order to align Idaho’s HCBS programs with the regulation. Actions necessary for Idaho to come into full compliance have been proposed in the Transition Plan along with a timeline for doing so.
Idaho completed the analysis of all HCBS settings on two of the three characteristics of an institutional setting as defined in the regulation. There are no HCBS settings that are in a publicly or privately owned facility providing inpatient treatment or on the grounds of, or immediately adjacent to, a public institution. Idaho has not yet completed its assessment of HCBS settings to ensure they do not have the effect of isolating individuals from the broader community of individuals not receiving Medicaid HCBS, the third characteristic of an institution. The Transition Plan describes Idaho’s plans for completing that assessment.
Idaho’s plan for assessing and monitoring all settings for all requirements, including community integration versus isolation, is now contained within Transition Plan (v3). Additional administrative rule (IDAPA) support for the HCBS setting requirements is expected to be promulgated during the 2016 legislative session and become effective July 1, 2016. Assessment of settings is expected to be completed by December, 2017. A preliminary plan for provider remediation and relocation of impacted participants is included within the Transition Plan.
Changes in the current Transition Plan (v3) include:
Changes made as a result of CMS comments received August 10, 2015
The addition of new details determined since the January 2015 publication
New information concerning the September 2015 publication, public noticing and public comments
Medicaid Home and Community Based Services (HCBS) settings will soon have new requirements to meet in order to continue to serve Medicaid participants funded with HCBS dollars. The regulations were passed by the Centers for Medicare and Medicaid Services (CMS) and are now law. They affect certified family home providers, residential assisted living facilities, residential habilitation agencies, and those providing services to Medicaid participants in adult day health centers, developmental disability agencies, support brokers and targeted service coordinators.
Idaho Medicaid will be promulgating rule changes in order to move our HCBS system into full compliance with these new regulations. Please watch this page for further announcements on the rule promulgation process.