AASD and DSD eList announcement

Date: June 17, 2022
To: Waiver service providers, lead agency staff and other interested parties
From: DHS Disability Services and Aging and Adult Services divisions
Purpose: To provide updates about the Home and Community-Based Services Settings Rule transition
Contact: hcbs.settings@state.mn.us

Updates on the HCBS Settings Rule transition

Centers for Medicare & Medicaid Services (CMS) site visit

CMS recently contacted the Minnesota Department of Human Services (DHS) to coordinate CMS HCBS Settings Rule site visits. CMS will visit a total of six customized living and adult day settings during the week of July 25, 2022. CMS randomly selected these settings from those submitted for the heightened scrutiny process.

During the site visit, CMS plans to review HCBS policies and a select number of person-centered support plans. CMS also plans to observe people’s experience at the setting to assess whether the setting is demonstrating the HCBS standards outlined in the rule. CMS will interview a small number of people and direct support staff. CMS will ask questions related to access to the community, freedom to come and go and choice of daily activities.

We’ve reached out to the selected providers and will work closely with them as CMS finalizes their itinerary. A DHS staff member will be present during the site visit to observe the process.

New HCBS settings implementation guidance

On May 24, 2022, CMS published HCBS Settings Rule Implementation – Moving Forward Toward March 2023 & Beyond (PDF), a strategy for implementation of the home and community-based settings regulation. The strategy aligns the focus of federal support and state compliance activities with the realities of the direct-service workforce crisis, which was made worse by COVID-19. 

This approach contains the following components which must be met for states to continue federal reimbursement of HCBS after the transition period:

· States must receive final Statewide Transition Plan (STP) approval by March 17, 2023.

· States and providers must be in compliance with all settings criteria not directly affected by COVID disruptions, including related workforce challenges, by March 17, 2023.

· Corrective action plans (CAPs) will be available to states to authorize additional time to achieve full compliance with settings criteria that are directly affected by COVID disruptions. These CAPs will be used when states document settings’ efforts to meet the requirements to the fullest extent possible and providers are in compliance with all other settings criteria.

What does this mean for Minnesota?

DHS received final approval of our STP in February 2019. In partnership with providers, we completed most of the assessment, validation and remediation work outlined in the STP before the public health emergency. DHS plans to be in full compliance with the HCBS settings rule requirements as outlined in Minnesota’s HCBS Settings Rule Statewide Transition Plan (STP) before March 17, 2023, and does not plan to submit CAPs for any waiver HCBS setting.

More information

· Home and Community Based Services Rule transition plan

· Heightened Scrutiny: Facts, Process and Content

Previous eList announcements

AASD LEAD AGENCY ARCHIVE | DSD LEAD AGENCY ARCHIVE | DSD STAKEHOLDER ARCHIVE