Pursuant to 42 CFR §431.408, the Indiana Family and Social Services Administration (FSSA) is seeking public input for its Division of Mental Health and Addiction's (DMHA) submission of a Home and Community-Based Services (HCBS) waiver setting requiring heightened scrutiny. The Centers for Medicare and Medicaid Services (CMS) adopted new federal regulations, known as HCBS Final Rules, which address home and community-based setting requirements for Medicaid HCBS waivers. CMS has defined settings presumed not to be home and community-based and will need to undergo heightened scrutiny as part of the HCBS Final Rules.

For settings presumed not to be home and community-based, states must present evidence of their home and community-based characteristics to CMS to determine if the setting has the qualities of a home and community-based setting and does not have the qualities of an institution, and therefore, can continue providing waiver services to individuals receiving Medicaid HCBS.

The DMHA settings will be open for public comment for 30 days, from July 24, 2019, to August 23, 2019. Visit the HCBS Final Rule web page at www.in.gov/fssa/da/4917.htm for more details.

This comment period will allow all HCBS members, providers, and stakeholders an opportunity to provide input to the plan.

Comments and input regarding the amended STP may be submitted in the following ways:

All comments will be tracked and summarized. The summary of comments as well as a summary of changes made in response to public comments will be added to the HCBS Final Rule web page at www.in.gov/fssa/da/4917.htm.

In cases where the state's determination differs from public comment, the additional evidence and rationale the state used in the final decision will be added to the STP. The final STP will be posted on the Final Rule site after it is submitted to CMS. A posted copy will be available at your local Division of Family Resources (DFR) office. For additional information available online regarding Division of Family Resources office locations, visit the DFR Benefits web page located at www.in.gov/fssa/dfr/2999.htm. Paper copies are available upon request.

Jennifer Walthall, M.D. MPH

Secretary

Family and Social Services Administration