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Upcoming changes to Medicaid’s Home and Community Based Services (HCBS) Regulations By Roberta Newton & Michelle Rojas Soto January 29, 2015
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Upcoming changes to Medicaid’s Home and Community Based Services (HCBS)
Regulations
By Roberta Newton & Michelle Rojas Soto January 29, 2015
Structure and Logistics
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About Michelle Rojas Soto
Moderator USC UCEDD Director of Community Education, Information Dissemination and Technical Assistance [email protected] www.uscucedd.org
The USC University Center of Excellence in Developmental Disabilities at Children’s Hospital Los Angeles (USC UCEDD) is one of 67 centers around the country. Our mission is to provide leadership in strengthening family-centered, culturally-competent services and systems for the benefit of individuals with, or at risk for, developmental, behavioral and/or special health care needs and their families in partnership with those who utilize the services.
About Roberta Newton
Presenter Manager, Los Angeles Regional Office State Council on Developmental Disabilities [email protected] http://www.scdd.ca.gov/areaboard10.htm
The State Council on Developmental Disabilities is established by state and federal law to ensure that individuals with developmental disabilities and their families participate in the planning, design and receipt of the services and supports they need which promote increased independence, productivity, inclusion and self-determination. The Council supports 13 regional offices that provide advocacy assistance, training, monitoring and public information.
Overview
What is CMS and HCBS?
Why is CMS and HCBS important
for DD families?
What changes will take effect and when?
How will the mandated changes impact
families?
Next steps
What is CMS and HCBS?
What is CMS and
HCBS?
Why is HCBS important for DD families?
What changes will take effect
and when?
How will the mandated
changes impact families?
Next steps
• CMS – Centers for Medicare & Medicaid Services • HCBS – Home and Community Based Services • HCBS includes the wide variety of services that people use to support them
in the community: o Personal care attendants o Supported living services o Transportation, etc.
• With a few exceptions, nearly all the services offered by your regional center are HCBS.
Why do CMS and HCBS matter?
What is CMS and HCBS?
Why is HCBS
important for DD
families?
What changes will take effect
and when?
How will the mandated
changes impact families?
Next steps
• CMS are a major source of funding for the developmental disability service system. About 50% of regional centers’ budgets comes from CMS.
• When CMS announced changes to their rules, states paid close attention. States know they may need to make changes to their services so that CMS will continue to pay for those services.
• It is important for people who receive HCBS to also pay attention to the new rules because your services could change as a result.
• HCBS include not only regional center services but some services provided by the Departments of Health Care and Aging.
How will HCBS change?
What is CMS and HCBS?
Why is HCBS important for DD families?
What changes will take effect and when?
How will the mandated
changes impact families?
Next steps
• The purpose of the new rule is to make sure that HCBS services provide real opportunities to work, live, and socialize in the community.
• Five Standards Integration into the community Individual Choice Individual Rights Autonomy Choice Regarding Services and Providers
More Info: http://autisticadvocacy.org/wp-content/uploads/2014/09/Guide-for-Advocates-and-Families.pdf
How will HCBS change?
What is CMS and HCBS?
Why is HCBS important for DD families?
What changes will take effect and when?
How will the mandated
changes impact families?
Next steps
• People must have the right to choose what services they receive and from whom, through a person-centered planning process.
• Service settings that are institutional in nature, that keep people segregated from their community, will probably not qualify for CMS funding. However, the new rule does not explicitly target any specific service categories for elimination.
• At this point , states are expected to begin assessing the various service settings to determine which may not comply with the new standards.
How will families be impacted?
What is CMS and HCBS?
Why is HCBS important for DD families?
What changes will take effect
and when?
How will the mandated changes impact
families?
Next steps
• States must encourage service recipients, advocates, and stakeholders to participate in assessing HCBS.
• Teams will visit and/or survey locations where services are delivered.
• Emphasis on “person-centered planning”. The regional center Individual Program Planning (IPP) process will probably change too.
• Some services or service categories may be eliminated.
• What is almost certain to change is how services look, how they operate and what rules they follow. For example, there will likely be the requirement that regional centers and providers document that a service was freely chosen from among an array of choices.
Where do we go from here?
What is CMS and HCBS?
Why is HCBS important for DD families?
What changes will take effect
and when?
How will the mandated
changes impact families?
Next steps
• By March 17, 2015, each state has to submit a “Transition Plan” to CMS that lays out the process they will follow for assessing their services and ensuring full compliance.
• California submitted its Transition Plan in December 2014. It includes an implementation timeline for education and outreach, assessments and appeals.
• It is expected that CMS will reject the initial plan and require the state to develop a more robust, detailed plan with greater stakeholder involvement.
• States are required to come into full compliance with the new rules by March 17, 2019.
Where do we go from here?
What is CMS and HCBS?
Why is HCBS important for DD families?
What changes will take effect
and when?
How will the mandated
changes impact families?
Next steps
• Review the state’s Transition Plan, track changes and new developments, and volunteer to participate in the ongoing evaluation process:
http://www.dhcs.ca.gov/services/ltc/Pages/HCBSStatewideTransitionPlan.aspx
This web site was established by the Department of Health Care Services (DHCS) because they are the lead agency for all HCBS waivers.
• Review the timeline: http://www.dhcs.ca.gov/services/ltc/Documents/STPTimeline19Dec14.pdf
• Submit comments: [email protected]
Where do we go from here?
What is CMS and HCBS?
Why is HCBS important for DD families?
What changes will take effect
and when?
How will the mandated
changes impact families?
Next steps
• DDS will develop a transition plan and timeline specifically for the developmental disabilities service system. The DDS HCBS Advisory Group is in the process of being established and will begin its work in February 2015.
• Track progress and provide input:
http://www.dds.ca.gov/HCBS/index.cfm
• Additional HCBS Information:
http://hcbsadvocacy.org/
http://tash.org/wp-content/uploads/2015/01/Joint-Statement-by-HCBS.pdf
Poll: Do you have a better understanding of HCBS and the new
rule now?
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