Wednesday, May 18, 2016

Michigan updates on implementation of the Home and Community-Based Services rule

Under the federal 2014 Home and Community-Based Services [or Settings] rule, states must submit transition plans to the federal Centers for Medicare and Medicaid Services (CMS) describing how they will implement federal policies on community integration. Part of that process is to determine whether settings using HCBS funding are in compliance with the federal rule. Michigan will use surveys to make this determination.

Home and Community-Based Services are often referred to as Medicaid Waiver services, because they allow the state to waive some Medicaid requirements in order to use funding in non-traditional ways to serve different populations of people with disabilities.

For people with disabilities who live in their own or their family’s home and receive residential supports funded by HCBS, their residences are presumed to be in compliance with the rule and they will not be part of the residential survey. For people not living in their own or their family’s home, the state will survey every provider of HCBS services and the people who receive HCBS services to evaluate whether the setting complies with the rule.

Michigan’s Habilitation Supports Waiver (HSW) is a Medicaid Waiver that provides services to people with developmental disabilities. The state has other Medicaid Waivers for different categories of the disabled population and people using these waivers will also be surveyed. HSW surveys will be conducted by the Developmental Disabilities Institute (DDI) at Wayne State University in Detroit.

The surveys for providers and participants in the HSW are available for review on-line, but the actual surveys will be conducted by the DDI after notifying providers who will then notify HCBS participants of when the survey will take place. DDI will cover 50% of providers and participants before October 1st, 2016 and 50% after October 1st, 2016.

If you are a guardian or family member of a person who receives HCBS and the person will need your assistance in answering survey questions, the best course of action is to tell the providers of services that you want to be informed of when the survey will be conducted and that you want to participate. If you have a family member with cognitive disabilities, it would also be a good idea to review the survey questions. I found that for my sons many of the questions were not aimed at people with such severe disabilities and that certain answers could be misconstrued as indicating that their services do not comply with the federal rule. Exceptions can be made to parts of the rule for health and safety reasons, but these must be included in the person’s Individual Plan of Services (ISP). Keep that in mind for your next Person-Centered Planning meeting.

For more information on the survey process:

Frequently Asked Questions

Surveys of providers and HSW beneficiaries with general information from DDI including surveys in Word document format

Participant surveys

Residential provider Survey

Non-residential provider survey Non-residential services include HCBS-funded programs such as employment, skill-building, prevocational, and day programs. 


Michigan’s revised State Transition Plan for HCBS

Michigan revised its State Transition Plan for HCBS for public comment in December 2015. The state then revised the plan further and responded to comments. The Revised STP was sent to CMS on March 15, 2016 for approval.

The first part of this document includes comments on the plan with responses from the Michigan Department of Health and Human Services. The rest of the document is the latest revision to the STP.

Here is more Information on the federal HCBS Rule and State Transition Plans.

This is the Michigan Website on HCBS Transition.

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