Home and Community-Based Services Program Transition

NEW List of Heightened Scrutiny Settings Submitted to CMS

Home and Community-Based Settings Regulation - Implementation Timeline Extension and Revised Frequently Asked Questions State Medicaid Director Letter

Extension of Transition Period for Compliance with HCBS Criteria

Final Rule

Medicaid Provider Manual Bulletin and New HCBS Chapter (Effective January 1, 2018)

HCBS HEF Grant

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 Final Approval Letter Michigan Statewide Transition Plan from the Centers for Medicare and Medicaid ( 3/10/2023)

Letter from the Centers for Medicare and Medicaid Services

L-20-54 (9/24/2020)

NEW - L 20-11 - MDHHS is accepting public comments on its revised Statewide Transition Plan - Comments due May 22, 2020

MDHHS Statewide Transition Plan - version 5.3 (December 2022)

NEW – Summary Consultation – STP – Final (January 2023)

Statewide Assessment, Remediation and Transition Strategy

Initial Approval Letter from the Centers for Medicare and Medicaid Services

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

A. Participant Survey B Waiver

B. Provider Survey B Waiver

C. Home and Community Based Services (HCBS) 2018 Survey

5. New Provider Provisional Approval Documents

A. MDHHS BHDDA New Home and Community Based Services Provider Requirements

B. New HCBS Non-Residential Provisional Provider Survey (updated 12/2/2021)

C. New HCBS Residential Provisional Provider Survey (updated 12/2/2021)

6. Heightened Scrutiny Tools
These tools are not standalone documents. they are to be used in conjunction with each other and with the residential and non-residential surveys.

A. MI Choice Participation Notification Settings in HS

B. MI Choice Notification to Setting of HS status

C. MI Choice Participation Letter of Upcoming Site visit

D. MI Choice Setting Refusal Letter

E. MI Choice Residential Site Survey

F. MI Choice Non-Residential Site Visit Survey

G. MI Choice Visit Staff Interview

H. MI Choice Visit Participation Interview

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.

HCBS Surveys Memo

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

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.

Heightened Scrutiny Setting Guidance Document

HCBS HS Provider Guidance (9/24/2020)

Managed Specialty Services and Supports Waiver (MSS and S) Documentation Guidance

Non-Residential Settings - HCBS Heightened Scrutiny Review Documentation Guidance

Residential Settings - HCBS Heightened Scrutiny Review Documentation Guidance

Summary of Resident Rights

MDHHS/LARA Joint Guidance Document

HCBS Provider Readiness Tool - Non-Residential Settings

HCBS Provider Readiness Tool - Residential Settings

HCBS Heightened Scrutiny Flowchart: Isolation

HCBS Heighted Scruitny Flowchart: Instution

HCBS Heightened Scrutiny Process