The Center for Medicaid and CHIP Services (CMCS) is pleased to share with State Medicaid Agencies, Operating Agencies, and other stakeholders a Home and Community Based Settings Toolkit to assist states develop Home and Community-Based 1915(c) waiver and 1915(i) SPA amendment or renewal application(s) to comply with new requirements in the recently published Home and Community Based Services' (HCBS) regulations.
The toolkit includes:
- March 2019 Updated Frequently Asked Questions on Heightened Scrutiny Provisions
- July 2019 CIB: Heightened Scrutiny Review of Newly Constructed Presumptively Institutional Settings
- All State Call Slides: FAQs on Heightened Scrutiny (PDF, 963.42 KB) - March 2019
- FAQs concerning Medicaid Beneficiaries in Home and Community-Based Settings who Exhibit Unsafe Wandering or Exit-Seeking Behavior
- A summary of the regulatory requirements (PDF, 80.25 KB) of fully compliant HCB settings and those settings that are excluded.
- Schematic drawings of the heightened scrutiny process (PDF, 60.49 KB) as a part of the regular waiver life cycle and the HCBS 1915(c) compliance flowchart (PDF, 116.19 KB) .
- Additional technical guidance on regulatory language regarding settings that isolate (PDF, 85.37 KB) .
- Exploratory questions that may assist states in the assessment of:
- Questions and Answers Regarding Home and Community-Based Settings (PDF, 141.55 KB)
- Statewide Transition Plan Toolkit (PDF, 206.69 KB) for Alignment with HCB Settings Regulation Requirements Suggestions for alternative approaches and considerations for states as they prepare and submit Statewide Transition Plans for the new federal requirements for residential and non-residential home and community-based settings. The regulatory requirements can be found at 42 CFR 441.301(c)(4)(5) and 441.710(a)(1)(2).
- Frequently Asked Questions Regarding the Heightened Scrutiny Review Process and Other Home and Community-Based Settings Information (PDF, 175.39 KB)
- Frequently Asked Questions on Planned Construction and Person-Centered Planning Requirements (PDF, 106.04 KB)