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Transition plan for home and community-based settings

In 2014, the federal Centers for Medicare & Medicaid Services (CMS) published regulations in the Federal Register that changed the definition of home and community-based settings for the 1915(c) and 1915(i) Medicaid HCBS waivers. The new definition considers a person’s experience and outcomes in addition to a setting’s location, geography or physical characteristics. CMS has given states until March 2022 to bring their systems into compliance with the new HCBS settings requirements.

HCBS settings evidentiary packages

CMS requires states to submit evidentiary packages for settings that CMS presumes are not home and community-based.

We will submit batches of evidentiary packages to CMS quarterly. We will send out an eList announcement at the start of each 30-day public comment period. We will post copies of evidentiary packages to the HCBS settings evidentiary packages webpage.

  • Batch 1: Public comment period held from Feb. 6, 2019, to March 7, 2019
  • Batch 2: Public comment period scheduled for April-May 2019
  • Batch 3: Public comment period scheduled for July-August 2019
  • Batch 4: Public comment period scheduled for October-November 2019

We will post a final version of each evidentiary package and a summary of the public comments on the HCBS settings webpage and announce the publication via eList.

DHS selects members for HCBS Settings Review Panel

DHS plans to use an HCBS Settings Review Panel to review evidentiary packages of settings that CMS “presumes are not HCBS” after the public comment period but before submission to CMS, when:

  • DHS does not believe the setting is HCBS
  • Public comment raises concern that the setting has institutional or isolating qualities.

In March 2019, DHS selected 11 HCBS SRP members who represent diverse perspectives and experiences. To read more, see the HCBS Settings Review Panel webpage.

CMS grants final approval to statewide transition plan 

On Feb. 12, 2019, CMS gave its final approval to Minnesota’s Home and Community-Based Services Rule Statewide Transition Plan (PDF) to bring settings into compliance with the federal HCBS regulations. To read more, see the Feb. 12 approval letter from CMS to DHS (PDF).

Latest information

Assessing compliance

CMS requires states to assess all settings that group people to receive home and community-based services. States must determine whether the settings meet the HCBS rule requirements. To conduct site-specific assessments, DHS developed, tested and launched an online provider attestation process for designated HCBS settings in 2017.

Validating compliance

The next steps to evaluating all HCBS provider settings is to use several validation strategies to ensure compliance.

Minnesota's statewide transition plan

On June 2, 2017, CMS gave its initial approval to Minnesota's statewide transition plan to bring settings into compliance with the federal HCBS regulations. To read more, see the June 2 letter from CMS to DHS (PDF)

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