HCBS Settings Rule Transition Planning
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Utah Waivers Home Acquired Brain Injury Waiver Aging Waiver Community Supports Waiver Community Transitions Home ICF Transition Program Medicaid Autism Waiver Medically Complex Children’s Waiver New Choices Waiver Physical Disabilities Waiver Technology Dependent Waiver EPAS Program HCBS Transition Planning (Settings Rule) Health Transportation PaymentThis website will provide access to the latest updates on the HCBS Transition Plan for the State of Utah as well as provide a means to sign-up for list-servs, and provide feedback on the Transition Plan, and its associated tools and publications.
Submitting Feedback
Feedback, general questions, a request for technical assistance, or any other inquiries can be submitted at HCBSSettings@utah.gov. In addition, the following link may be used to supply information on specific settings believed to have issue demonstrating compliance with the HCBS Settings Rule.
To submit Public Comments on the settings out for public comment click on the “Submit Comments” tab below.
Finding Documents
All documents are posted under the Documents and Handouts Tab. This includes the current and other iterations of the Transition Plan, as well as periodic reports, tool-kits, and other resources.
Provider Compliance Activities
All provider and setting compliance activity documents are posted under the Provider Settings Compliance Activities Tab. This includes previously submitted heightened scrutiny packages, validation visit tools, and other previously used tools.
Signing-Up for Email Updates
In order to receive email updates regarding the Transition Plan and its associated tools and publications, please sign-up for our newsletter.
Relevant Documents
New Provider Requirements
All new home and community-based settings must be in compliance with the Settings Rule when they start providing services.
- Training
- DSPD Providers
- NCW Providers
- AW Providers
- DSPD Providers
- Attestation Form
- Self-Assessment
Training
HCBS Settings Rule training on the revised NCW and AW PCCP addendum.
- NCW and AW
- Flyers and Brochures
- General Stakeholder Information:
- Settings Rule for Home and Community Based Services for Individuals, Families, and Caregivers (brochure)
- Settings Rule for Home and Community Based Services for Providers (brochure)
- HCBS Stakeholder Update May 2019 (flyer)
- Heightened Scrutiny
- Stakeholder Update July 2020
- Isolating and Institutional Factors
- Restrictions and Modifications (flyer)
- Restrictions and Modifications Examples
- Settings Rule Progress During COVID-19
- Opportunity for Employment
- Stakeholder Update Settings Compliance Timelines 2022
- Using Virtual Integration Activities to Work Towards Settings Compliance
- Virtual Integration Activities Community Resources
- HCBS Settings Rule Clarification: Desired Level of Integration
- Community Inclusion and Integration Flyer
- Community Inclusion and Integration Examples
- Residential Stakeholder Information:
- General
- NCW Specific
- DSPD Waiver Specific
- General
- General Stakeholder Information:
State Transition Plan (STP) and Related Documents
- Final Approved Transition Plan and Related Documents
- Submitted Transition Plan and Public Comments
- Draft Transition Plans
- Draft Corrective Action Plans (CAPs)
Systemic Assessment
- Settings Crosswalk/Systemic Assessment
- Documents to Accompany Systemic Assessment
- Currently Approved Acquired Brain Injury Waiver Implementation Plan
- Currently Approved Aging Waiver Implementation Plan
- Currently Approved Community Supports Waiver Implementation Plan
- Currently Approved Medicaid Autism Waiver Implementation Plan
- Currently Approved Medically Complex Children’s Waiver Implementation Plan
- Currently Approved New Choices Waiver Implementation Plan
- Currently Approved Physical Disabilities Waiver Implementation Plan
- Currently Approved Technology Dependent Waiver Implementation Plan
- DSPD Contract Requirements
Stakeholder Meetings
- Workgroup Meetings
- Documents for Workgroup Meeting on April 3, 2018 (Non-residential Integration)
- Documents for Workgroup Meeting on April 10, 2018 (Modifications and Restrictions)
- Documents for Workgroup Meeting on on April 17, 2018 (Residential Integration)
- Documents for Workgroup Meeting on May 1, 2018 (Heightened Scrutiny)
- Focus Group Meetings
- Documents for Focus Group Meeting on June 5, 2018 (Adult Day Care Settings)
- Documents for Focus Group Meeting on June 19, 2018 (NCW, Residential Settings)
- Documents for Focus Group Meeting on June 26, 2018 (DSPD, Day Program Settings)
- Documents for Focus Group Meeting on July 3, 2018 (Employment, Non Residential settings)
- Documents for Focus Group Meeting on July 10, 2018 (DSPD, Residential Settings)
- Documents for Focus Group Meeting on August 28, 2018 (Person Centered Care Plan)
- Documents for Focus Group Meeting on September 11, 2018 (Modifications and Restrictions)
- Other Stakeholder Meetings
Settings Reports
External Resources
On March 17, 2014, new federal Medicaid rules for Home and Community Based Services (HCBS) went into effect. The rules impact many parts of HCBS. One of the most important topics is the places where HCBS can be provided.
Because HCBS programs are offered as alternatives to nursing and intermediate care facility services, the new rules make sure that HCBS are provided in settings that are not institutional in nature. To follow this rule, states must make sure that HCBS settings are part of a larger community, people are able to have choices about their service settings, and that people are assured their rights to privacy, dignity and respect.
States must evaluate their HCBS programs to determine the level of compliance with the new rules.
How to Provide Comments
Once distributed, Utah will accept public comments and recommendations about the draft for a minimum 30-day period. In addition to submitting comments via the form below, public comments will be accepted through the following methods:
- Via fax: 801-536-0153
- Via Email: HCBSSettings@utah.gov
Via mail:
Utah Department of Health and Human Services
Division of Integrated Healthcare
Attn: HCBS Settings Rule Public Comments
PO BOX 143112
Salt Lake City, UT 84114-3112
What’s Happening Now?
Heightened Scrutiny
Here is a flowchart to explain the pathway to compliance and what leads a setting to go through the heightened scrutiny process.
The following tools are and will be used in the heightened scrutiny process:
The following settings have gone through the public comment process and have been submitted to CMS for review.
Public Comment Period October 24, 2022 to November 28, 2022
The following settings were previously identified as presumptively institutional, but subsequently demonstrated compliance with the settings criteria by July 1, 2021
- Ability and Choice Services, Inc. Site 341
- Ability and Choice Services, Inc. Site 342
- CHRYSALIS UTAH, INC. Site 395
- CHRYSALIS UTAH, INC. Site 399
- CHRYSALIS UTAH, INC. Site 402
- CHRYSALIS UTAH, INC. Site 816
- DANVILLE SERVICES OF UTAH, LLC Site 1394
- DANVILLE SERVICES OF UTAH, LLC Site 1402
- DANVILLE SERVICES OF UTAH, LLC Site 1405
- Friends 4 Life Found Site 2336
- PHEASANT HOLLOW VALLEY MNTL Site 139
- STEPS, inc. Site 1679
- Stride Services Site 1818
- Truewood By Merrill Site 70
Public Comment Period March 5, 2021 to April 6, 2021
- New Settings
- Settings located in, on the grounds of, or immediately adjacent to a public institution
- Public Comment
Validation Visits
Validation visits are conducted for settings that had previously been identified as having segregating or institutional characteristics once they have completed their remediation or transformation plans and they have submitted their evidence for compliance for review. Due to the COVID-19 pandemic, the majority of these reviews have been conducted remotely. Setting tours, observation of daily observations, HCBS Waiver recipient interviews, staff interviews, leadership interviews, and document/record reviews took place as part of the validation process. The following tools were utilized in the validation process:
- Pre-Validation Visit Communication
- HCBS Settings Staff HS Validation Interview Tool
- HCBS Settings Leadership HS Validation Interview Tool
- HCBS Settings Individual Served HS Validation Interview Tool
- Validation Visit Review Provider Summary Report
Previous Compliance Activities
Corrective Action Plans (CAPs)
Applications were accepted through December 30, 2022.
Read through the both the Utah HCBS Settings Rule CAP below and the HCBS Settings Rule CAP Application instructions thoroughly prior to committing to completing the application. The application does not have an option to save and return, it must be completed all at one time.
Provider Self-Assessments
During the week of April 25th, 2016 providers were mailed letters outlining all of the settings that they will need to complete a self-assessment for. The State identified Residential and Non-Residential sites that were known. Providers will be expected to complete the appropriate survey for any setting they manage and to provide information about locations that they no longer have.
- Copy of the Letter Mailed to all Waiver Providers with Settings Identified for Review
- Provider Self-Assessment Survey – Residential (PDF)
- Provider Self-Assessment Survey – Residential (Excel)
- Provider Self-Assessment Survey – Non-Residential (PDF)
- Provider Self-Assessment Survey – Non-Residential (Excel)
- Self-Assessment Instructions
- Settings Transition Presentation Slides (From Stakeholder Meetings)
- Sample Self Assessment
Provider Remediation Plans
During the months of January and February of 2018, providers were emailed their self-assessment results and all the settings they will need to complete a remediation plan for. Remediation plan templates were generated for each setting specifying which self-assessment indicators required additional information or a corrective action plan to demonstrate compliance.
- SE Provider Letter HCBS Settings Self-Assessment Report
- Document 1 (Instructions) State Self-Assessment Report and Remediation Plan Non Residential
- Document 1 (Instructions) State Self-Assessment Report and Remediation Plan Residential
- Settings Transition and Remediation Plan Presentation 2.12.18.pptx
In-Depth Addition Review Site Visits
An in-depth additional review site visit was or will be conducted for settings that the State was unable to categorize based only on the self-assessment and validation review process. The majority of these reviews occurred during the months of August to October of 2019. This will continue to be an ongoing process if additional settings are identified as requiring further review. Setting tours, observation of daily operations, HCBS Waiver recipient interviews, staff interviews, leadership interviews, and document/record reviews took place as part of the additional review process. The following tools were utilized in the review process:
- Non-residential Additional Review Assessment Tool
- Residential Additional Review Assessment Tool
- Non-residential Additional Review for Individuals Receiving Services Interview Tool
- Residential Additional Review for Individuals Receiving Services Interview Tool
- Additional Review Leadership Interview Tool
- Additional Review Staff Interview Tool
For settings that had identified areas of non-compliance, a remediation plan is required. The following remediation plan template is not required; providers can choose to use their own format as long as the plan includes the minimum requirements.
Completion of the remediation plan is mandatory and must be completed and returned to the State within 30 days of notification. For technical assistance or further information email: HCBSSettings@utah.gov