Home and Community-Based Services Program Transition
On March 17, 2014 the Centers for Medicare and Medicaid Services 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 is developing a statewide 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.
Medicaid Provider Manual Bulletin and New HCBS Chapter (Effective January 1, 2018)
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.
NEW - L 20-11 - MDHHS is accepting public comments on its revised Statewide Transition Plan - Comments due May 22, 2020
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)
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
4. Managed Specialty Services and Supports Waiver Program
5. New Provider Provisional Approval Documents
For more information on the survey process for the Habilitation Supports Waiver (HSW) and Managed Specialty Services and Supports Waiver (B Waiver) HCBS Waiver, please send an email to HCBSTransition@michigan.gov.
MDHHS and the Developmental Disabilities Institute developed the following documents to provide additional details on the survey process 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.
HCBS HS Provider Guidance (9/24/2020)
For additional information on licensing rules, please visit the Department of Licensing and Regulatory Affairs website through the following link.
Outreach and Education
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.)
Guide for Individuals and Families (3/1/2020)
HCBS and Person Centered Planning (3/1/2020)
Updated HCBS Frequently Asked Questions (August 2020)
Home and Community Based Rule - Revised Heightened Scrutiny Process
HCBS Joint Guidance Document Webinar
Overview of Person Centered Planning Process Webinar
BHDDA HCBS CMHSP Heightened Scrutiny Leads Contact Information (revised 2/13/2021)
HCBS PIHP Regional Leads Contact Information (revised 5/14/2021)
MDHHS Behavioral and Developmental Disabilities Administration HCBS transition e-mail HCBSTransition@michigan.gov