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​Office of Developmental Programs HCBS Final Rule

On January 16, 2014, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for Home and Community-Based Settings (HCBS). The CMS HCBS rule became effective on March 17, 2014, and applies to the settings in which ODP waiver services are provided. Per CMS guidelines, all states must be compliant with the regulations by March 2019.

The purpose of the CMS HCBS rule is to make sure individuals receive services in settings that are integrated into the community and individuals receiving services have access to community resources equal to that of those who do not receive services. Individuals receiving services should be able to:

    • Have opportunities to seek employment and work in competitive and integrated settings.
    • Engage in community life.
    • Control personal resources.
    • Obtain services in the community.

The rule also aims to make sure individuals receiving services have free choice of where they live and what provider to choose as long as the providers is willing and qualified. The CMS HCBS Rule also ensures that each individual's rights are not restricted and clarifies that services will not be allowed in settings that have the qualities of an institution.

The rule's settings requirements apply to each of ODP's 1915(c) waivers. The three waivers offered by ODP are the Adult Autism Waiver, the Consolidated Waiver, and the Person/Family Directed Support (P/FDS) Waiver. To find more information on each of these waivers, please see the following:

Waiver Specific Transition Plans
As part of the implementation of the CMS HCBS Rule, ODP is required to submit a transition plan for each waiver to CMS detailing the steps the state will take to come into compliance with the regulations. The current ODP transition plans submitted to CMS in March 2016 are available in the sidebar and are also included as appendices of the Statewide Transition Plan

2015 Home and Community-Based Settings (HCBS) Waiver Specific Transition Plans

Per CMS requirements, ODP created the following document that reflects summaries of the comments received during the public comment period of December 20, 2014, through February 2, 2015, reasons why comments were not adopted, and any modifications to the transition plans based upon those comments. Multiple comments that convey the same meaning were consolidated. This document reflects comments received for all three of ODP's waivers.

CMS requires that states undergo activities to assess whether or not their waiver providers are in compliance with the rule and to incorporate continued provider compliance into their overall monitoring activities. To begin the assessment process in Pennsylvania, the Department of Human Services (Department) surveyed all providers of waiver services administered by the Office of Developmental Programs (ODP) and the Office of Long-Term Living (OLTL) to learn how services are currently being provided. Providers were instructed to complete the survey for each enrolled site location in which services are provided. For instance, if a provider has a home office (no services provided) and four locations where services are provided, four surveys would be completed. If a provider is enrolled with both ODP and OLTL to provide services in shared settings, one survey should be used to provide information for both offices. The survey was open for the period of April 2, 2015, to April 30, 2015.