CMS Issues Guidance Concerning Home and Community Based Services Settings

 CMS issued new guidance Monday in the form of a “Home and Community Based Settings Toolkit” to assist states with the process states they follow for developing their 1915 (c) and 1915 (i) waiver plan amendments and renewal applications.  The toolkit is designed to help states determine which settings will be considered home- and community-based settings (HCBS).   The components of the five-piece tool kit can be found at the bottom of the home page at  www.medicaid.gov/hcbs. 
Also, a PDF of the toolkit may be accessed by clicking here.

The agency further describes the qualities HCBS settings and the options that must be provided by states to Medicaid beneficiaries.  Specifically, CMS spells out those settings that are presumed to have the qualities of an institution and will fall under “heightened scrutiny” for both waiver programs.  The guidance includes decision trees for states to follow in making heightened scrutiny determinations for the transition plan process and the standard waiver process.