3142
THE JOURNEY TO COMMUNITY HOUSING WITH SUPPORTS
CMS “FINAL RULE” AND NJ STATEWIDE TRANSITION PLAN What does the CMS “Final Rule” say about integration? In January 2014, the Centers for Medicaid and Medicare Services (CMS) issued guidance to the states that administer Home and Community-Based Services (HCBS) Waivers. Funded community-based services must also be provided in the most integrated settings appropriate to the needs of the person. Settings that tend to isolate people from the broader community may not be eligible for federal funding, if they violate the ADA mandates. For more information, visit www. medicaid.gov/Medicaid-CHIP-Program-Information/ By-Topics/Long-Term-Services-and-Supports/Home-and- Community-Based-Services/Downloads/Settings-that- isolate.pdf . The following are excluded settings for Medicaid Home and Community Based Services. s .URSING HOMES NJ Statewide Transition Plan (STP)
access to the community as people not receiving Medicaid HCBS. The setting must promote individual initiative, autonomy, and independence in making life choices.” For more information visit www.state.nj.us/humanservices/ dmahs/info/hcbs_trans.html . All individuals receiving HCBS waiver services must have full access to the benefits of community living like others without disabilities and have the opportunity for choice, privacy, community integration, landlord tenant protections and the ability to select supportive services based on individual needs. What are some of the implications of the STP for housing? DDD has made a tangible commitment to diversify housing options for individuals with developmental disabilities and expand community-based options. The STP submitted - but not yet approved - includes a “Community Integration Review” process to gather relevant information for all new settings. The STP limits the number of individuals with disabilities who can live together and discourages certain settings. s #OMMUNITY RESIDENCES FOR INDIVIDUALS WITH INTELLECTUAL and/or developmental disabilities will typically have a level of service of no more than four. However, this can be expanded to more than four for programmatic reasons with prior approval by DDD. s %ACH INDIVIDUAL SERVED IN ANY SETTING REGARDLESS OF SIZE shall be integrated into the community to the maximum level possible, based on their individual abilities, preferences and needs. s -ULTIPLE PROGRAMS CANNOT BE CO LOCATED A WAIVER OF this prohibition may be granted based on clinical need). s 'ATED OR SECURE COMMUNITIES AS WELL AS RESIDENTIAL schools are discouraged from consideration as home and community based and must be subject to a
s )NTERMEDIATE #ARE &ACILITIES )#& s )NSTITUTES FOR -ENTAL $ISEASES )-$
s (OSPITALS
According to CMS, large long-term care settings such as gated or secure communities, farmsteads, disability specific or intentional communities or residential schools might not be eligible for Medicaid funding. Even smaller group homes are subject to a higher level of scrutiny to demonstrate that people have autonomy as well as integration within these settings. The residents served in specialized housing must have opportunities to access the benefits of community living while living in the most integrated settings. Day habilitation programs must meet these requirements, as well. States must implement a transition plan indicating how such programs within the state will become compliant with these regulations.
heightened scrutiny process to secure CMS approval for individuals using HCBS funds.
Go to www.HCBSAdvocacy.org for state-specific information about this transition planning process.
All settings, existing and new, must comply with the HCBS Final Rule. The site-specific assessments to be conducted by DDD will determine whether each existing setting complies with the State’s Transition Plan. For existing sites, the size of the site, in and of itself, will not be the sole determinant of compliance with the regulations.
NJ Statewide Transition Plan (STP) New Jersey’s plan declares that, “HCBS settings must provide opportunities for individuals to: seek employment and work in a competitive and integrated environment; engage in community life and control personal resources with the same
Made with FlippingBook - Online magazine maker