OLTL Waiver Amendments, Renewals and Accompanying HCBS Transition Plans
The Office of Long-Term Living (OLTL) administers two 1915(c) Waivers: the Community HealthChoices (CHC) Waiver and the OBRA Waiver.
OLTL previously managed four other waivers: the CommCare Waiver which closed on December 31, 2017, and the Aging Waiver, the Attendant Care Waiver, and the Independence Waiver until they closed on December 31, 2019. When these waivers closed, all participants were transferred to the CHC waiver.
This page also houses all of the documents submitted to the Centers for Medicare and Medicaid Services (CMS) regarding the HCBS Final Rule.
All documents related to the 2023 CHC and OBRA Waiver Amendments are located in Additional Resources.
2014 HCBS Final Rule
CMS published the HCBS final rule amending regulations contained in 42 CFR 441.301 on January 16, 2014. The rule supports enhanced quality in the HCBS programs and adds protections for individuals receiving services. In addition, this rule reflects CMS' intent to ensure that individuals receiving services and supports through Medicaid's HCBS programs have full access to the benefits of community living and are able to receive services in the most integrated setting. For more information on the Final Rule, go to: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html
OLTL Transition Plans
Transition plans are documents in which states and waivers determine their compliance with the regulatory requirements for home and community‐based settings and describe to CMS how they will comply with the new requirements. The HCBS final rule requires that a transition plan be submitted with each waiver amendment and that public comment be obtained on the transition plans. OLTL originally released draft transition plans for the Aging, AIDS, Attendant Care, and Independence waivers for public comment on November 26, 2015. Those transition plans have been approved by CMS and can be found below.
Approved by CMS
Per CMS requirements, OLTL created the following document that reflects summaries of the comments received during the public comment period of November 26, 2015, through December 29, 2015, reasons why comments were not adopted, and any modifications to the transition plan based upon those comments. Multiple comments that convey the same meaning were consolidated. The Plan Comments document reflects comments received for the Aging, Attendant Care, AIDS, and Independence waiver transition plans.
CMS Approval Pending
OLTL created the following document that reflects summaries of the comments received during the public comment period of December 20, 2015, through February 3, 2015, reasons why comments were not adopted, and any modifications to the transition plan based upon those comments. Multiple comments that convey the same meaning were consolidated. The Plan Comments document reflects comments received for the CommCare and OBRA waiver transition plans.
OLTL Education and Outreach
OLTL will post Transition Plan education and outreach events as they are developed:
OLTL Transition Plan Stakeholders
OLTL is committed to stakeholder involvement in the development of its Transition Plans, as well as in the assessment of provider settings and the remediation processes. A representative list of waiver participants, providers and advocates can be found here.
May 7th Stakeholder meeting:
OLTL held a Stakeholder Meeting on May 7, 2015, to discuss CMS' Final Rule related to Home and Community Based settings. There were 35 attendees representing various associations, participants, advocates, providers, and Department of Human Services' staff. The meeting was facilitated by Dering Consulting Group.
CMS requires that states undergo activities to assess whether or not their waiver providers are in compliance with the new rule and to incorporate continued provider compliance into their overall monitoring activities. To begin the assessment process in Pennsylvania, the Department of Human Services' Office of Developmental Programs (ODP) and Office of Long-Term Living (OLTL) developed a web-based survey to be completed by all ODP and OLTL providers. For OLTL, this includes providers supporting individuals within the Aging, AIDS, Attendant Care, COMMCARE, Independence, and OBRA Waivers. The intent of the survey is to assist the Department to get an overall understanding of the settings in which waiver services are being provided and help to determine the specifics of future assessment activities and inform policy development.
OLTL will also be submitting waiver-specific Transition Plans for the CommCare and OBRA waivers in accordance with guidance from the Centers for Medicaid and Medicare Services (CMS) relating to the provisions of the final Home and Community-Based Services regulations. Information on the federal rule can be found at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html.
The public notice announcing waiver amendments to the Aging, Attendant Care, and OBRA waivers, the CommCare and Independence waiver renewals and Transition Plans for CommCare and OBRA can be viewed in the December 20, 2014issue of the Pennsylvania Bulletin.
OLTL is seeking public comment on all of these documents. Interested persons are invited to submit written comments regarding the amendments, renewals, and Transition Plans announced in the December 20, 2014 public notice to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Jennifer Hale, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent to RAfirstname.lastname@example.org. The public comment period ends on February 3, 2014. Comments received within the 45-day comment period will be reviewed and considered for revisions to the amendments, renewals and the Transition Plans.
The Office of Long-Term Living will offer two webinars in January for public input and discussion. The webinar's will be held on Webinars January 6 and January 8, 2015