In January 2014, the Centers for Medicare & Medicaid Services published regulations to better define the settings in which states can provide Medicaid Home- and Community-Based Services. The HCBS final rule became effective March 17, 2014. The HCBS settings final rule, along with additional guidance and fact sheets, is available on the CMS Home- and Community-Based Services site.
The purpose of these regulations is to ensure that members receive Medicaid HCBS in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources and receive services in the community to the same degree as individuals who do not receive HCBS. CMS expects all states to review current HCBS programs and to develop a transition plan providing an assessment, strategies and timelines for compliance with the new rules.
The programs currently under review include 1915(c) HCBS Waivers and 1915(i) HCBS State Plan programs operated by the following divisions within the Family and Social Services Administration.
Division of Aging
Waivers
Trainings
- Community Integration Training
- For families with loved ones in Adult Day Service
- Person-centered service plans & rights modifications
- Settings Rule 101 for Administrative Professionals
- Settings Rule 101 for Direct Service Professionals
- Settings Rule and Adult Day Centers
- Settings Rule Training for Care Managers
FAQs
- Frequently asked questions about settings rule implementation
- Frequently asked questions regarding assisted living and the settings rule
Division of Disability and Rehabilitative Services
- Final approval of Indiana’s Home- and Community-Based Services Final Rule Statewide Transition Plan announcement (09/02/22)
- Non-residential HCBS final rule and remediation process for providers April 2019
- REMINDER- HCBS Non-Residential Site Assessment Remediation Tool Submission Period (12/11/2018)
- HCBS Non-Residential Site Assessment Remediation Process documents (11/13/2018)
- Web sessions – BDDS Portal, PCISP Development and HCBS Compliance (10/30/2018)
- HCBS Non-Residential Site Assessment Remediation Process Training presentation available (10/26/2018)
- Release of HCBS Non-Residential Site Assessments (10/12/2018)
- HCBS Non-Residential Site Assessment Remediation Process Training (10/01/2018)
- Community Integration and Habilitation waiver
- Family Supports Waiver
- Family Supports Waiver comprehensive transition plan
- Community Integration and Habilitation waiver comprehensive transition plan
- HCBS rule changes presentation
- Introducing the individual experience survey
- Individual experience survey (questions and answers)
- Indiana individual experience survey (definitions and instructions)
- FAQ
- Webinar Q&A
- Resources - HCBS rules
- Non-residential self assessment (September 2016)
- Non-residential self assessment validation process
- HCBS Non-residential site assessment remediation process training for providers
- HCBS non-residential site assessment remediation process training for families and stakeholders
Division of Mental Health and Addiction
Youth programs
Adult programs
- Behavioral and Primary Healthcare Coordination program
- Adult Mental Health Habilitation program
- HCBS information for AMHH and BPHC providers
- HCBS compliance and modifications provider training (November 18, 2016)
- Responses to questions from the HCBS training (November 18, 2016)
- HCBS residential setting screening tool (July 1, 2019)
- Non-POCO residential setting assessment information and instructions (Effective July 8, 2017)
- Non-POCO residential setting assessment worksheet (Effective July 8, 2017)
Heightened scrutiny evidence packets
Aging
DDRS
- DDRS residential settings that requires heightened scrutiny
- Dyer Nursing
- Spring Mill Health Campus
DMHA
Statewide Transition Plan
The Indiana Family and Social Services Administration has created a Statewide Transition Plan to assess compliance with the HCBS Settings Final Rule and identify strategies and timelines for coming into compliance with the new rule as it relates to all FSSA HCBS programs. Indiana’s initial STP was submitted to CMS for review and approval in December 2014. In September 2016, FSSA submitted a third version of the STP incorporating site-specific assessment results for Indiana’s HCBS programs. A fifth version with technical corrections was submitted to CMS, which received initial approval on November 8, 2016.
In May 2017, CMS extended the implementation date of the HCBS Settings Final Rule to March 17, 2022, to allow states additional time to come into full compliance. Indiana submitted version seven of the STP to CMS on September 29, 2017. On December 1, 2017, CMS requested technical corrections for consideration of final approval. Per a directive from the Secretary, Indiana paused efforts towards becoming compliant with the final rule to allow all divisions an opportunity to regroup to better reflect the partnerships between FSSA, other agencies and key stakeholders, including CMS, and to better understand how to meet our members’ needs. Indiana resumed efforts towards compliance on May 1, 2018, and submitted version eight of the STP to CMS for final approval in October 2018. All technical correction versions are located below.
Indiana Medicaid | Approved CMS Statewide Transition Plan
- Available upon request, click here.
Newsletters
- HCBS Statewide Transition Plan June newsletter (06/13/2018)
- HCBS Statewide Transition Plan December newsletter (12/12/2017)
- HCBS Statewide Transition Plan May newsletter (05/23/2017)
- HCBS Statewide Transition Plan December newsletter (12/09/2016)
- HCBS Statewide Transition Plan August newsletter (08/03/2016)
- HCBS Statewide Transition Plan April newsletter (04/08/2016)
- HCBS Statewide Transition Plan December newsletter (12/21/2015)
- HCBS Statewide Transition Plan September newsletter(09/11/2015)
Notices
- HCBS Final Rule Statewide Transition Plan public notice (1/31/2020)
- Public Comment period for DMHA residential settings that require heightened scrutiny (07/24/2019)
- Notice of Technical Correction to the Statewide Transition Plan nine(07/18/2019)
- HCBS Final Rule Statewide Transition Plan public notice (06/19/2019)
- HCBS Final Rule Statewide Transition Plan public notice (01/18/2017)
- HCBS Final Rule Statewide Transition Plan public notice (07/27/2016)