HCBS Settings Rule Transition Planning

This 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

HCBS Settings Rule training on the revised NCW and AW PCCP addendum.

NCW and AW
1. PCCP Training
Flyers and Brochures
1. General Stakeholder Information:
2. Residential Stakeholder Information:
  1. General
  2. NCW Specific
    1. Policy and the Use of Cameras in the New Choice Waiver Residential HCBS Settings (flyer)
    2. NCW Licensing and Settings
  3. DSPD Waiver Specific
    1. DSPD Licensing and Settings
    2. Rights Restrictions for Providers
    3. Rights Restrictions for Individuals Served

State Transition Plan (STP) and Related Documents

Systemic Assessment

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.

The following new settings were previously identified as presumptively institutional, but subsequently demonstrated compliance with the settings criteria:

Click on each setting to review how the State determined their setting compliance.

Day Support Services
1. Adult Autism Center of Lifetime
2. Bear O Care

Additional information on Heightened Scrutiny can be found here:

HCBS Settings Compliance Flow Chart

A Public Meeting has been scheduled to discuss these settings:

October 25, 2023 from 10:00-10:30 am.

Google Meet joining info:

Video call link: https://meet.google.com/byz-uudm-mtd
Or dial: ‪(US) +1 317-947-5120 PIN: ‪754 212 162#

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:

Fax: 801-536-0153
Email: HCBSSettings@utah.gov
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.

HCBS Settings Compliance Flow Chart

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 July 26, 2023 to August 2, 2023

Public Comment Period January 2, 2023 to February 3, 2023

Public Comment Period December 12, 2022 to January 13, 2023

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

Public Comment Period March 5, 2021 to April 6, 2021

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:

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.

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.

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:

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.

Provider Remediation Plan Template

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

HCBS Settings Rule Transition Planning

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