March 9, 2023

HCBS Settings Rule Implementation Deadline Is Here

On March 9, 2023 by Bobbie Guidry

The Home and Community-Based Services (HCBS) Settings Rule became effective on March 17, 2014, with transition activities underway since that time. Due to covid delays, the date for full compliance is March 17.

Assisted living and adult day services are categorized as home and community-based services. While the rule applies to those enrolled in Minnesota Health Care Programs to accept waiver payments for services, Minnesota incorporated several standards for all residents and clients.

A several-year process of developing Minnesota’s State Transition Plan to comply with the new standards culminated in providers attesting to how they would meet each requirement. Minnesota is only one of 18 States that has received final approval of the statewide transition plan. The Centers for Medicare and Medicaid (CMS) approved the Minnesota State Transition plan on Feb. 12, 2019.

CMS site visits

CMS completed on-site visits of several Minnesota HCBS providers in July 2022. CMS provided DHS a written summary of these visits in December 2022, including areas they felt required remediation by providers. These areas included community integration, use of locks on doors, documenting rights modifications, access to food at any time, and staff training. CMS emphasized that for services to be provided in a person-centered way, staff must be trained on each person’s individual plan.

DHS provided this summary to providers who were visited. It identified issues specific to certain sites, and those providers were required to develop remediation plans within 30 days of receiving the summary. These plans include identification and completion dates of the steps that will be taken to bring their sites into compliance. DHS provided a template, information, and technical assistance to assist providers in developing these plans. Remediation plans were submitted to DHS for feedback or technical assistance. DHS informed CMS of the plans to address these issues and is awaiting further input or guidance from CMS.

You can find more information on the visits and Minnesota’s transition plan on the Statewide Transition Plan webpage.