This Pipeline EXTRA was distributed on 3-13-15.
In January 2014, the federal Centers for Medicare and Medicaid Services (CMS) released new requirements for Home and Community Based Services (HCBS) waivers administered by states. Essentially, the rule says that federal Medicaid funds can no longer be used to pay for waiver services that are offered in an institutional setting, or settings adjacent to public institutions or other settings that have the effect of isolating people who are receiving HCBS.
The rule became effective March 17, 2014. Each state was required to examine its waiver system, determine if any settings existed which did not meet the new HCB settings characteristics outlined in the rule, and develop a statewide plan to ensure compliance within five years of the rule’s effective date. DODD convened a CMS Transition Plan Committee comprised of stakeholders from across the DD system to review our current waiver services/rules, to identify settings that may not fully comply with the regulation, and to develop recommendations for how to bring them into compliance. DODD used the recommendations from the Transition Plan Committee when working with the Ohio Departments of Aging and Medicaid, and the Governor’s Office of Health Transformation to draft Ohio’s Transition Plan.
The next step in the process was to seek feedback from the public, including individuals and families, providers, and County Boards. Ohio accepted public comment via email, voice mail, video, U.S. Mail, and two public hearings. This feedback was summarized and used to make changes to Ohio’s plan. A complete summary of the feedback and resulting changes, as well as a copy of the plan that was submitted to CMS, is available online. Documents include:
- The transition plan submitted to CMS with changes marked
- A presentation explaining what changes were made based on public comment, and what changes submitted by the public were not made and why
- A one-page overview
The items outlined in the state’s transition plan and the timing of their implementation will be based on CMS’ approval. CMS has not shared information about when they will respond to states’ transition plans.
We will keep you informed as we learn more about the status of Ohio’s CMS Transition Plan, including approval of the plan and/or any clarifications and changes requested by CMS.