The web Browser you are currently using is unsupported, and some features of this site may not work as intended. Please update to a modern browser such as Chrome, Firefox or Edge to experience all features Michigan.gov has to offer.
Home and Community-Based Services Program Transition
MDHHS BPHASA BEHAVIORAL HEALTH HEIGHTENED SCRUTINY PUBLIC COMMENT BEGINS AUGUST 19, 2022
Tribal Notice
Michigan Department of Health and Human Services Behavioral and Physical Health and Aging Services Administration
Home and Community Based Services Public Comment for Heightened Scrutiny (HS) Settings
Please see L-letter L 22-34 at the following link: 2022 Medicaid Provider L Letters (michigan.gov)
DIRECTIONS FOR PUBLIC COMMENT REVIEW AND FEEDBACK
This phase of the Heightened Scrutiny process will cover all HCBS settings that require an HS review statewide.
MDDHS BP-HASA (BHDDA) SURVEY PROCESS
MDHHS contracted with Michigan State University to gather evidence from settings related to the reasons they were on Heightened Scrutiny (HS).
This information was then uploaded into a format to allow the Heightened Scrutiny Review Committee (HSRC) to review each settings information and provide the department with feedback.
The HS review forms were redacted in the following ways:
- Information related to specific locations of settings, such as the name of a local coffee shop, or a specific area attraction were redacted to support the goal of unbiased reviews. The Heightened Scrutiny Review Committee was not aware of the specific name or location of the setting they were reviewing.
- Specific diagnoses were often removed to protect the privacy of the individuals’ receiving services in a setting. When redacted this information was deemed unnecessary to assess the HBCS compliance of a setting.
- Symptoms of a behavioral health diagnosis were often redacted and replaced with less personal or private information in most cases this information is not needed to assess the HCBS compliance of a setting.
- MDHHS has instituted a process where all the individualized plans of service (IPOS) of waiver participants were reviewed for compliance to the rule. These plans are private and have not been shared with anyone outside of MDHHS consistent with laws around privacy.
- When a redaction was made, replacement information that is less revealing is inserted and will look like this <additional information>.
SETTINGS INFORMATION
COUNTIES REPRESENTED ON HS PUBLIC COMMENT
Alcona County |
Gogebic County |
Muskegon County |
Allegan County |
Grand Traverse County |
Newaygo County |
Alpena County |
Houghton County |
Oakland County |
Antrim County |
Ingham County |
Oceana County |
Baraga County |
Kalamazoo County |
Ogemaw County |
Bay County |
Kalkaska County |
Otsego County |
Berrien County |
Kent County |
Ottawa County |
Branch County |
Lake County |
Presque Isle County |
Calhoun County |
Lapeer County |
Roscommon County |
Charlevoix County |
Lenawee County |
Sanilac County |
Cheboygan County |
Mackinac County |
St. Clair County |
Chippewa County |
Macomb County |
St. Joseph County |
Clinton County |
Marquette County |
Van Buren County |
Delta County |
Menominee County |
Washtenaw County |
Dickinson County |
Monroe County |
Waukesha, Wisconsin |
Eaton County |
Montcalm County |
Wayne County |
Genesee County |
Montmorency County |
Wexford County |
To review a setting, you will search for it through the link below by identifying following information
- County where setting is located
- City where setting is located
- Name of setting
Please follow this link to the setting list
TO ACCESS SURVEYS
Click on the link below. This will take you to a search function that will allow you to review specific settings.
https://hsrctribal.azurewebsites.net
When you have completed your review of the information provided you will see a survey link at the bottom of the page. If you would like to leave feedback related to the setting you may complete the survey. MDHHS will review feedback as part of our full review process in determining which setting, we will move forward to the Centers for Medicaid and Medicare Services (CMS) for their final approval.
When this process is completed MDHHS will post information related to those settings that successfully completed the HS review and those that did not.
A consultative summary will be posted on this webpage following the completion of the HS review process where we will identify and respond to concerns noted.
There is no public hearing scheduled for the HS public comment. Input regarding HS is highly encouraged, and comments regarding this notice of intent may be submitted to Lorna Elliott-Egan, MDHHS Liaison to the Michigan tribes. Lorna can be reached at 517-512-4146 or via email at Elliott-EganL@michigan.gov. Please provide all input by October 3, 2022.
IF YOU REQUIRE ASSISTANCE WITH THE HS REVIEW PROCESS
If you encounter difficulties utilizing the survey webpage, please contact the help desk at Help@PTDTechnology.com.
If you have questions related to the HCBS Final Rule policy, you may contact MDHHS at HCBSTransition@michigan.gov
If you need assistance identifying a setting, please contact MDHHS at HCBSTransition@michigan.gov you must include the name and city of the setting in your email in order for us to assist you
For assistance related to the survey page please contact joet@tbdsolutions.com
Extension of Transition Period for Compliance with HCBS Criteria
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.
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
Revised Statewide Transition Plan for HCBS Waiver Programs (Oct 2020)
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
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.
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
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
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)
Person Centered Planning Toolkit for Individuals and Family Members (8/31/2020)
Person Centered Planning Fact Sheet for Individuals and Family Members (8/31/2020)
Person Centered Planning Frequently Asked Questions for Individuals and Family Members (8/31/2020)
HCBS Rule Heightened Scrutiny Guide for Individuals and Family Members (10/11/2019)
HCBS Guide for Individuals and Family Members - One Pager (8/31/2020)
HCBS Guide for Individual and Family Members
Updated HCBS Frequently Asked Questions (August 2020)
HCBS Reports in WSA for HSW Webinar
MI Choice and MI Health Link Educational Document
Centers for Medicare and Medicaid Services (CMS) Advisory on Home and Community-Based Settings
Developmental Disabilities Council Presentation
Medicaid Provider Manual Policy Bulletin MSA-17-31
Review of the Joint Guidance Document
2017 Waiver Conference Presentation
MDHHS BHDDA HCBS Guardianship FAQs
Home and Community Based Rule - Revised Heightened Scrutiny Process
HCBS Joint Guidance Document Webinar
Overview of Person Centered Planning Process Webinar Handouts
Overview of Person Centered Planning Process Webinar
Contact Information
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
Developmental Disabilities Institute Home and Community Based Services Transition Webpage