Letter IL 2023-09: Host Home Provider’s Who Are Immediate Family Members & New CMS Rules For HCS

by | Feb 27, 2023

February 27th, 2023

Letter IL 2023-09 discusses that Sections 263.502 and 263.503 (a)(1)(A) and (b) through (m) of the new Chapter 263 CMS rules do not apply to HH/CC providers in which the HH/CC provider is an immediate family member of the person receiving HH services.  See page 1, 2nd paragraph of the IL for the definition of an immediate family member.  Sections 263.502 and 23.503 (a)(1)(A) and (b) through (m) will however, apply if a HH/CC provider does not meet the definition of an immediate family member

Under Chapter 263, Subchapter F related to Provider Owned or Controlled Residential Settings, in particular Sections 263.501, 263.510 and 263.503.  The rules under these sections address the following:  requirements related to HCBS settings (Section 263.501); requirements as to what providers must ensure in the delivery of services, such as privacy in bedrooms, an operable bedroom door lock, access to food, choice of roommates, etc. (Section 263.502); and requirements related to residential lease agreements (Section 263.503).

Providers must follow the instructions on page 2 of the letter related to obtaining written documentation of all HH/CC settings in which the HH/CC service provider is an immediate family member of persons receiving HH/CC services. Providers and LIDDAs Need to Document Immediate Family Member.   This must be done within 60 days of the date of the IL and signed by the program provider, HH/CC service provider and the individual or LAR.  The signed document must be sent to the LIDDA SC to be added as an addendum to the PDP.
Upon receipt of the signed document, the LIDDA SC must complete Form 8665-ID to document whether the HH/CC is an immediate family member and to specify the relationship between the HH/CC service provider and the individual.