March 26th, 2023
HHSC published PL 2023-06 Compliance with New HCBS Settings Rules
HHSC Long-term Care Regulation published Provider Letter 2023-06 regarding Compliance with New HCBS Settings Rules on March 24, 2023. This letter explains how LTCR surveyors will assess HCS providers for compliance with the new HCBS settings requirements.
March 15th, 2023
The Center for Medicaid and CHIP Services (CMCS) is sharing this toolkit with State Medicaid Agencies, Operating Agencies, and other stakeholders a Home and Community-Based Settings Toolkit to assist states to develop Home and Community-Based 1915(c) waiver and 1915(i) SPA amendment or renewal application(s) to comply with new requirements.
These requirements were noted in the recently published Home and Community-Based Settings (HCBS) regulations. HHSC is amending TAC rules to add requirements for all settings in the HCS program, including 3-person and 4-person group homes and host home/companion care settings, to comply with HCBS settings requirements at 42 CFR §441.301(c)(4)(i)-(v).
These new HCS rules have been added as TAC Title 26, Part 1, Chapter 263.
Texas Home Living HCBS regulations for compliance requirements is the following TAC title 26 part I Chapter 262
I would pay attention, in particular to the following information in the toolkit: Info on residential & non-residential settings, Q&A for HCBS, Transition Plan toolkit, and the info on Heightened Scrutiny and the Review process for it, as well as person-centered requirements.
Handy Dandy List of Items In The Toolkit:
- SMDL: Home and Community-Based Settings Regulation – Implementation Timeline Extension and Revised Frequently Asked Questions – July 14, 2020
- March 2019 Updated Frequently Asked Questions on Heightened Scrutiny Provisions
- July 2019 CIB: Heightened Scrutiny Review of Newly Constructed Presumptively Institutional Settings
- All State Call Slides: FAQs on Heightened Scrutiny – March 2019
- FAQs concerning Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exit-Seeking Behavior
- A summary of the regulatory requirements of fully compliant HCB settings and those settings that are excluded.
- Schematic drawings of the heightened scrutiny process as a part of the regular waiver life cycle and the HCBS 1915(c) compliance flowchart.
- Additional technical guidance on regulatory language regarding settings that isolate.
- Exploratory questions that may assist states in the assessment of:
- Questions and Answers Regarding Home and Community-Based Settings
- Statewide Transition Plan Toolkit for Alignment with HCB Settings Regulation Requirements Suggestions for alternative approaches and considerations for states as they prepare and submit Statewide Transition Plans for the new federal requirements for residential and non-residential home and community-based settings. The regulatory requirements can be found at 42 CFR 441.301(c)(4)(5) and 441.710(a)(1)(2).
- Frequently Asked Questions Regarding the Heightened Scrutiny Review Process and Other Home and Community-Based Settings Information
- Frequently Asked Questions on Planned Construction and Person-Centered Planning Requirements