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In January 2014, the Centers for Medicare and Medicaid Services (CMS) published regulations to better define the settings in which states can provide Medicaid Home- and Community-Based Services (HCBS). The HCBS final rule became effective March 17, 2014. The HCBS final rule, along with additional guidance and fact sheets, is available on the CMS Home and Community Based Services site.
The purpose of these regulations is to ensure that members receive Medicaid HCBS in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources and receive services in the community to the same degree as individuals who do not receive HCBS. CMS expects all states to review current HCBS programs and to develop a transition plan providing an assessment, strategies and timelines for compliance with the new rules.
The programs currently under review include 1915(c) HCBS Waivers and 1915(i) HCBS State Plan programs operated by the following divisions within the Family and Social Services Administration.
The Indiana Family and Social Services Administration (FSSA) has created a Statewide Transition Plan (STP) to assess compliance with the HCBS Final Rule and identify strategies and timelines for coming into compliance with the new rule as it relates to all FSSA HCBS programs. Indiana’s initial STP was submitted to CMS for review and approval in December 2014. In October 2015, CMS responded to Indiana’s STP with a request for supplemental information, noting the STP was not approved by CMS at this time. Through guidance from CMS, Indiana is submitting a modified STP to CMS by April 30, 2016, that provides additional detail from its systemic assessments and incorporates changes related to CMS’ October 2015 guidance.
The Indiana Family and Social Services Administration sought public input on the modified statewide transition plan. The plan was open for public comment for 30 days, March 7 - April 6, 2016. This comment period allowed all HCBS members, providers and stakeholders an opportunity to provide input to the plan.
Comments and input regarding the draft transition plan were submitted in the following ways:
All comments will be tracked and summarized. The summary of comments, in addition to a summary of modifications, made in response to the public comments will be added to the modified statewide transition plan. In cases where the state's determination differs from public comment, the additional evidence and rationale the state used to confirm the determination will be added to the modified statewide transition plan. The modified statewide transition plan was submitted to CMS by April 30, 2016. Once it is submitted, the updated transition plan was posted on this webpage. Paper copies available upon request.
The statewide transition plan will be posted and available for review for the duration of the transition period.