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hcbs

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The Centers for Medicare & Medicaid Services (CMS) has made updates to the training schedule for Home and Community-Based Services (HCBS) provisions of the Medicaid Access Rule. The new training session dates and tentative topics for each session can be found below. These dates and topics are subject to change.

  • May 14, 2025, 3:00 pm ET: Timely Access, Waiting Lists, Person-Centered Planning Reporting Requirements & Minimum Performance Levels, and Website Requirements
  • June 11, 2025, 3:00 pm ET: Institutional Rule Provisions*

*Nursing Facility and Intermediate Care Facilities for Individuals with Intellectual Disabilities Rate Transparency provisions finalized in CMS-3442-F: Medicare and Medicaid

You can learn more about the training series and register for upcoming sessions on the HCBS Provisions of the Medicaid Access Rule Training Series registration web page.

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The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver renewal. The renewal will be effective on January 1, 2025.

The current approved CHC Waiver document is available here. Additional information about the CHC Waiver is located here.

Changes in the approved renewal include:

  1. Amend the following service definitions:
    1. Benefits Counseling
    2. Employment Skills Development Home Adaptations
    3. Telecare
  2. Add teleservices to the following services (details regarding teleservices can be found within each service definition as well as in the Main Module):
    1. Cognitive Rehabilitation
    2. Counseling Services
    3. Nutritional Consultation
  3. Add Chore Services as a new waiver service.
  4. Add language to reinforce that if a participant’s rights in a setting need to be modified due to an assessed need, it must be documented in the Person-Centered Service Plan (PCSP), and if a provider creates a treatment or service plan, that plan must be incorporated into the PCSP.
  5. Remove references to the Organized Health Care Delivery System (OHCDS) and the Participant Review Tool.
  6. Reduce timeframes for developing and implementing Person-Centered Service Plans from 30 days to 15 business days.
  7. Reduce the years of experience needed for Structured Day Habilitation Support Staff from five years to two years.
  8. Update Appendix C-5 to include information about the Home and Community-Based Settings Rule.
  9. Update Appendix E: Participant Direction of Services that Service Coordinators are responsible to inform the participant of the availability of the direct care worker referral and matching system.
  10. Update Appendix G: Participant Safeguards to the current process.
  11. Update the Quality Strategy to current process.
  12. Modify language throughout for better readability.

Questions about the 2025 CHC renewal can be submitted electronically.

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Thursday, December 5, 2024
2:00 pm – 3:00 pm ET
11:00 am – 12:00 pm PT
Register Here

This spring, the Centers for Medicare & Medicaid Services (CMS) finalized the highly anticipated “Ensuring Access to Medicaid Services” rule (or the “Access Rule”) that, among other things, updates program standards and processes for Medicaid home- and community-based services (HCBS), including HCBS for people with intellectual and developmental disabilities (I/DD). Individuals with I/DD rely on Medicaid HCBS to support their independence and ability to live at home in their communities. The changes required by the Access Rule—and how states implement those changes—will have far reaching impact on state I/DD systems and the people they serve.

Join the Policy Information Exchange (PIE) for a discussion with state and provider experts who are thinking through their own approaches to Access Rule implementation. During the webinar, they will dive into the Access Rule’s impact on state I/DD programs, HCBS providers, and community partners, and individuals with I/DD and their families and caregivers. Specifically, they’ll discuss:

  • New and updated requirements related to HCBS incident management and grievance systems, payment adequacy and transparency, access and quality reporting and disclosure.
  • The implications for state I/DD systems—including challenges—as they plot a path to full implementation of the Access Rule within required timelines.
  • Strategies for building effective and collaborative engagement with community partners, people receiving services, providers, case management entities, and direct care workers.
  • Immediate steps that state I/DD systems should take now to assess their HCBS programs, processes, and IT infrastructure needs.

If you can’t make the live session on December 5, visit here to register for the free webinar now, and you’ll receive a link to view the program on demand.

More Details

Facilitators

Panelists

  • Pete Cervinka, Acting Director and Chief Deputy Director, California Department of Developmental Services (DDS)
  • Conor O’Dea, HCBS Policy Advisor, The Vermont Agency of Human Services
  • Lydia Dawson, Vice President of Government Relations, ANCOR

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The Office of Long-Term Living (OLTL) has announced new services that will be available as a result of the Community HealthChoices (CHC) Waiver renewal and OBRA Waiver renewal. Effective January 1, 2025, the following services will be available:

Chore Services – CHC Only

  • Provider Type: 59
  • Specialty Code: 431
  • Procedure Code: S5131

Teleservice Cognitive Rehabilitation Therapy – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 207
  • Procedure Code: W0176

Teleservice Counseling Services – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 231
  • Procedure Code: W0175

Teleservice Nutritional Consultation – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 230
  • Procedure Code: W0170

The rates for the OLTL Home and Community-Based Services (HCBS) rates, effective January 1, 2025, are available here.

Additional information on the licensure and certification requirements can be found in the Service Definitions under Appendix C of the waivers. Please note that these documents have not received final approval from the Centers for Medicare & Medicaid Services (CMS). Once approval is received, a ListServ message will be sent with links to the final approved waiver applications.

The Fee for Service rates for Teleservice Cognitive Rehabilitation Therapy, Teleservice Counseling Services, and Teleservice Nutritional Consultation have been added to the fee schedule attached to the ListServ.

For existing OLTL providers to enroll in the services listed above a request must be submitted to the enrollment and certification resource account. The required documentation should include an updated Provider Enrollment Information Form (PEIF), a copy of the required license or certification, and a copy of the job description for the service you are requesting to add to your provider profile. If you have any questions related to the new services you can reach out to the enrollment and certification unit at 1-800-932-0939, option 1, or via email.

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The Department of Human Services (DHS) Office of Long-Term Living (OLTL) has developed a funding opportunity under an approved home and community-based services (HCBS) spending plan that includes the two following HCBS provider types:

  • Adult Daily Living; and
  • Specialized Medical Equipment and Supplies.

OLTL will provide the American Rescue Plan Act (ARPA) funds to these enrolled providers to strengthen HCBS. Consistent with the original announcement, the purpose of the funding opportunity is for the implementation of quality improvement projects by HCBS providers to improve the services available to HCBS participants through the Community HealthChoices (CHC) and OBRA 1915(c) waivers. More specifically, this funding opportunity is focused on supplementing activities in a manner that improves and strengthens the quality of HCBS services. The use of the ARPA funding, however, is limited to those activities that supplement HCBS services rather than supplant the existing services.

DHS will provide funding of up to forty thousand dollars ($40,000) per approved request submission to qualified providers. DHS will approve funding on a one-time basis to each qualified provider and will review and approve submissions in the order in which they are received until the total funding allocated has been exhausted. Funding will only be provided for the following improvement projects:

  • Supplemental activities to address the Social Determinants of Health (SDOH). For example, SDOH activities may include:
    • Activities to address affordable and accessible housing. Rent and room and board are not allowable expenditures under this funding opportunity.
    • Activities to improve access to competitive integrated employment for participants. This may include access to benefits counseling, or remote technology to support employment.
    • Activities to improve or enhance transportation for CHC and OBRA participants.
    • Activities to improve food insecurities for participants.
  • Purchase of remote support technology by providers. This can include provider technology initiatives that improve service transparency and quality assurance, such as providing direct care workers with access to tablets and software that support in-home documentation of participant conditions and other related care needs.
  • Payment for the development and implementation of enhanced training for direct care workers, Medical Assistance (MA) providers, or both. This may include enhanced training on infection control practices, which can include the development of videos and online modules to address best practices in infection control. This may also include training for professional development. For example, this funding may be used to promote training or coursework related to the professional advancement or development for direct care workers.
  • Purchase and implementation of new software and technology for electronic health records or quality or risk management functions. This includes funding for providers to contract with a Health Information Organization. Having access to electronic health care records enables HCBS providers to connect with local hospitals and physicians, and ensure real time communication between the HCBS provider and the participant’s medical providers.

Please see the Funding Opportunity document for more information and for the HCBS Quality Incentive Funding Request Form. The document is also available on the Department’s Long-Term Care Providers web page under the heading “Home and Community-Based Services (HCBS) Quality Improvement Funding Opportunity.”

If you have any questions about this message, please send them to the OLTL HCBS Opportunities Resource account.

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