Division of Aging Holds Listening Session on HCBS Transition Plan

On November 10th, IHCA/INCAL staff attended the second of six listening session that have been scheduled by the Indiana Family and Social Services Administration’s Division of Aging (DA). (Click here for a copy of the listening session presentation.) The listening session included the DA’s broad overview of the CMS HCBS Final Rule and the work that the DA has done so far to help Indiana come into compliance with those CMS Rules through the FSSA’s draft HCBS transition plan. Click here for the schedule of the remaining listening sessions that all occur in the next week!  Comments to the DA on the transition plan are due December 1. 

The DA staff mainly addressed two types of waiver settings and providers at the November 10th meeting – Adult Family Care and Assisted Living waiver providers.  The DA recently published the draft statewide transition plan, which is posted at www.in.gov/fssa/4917.htm, and it addresses the issues that the DA has identified with current provider operations and the CMS rules.  The transition plan also includes other divisions of FSSA and HCBS service categories.  The transition plan also sets out timing for providers to meet the new requirements, but leaves a lot of detail out that still needs to be determined.

To develop that detail, the DA is reviewing existing state law and regulation, as well as internal policies, to determine what must be changed to conform with the CMS rule.  Part of the DA’s work has also been a survey of waiver providers.  As you know, the DA surveyed 87 existing AL waiver providers and 62 responded.  These responses were used to develop the transition plan for the AL waiver section.  The DA noted the following areas with AL providers that must be addressed in the years to come through law, rule and policy changes to ensure compliance with the CMS rule:

• Hours of visitation will need to become more resident friendly and broader
• Permitting Secured Units for Alzheimer/Dementia patients will be subject to “heightened scrutiny”
     o A provider, and the DA, must show why secured units for AL are different than secured units for skilled nursing with a focus on patient integration with others in the residential care facility and the greater community.
• 24-hour resident access to food and drink need to be defined and improved
• Putting in place enforceable leases that conform to landlord tenant laws for each resident
• Clarifying roommate choice
• Ensuring medical services are provided in private areas only
• Improving transportation to areas outside of the facility

Many of these issues will require in-depth review of current DA and ISDH regulations to ensure residents receive appropriate services and that providers are not place in a legal/regulatory catch-22.  IHCA/INCAL will continue to participate in the development of the state’s HCBS transition planning and implementation.

For additional information, contact Katie Niehoff at kniehoff@ihca.org or Zach Cattell at zcattell@ihca.org.