Home and Community-Based Services Program Transition

The Centers for Medicare and Medicaid Services recently published a new set of rules for the delivery of Home and Community Based Services through Medicaid waiver programs. Through these rules, the Centers for Medicare and Medicaid Services aim to improve the experience of individuals in these programs by enhancing access to the community, promoting the delivery of services in more integrated settings, and expanding the use of person-centered planning.

In response, the Michigan Department of Health and Human Services will be developing a transition plan to bring its waiver programs into compliance with the new regulations while continuing to provide vital services and supports to Michigan citizens. The Department is committed to an inclusive process partnering with people receiving services, their allies, health care providers, and other organizations to create a transition plan that serves the best interests of the people of Michigan while also meeting requirements from the Centers for Medicare and Medicaid Services.

As the Department develops new opportunities for stakeholders to provide feedback on this project, information about these events and opportunities will be published on this webpage. If you have any questions about this project, please send an email to HCBSTransition@michigan.gov.

 

Statewide Transition Plan

The Michigan Department of Health and Human Services developed a Statewide Transition Plan for bringing Medicaid waivers into compliance with the new rule. The Michigan Department of Health and Human Services submitted the first version of the Statewide Transition Plan to the Centers for Medicare and Medicaid Services on January 16, 2015.

The Centers for Medicare and Medicaid Services sent a response letter to the Department with requested revisions and clarifications to the Statewide Transition Plan. The letter is included below.

Letter from the Centers for Medicare and Medicaid Services

The Department revised the Statewide Transition Plan based upon this letter and feedback from Michigan stakeholders. MDHHS posted the revised Statewide Transition Plan for public comment between December 16, 2015 and January 22, 2016. MDHHS incorporated the feedback from public comment into the revised Statewide Transition Plan. Additionally, the department also produced a consultation summary in response to stakeholder comments and questions. MDHHS sent the revised Statewide Transition Plan and Consultation Summary to the Centers for Medicare and Medicaid Services on March 15, 2016.

Revised Statewide Transition Plan (with the Consultation Summary from Public Comment)

 

Individual Waiver Transition Plans

The Centers for Medicare and Medicaid Services requires states to submit transition plans for individual waivers if the state makes an amendment to the waiver before the statewide implementation date. The Michigan Department of Health and Human Services has made amendments to three of its waivers: the MI Choice waiver, the Habilitations Supports Waiver, and the Waiver Program for Children with Serious Emotional Disturbances. These documents are available for your review at the links below:

MI Choice Waiver (APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES)

Habilitation Supports Waiver (APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES)

Waiver Program for Children with Serious Emotional Disturbances (APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES)


Survey Tools and Process

As part of the transition process, the Department must determine whether settings under these waiver programs have “home and community-based” characteristics. For this purpose, the Department is developing a set of “survey tools” to assess individual settings for home and community-based characteristics.

The Department has published the survey tools for the following waiver programs.

1. MI Health Link HCBS Waiver

     A. Residential Survey - Sections 1 through 5

     B. Residential Survey - Section 6

     C. Non-Residential Survey - Section 1

     D. Non-Residential Survey - Section 2

2. MI Choice Waiver

     A. Residential Survey

     B. Non-Residential Survey

3. Habilitation Supports Waiver

     A. Participant Survey

     B. Residential Provider Survey

     C. Non-Residential Provider Survey

For more information on the survey process for the MI Choice Waiver and MI Health Link HCBS Waiver, please send an email to HCBSTransition@michigan.gov.

The Michigan Department of Health and Human Services is partnering with the Developmental Disabilities Institute of Wayne State University to conduct the statewide assessment process for the Habilitation Supports Waiver. For more information on the statewide assessment process for the Habilitation Supports Waiver, please visit the following website: http://ddi.wayne.edu/hcbs.php

MDHHS and the Developmental Disabilities Institute developed the following documents to provide additional details on the survey process for the Habilitation Supports Waiver.

Memo on the National Core Indicators and Home and Community-Based Services Survey

Frequently Asked Questions for Survey Respondents

Memo with Updates on the HCBS Survey for the Habilitation Supports Waiver

 

Remediation and Ongoing Compliance

The Michigan Department of Health and Human Services will post documents related to the remediation and ongoing compliance process on this page. These documents may provide further guidance to stakeholders regarding the implementation process for the rule and the process for individual settings to come into compliance.

The Michigan Department of Health and Human Services and the Department of Licensing and Regulatory Affairs have received several questions about how the rule intersects with state licensing laws. The two Departments issued the following guidance to stakeholders to help address these issues.

Joint Communication on the HCBS Rule and Licensing Issues

Summary of Resident Rights

For additional information on licensing rules, please visit the Department of Licensing and Regulatory Affairs website through the following link.

 

Additional Resources

Final Rule

Centers for Medicare and Medicaid Services (CMS) Webpage for the Rule (The federal toolkit for implementation as well as exploratory assessment questions are posted here.)

MI Choice and MI Health Link Educational Document

NEW CONTENT - Centers for Medicare and Medicaid Services (CMS) Advisory on Home and Community-Based Settings