The Centers for Medicare & Medicaid Services (CMS) issued a final rule for home and community-based settings, effective March 17, 2014.
Under 42 C.F.R. §441.301, States must meet new requirements for home and community-based services and supports. The new home and community-based requirements define the settings in which it is permissible for states to provide services. The purpose of these regulations is to ensure that individuals receive 1915(c) waiver services in the most integrated settings possible and that the services support full access to the greater community including opportunities to seek competitive employment and work in an integrated setting, engage in community life, and control personal resources in a manner similar to individuals who do not receive 1915(c) waiver services.
The rule also provides for a transitional period for States to come into compliance with the new waiver program requirements. States are required to develop a transition plan to assess compliance, develop remediation strategies, and establish timelines for meeting the requirements of the new rule.
The Texas Health and Human Services Commission is submitting to CMS a timeline that outlines the transition plan to comply with the new Home and Community-based Services (HCBS) regulations for the Youth Empowerment (YES) waiver program, a waiver implemented under the authority of §1915(c) of the Social Security Act.
Assessment and Public Input
- July 2014 – August 2014: Conduct assessment of settings in the YES waiver to ensure compliance with new HCBS rules.
- July 2014 – August 2014: Develop high level settings transition plan with timeline for remediation of any YES settings not already in compliance.
- August 2014: Release public notice for review of the YES settings transition plan.
- August 2014 – September 2014: Period for public input on transition plan.
- September 2014: Review and include appropriate revisions to the MDCP settings transition plan based on public input and submit settings transition plan in waiver amendment.
- November 2014 - December 2014: Public input of assessment results and full transition plan which will be incorporated into the full transition plan.
- December 2014: Submit full transition plan to CMS.
- November 2014 – November 2015: If determined necessary based on assessment and public input, amend YES program rules, Title 25, Part 1, Chapter 419, Subchapter A - Youth Empowerment Services, and other necessary rules and policies to ensure the services comply with the new HCBS guidelines.
- November 2014 – January 2015: If changes to existing waiver policies are required based on assessment and public input, deliver educational webinars for HCS providers about new HCBS guidelines.
- April 2015 – November 2015: If determined necessary based on assessment and public input, revise the YES manual to further outline HCBS requirements.
- November 2015: If changes to existing waiver policies are required based on assessment and public input, submit YES amendment updating the settings transition plan.
The YES waiver program is designed to provide community-based services to children with serious emotional disturbances and their families, with a goal of reducing or preventing children’s inpatient psychiatric treatment and the consequent removal from their families. At any given time, the waiver can serve up to 400 youth who are at least age three but under age 19 and who are predicted to remain in the waiver for 12 months.
Archived State Transition Plan Comments and Feedback
State Transition Plan Comments and Feedback, posted 10/6/16:
"HHSC plans to submit an update to the Home and Community-Based Services (HCBS) statewide transition plan (STP) to the Centers for Medicare & Medicaid Services (CMS). The updates include responses to CMS' feedback received in Summer 2016. These updates are mainly to clarify and strengthen components of the STP and to help the state obtain federal approval of the STP. The updated STP will be located on the HHSC Website on October 17, 2016. If you'd like to send comments regarding the updated STP, send them to Medicaid_HCBS_Rule@hhsc.state.tx.us. The comment period is open from October 17, 2016, through October 21, 2016, at 5 p.m. Because of a short submission deadline, comments provided will be considered in future updates to the STP. HHSC will update the STP in the Spring of 2017, and will include more substantive changes. The 2017 STP updates will be posted for the full 30 days to allow for public comment and inclusion of comments in the update."
To obtain copies of information relating to the matter for which notice was published, interested parties may contact Beth Rider by mail at Texas Health and Human Services Commission, P.O. Box 13247, Mail Code H-370, Austin, Texas 78711-3247, phone (512) 730-7421, fax (512) 730-7472, or by email at TX_Medicaid_Waivers@hhsc.state.tx.us.