Home & Community Based Services (HCBS)
Power Hour: Compliance Time
Dr. Tiffany Swan
San Diego Regional Center
hcbs.frule@sdrc.org
Lindsay Reyes
Amy MacKenzie
Anna Keller
Next sessions of Advanced HCBS Training
8/13, 8/14, 8/15
Agenda
HCBS Resource Public Page
Why is HCBS Final Rule Important?
On March 14, 2014, the federal Centers for Medicare & Medicaid Services (CMS) set forth The Final Rule (requirements) for homes and programs where Home and Community-Based Services (HCBS) are delivered. Vendors must meet this criteria in order to qualify for federal funding under the Medicaid program (called “Medi-Cal” in California). SDRC is devoted to assisting our vendors in meeting the rules. Our goal is to provide technical assistance to vendors in order to obtain 100% compliance by August 31, 2024.
For vendors who do not meet HCBS compliance their federal funding will be reduced to 50% and they will not be able to continue to provide services.
Statewide Transition Plan
Timeline:
CMS and DDS are requiring the following timeline of SDRC to report – Number of Visits, Number of Vendors found in Compliance, Number of Vendors found to be working towards Compliance, Number of Vendors who are current under a Corrective Action Plan (CAP), Number of Vendors who not able to comply with their CAP and Number of Vendors who are Appealing the CAP. SDRC goal is to work with each vendor prior to issuing CAP.
HCBS Final Rule Requirements: The Setting (All Providers)
The setting is integrated in, and supports full access of individuals with disabilities, to the greater community to the same degree of access as their non-disabled peers.
2. Choice of Setting
The setting is selected by the individual from among setting options including a nondisabled specific setting and an option for a private unit in a residential setting.
3. Right to be Treated Well
The setting ensures an individual's right of privacy, dignity and respect, as well as freedom from coercion and restraint.
4. Independence
The setting optimizes but does not regiment, individual initiative, autonomy and independence in making life choices, including but not limited to: daily activities, physical environment, and with who to interact.
5. Choice of Services & Supports
The setting facilitates individual choice regarding services and supports and who provides them.
1. Access to Community
HCBS Final Rule Requirements: Residential Settings
7. Privacy
Each individual has privacy in their sleeping or living unit; including doors lockable by the individual, choice of roommate, freedom to furnish/decorate their living unit
8.Schedule & Access to Food
Individuals have freedom and support to control their scheduled and activities, and have access to food at any time.
9. Right to Visitors
Individuals are able to have visitors of their choosing at any time.
6. Residential Agreement
In a unit or dwelling is a specific physical place that can be owned, rented or occupied under a legally enforceable agreement by the individual receiving services.
10. Accessibility
The setting is physically accessible to the individual.
What Is Needed For HCBS Compliance?
What Is Needed For HCBS Compliance Con’t.
What Is Your Status?
Have you received an email from HCBS team or SC?
Have you responded to the email from the HCBS team or SC?
If you don’t know your status of compliance email the HCBS team at HCBS.frule@sdrc.org
MODIFICATION: A modification is when there is a health and safety concern that would create a restriction to one or more of the Federal Regulations…
Work with the planning team to create a modification on the IPP/IPA.
•Identify specific & individual assessed need (Add CDER Qualifier if applicable)
•Document the positive interventions & supports
•Document less intrusive methods tried but not successful
•Include clear description to the specific assessed need
•Monitoring Plan: Roles and Responsibilities
•Establish a Timeline
•Informed consent of individual & ensure this will not cause harm to individual
CORRECTIVE ACTION PLANS:
Starting 8/12/24, we will begin issuing CAPS if compliance has not been met or responses to communications have not been received.
Per the 12/1/23 DDS directive:
If a provider is found to not be in compliance with any of the federal HCBS requirements, SDRC will implement the Corrective Action Plan (CAP) processes used in California Code of Regulations, Title 17 section 56056 for residential facilities, which include the provision of vendor appeal rights.
https://www.dds.ca.gov/wp-content/uploads/2023/12/HCBS_Directive_Monitoring__Corrective_Action_12012023.pdf
PRO TIPS FOR HCBS COMPLIANCE
DEADLINE TO HCBS-FR
COMPLIANCE is
AUGUST 31, 2024!
50% of your funding will be withheld if compliance has not been met by August 31, 2024. Are you compliant with HCBS Final Rule? hcbs.frule@sdr.org
If you have not been contacted please send us an email to obtain the status of your HCBS compliance.
(include your name, vendor name and vendor #)
Questions / Comments:
Email: HCBS.FRule@sdrc.org
Website: HCBS - SDRC (sdrc-hcbs.info)
1st Wednesday of the month
2 pm to 3 pm - via Zoom
Next Power Hour:
9/4/24
10 am-11am
Via Zoom
Topic:
TBD