NACDD: Year One Highlights for AIDD Supporting Families Project
NACDD: Making Sense of LTSS Policy. Rachel Patterson
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Transcript of NACDD: Making Sense of LTSS Policy. Rachel Patterson
Implementation of the HCBS Settings Rule: Resources for Advocates
Rachel Patterson
Association of University Centers on Disabilities
July 8, 2014
What Counts as a Home or Community-
Based Setting?
HCBS Rule: The Key Points
1. Setting is integrated in the community
2. People have self-determination
3. Additional protections for provider-owned
4. Everyone has a Person-Centered Plan
5. Some settings presumed not HCBS
HCBS Rule: Other provisions
• Improved Enforcement of waiver provisions• Caregiver assessment in 1915(i)• Heightened scrutiny for settings that isolate• Documentation of compliance in person-centered plan
• What about non-residential services?
Key Dates
• Published: January 16, 2014• Effective: March 17, 2014• Transition Plans Due: March 17, 2015
Unless states submit a waiver renewal or amendment before March 17, 2015, then:• States must submit a Transition Plan for the services in that waiver with the submission
• 120 days later submit a Transition Plan for their remaining HCBS system
HCBS Rule: Transition Plan
• 2 public notices• 30 day public comment period on full transition plan
• Modify the plan in response to comments• Save comments and submit summary to CMS
• Plan can be up to 5 years in length
Transition Plans: What we’ve seen so far
• Strict timelines• Assessment plans and Plans to write a Transition Plan
• Lack of detail
Stakeholder Engagement:
This is where you come in!
Stakeholder Engagement
• Did the state post the full transition plan?• Did the state modify the plan based on comments?
• Are the comments publically available?
Tools on HCBSadvocacy.org
HCBSadvocacy.org
Tips for Advocates
• Learn About the Rule• Spread the Word• Get Involved
• Public Comment• Stakeholder Committees• Town halls
• Advocate• Improved Stakeholder Engagement
Tips for Advocates
• Work in coalition• Olmstead coalitions or task forces• Protection & Advocacy• DD Council• University Centers• Area Agencies on Aging• Mental Health America or NAMI local• Centers for Independent Living• AARP local chapter
Tips for Advocates
• Build on Existing Reform Work in the State• Olmstead Settlements• Medicaid reform
• 1115 waivers• Managed Care• Community First Choice Option• Balancing Incentive Program • 1915(i) HCBS State Plan Amendments
Leverage these and other opportunities for increased stakeholder engagement