HCBS Settings Rule Transition Planning
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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.
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.
Public comments will be accepted through February 3rd, 2023.
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.
To apply to a Corrective Action Plan click on the “Provider Settings Compliance Activities” tab below. Applications will be accepted through December 30, 2022.
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.
New Provider Requirements
All new home and community-based settings must be in compliance with the Settings Rule when they start providing services.
- Attestation Form
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:
- NCW Specific
- DSPD Waiver Specific
- 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)
- 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
- 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
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 settings were previously identified as presumptively institutional, but subsequently demonstrated compliance with the settings criteria or submitted a plan to come into compliance with the settings criteria after the July 1, 2021 deadline.
- Alta Ridge Memory Care Site (175) Evidentiary Package
- Apple Village Assisted Living Site (178) Evidentiary Package
- Beehive Homes of West Jordan Site (23) Evidentiary Package
- Central Utah Enterprises (CUE) Site (393) Evidentiary Package
- Columbus Foundation, Inc Site (1286) Evidentiary Package
- Columbus Foundation, Inc Site (753) Evidentiary Package
- Community Treatment Alternatives (CTA) Site (242) Evidentiary Package
- Community Treatment Alternatives (CTA) Site (244) Evidentiary Package
- Community Treatment Alternatives (CTA) Site (252) Evidentiary Package
- Daybreak Training Services Site (276) Evidentiary Package
- Foundations For Independence Site (1816) Evidentiary Package
- Front Line Services, Inc. Site (744) Evidentiary Package
- Legacy House of Ogden Site (113) Evidentiary Package
- R.I.T.E.S., Inc. Site (1143) Evidentiary Package
- RISE, Inc Site (2251) Evidentiary Package
- RISE, Inc Site (1174) Evidentiary Package
- RISE, Inc Site (1169) Evidentiary Package
- Training in Life Choices, L.L.C. Site (1534) Evidentiary Package
- Transitions, Inc. Site (1545) Evidentiary Package
- TrueWood by Merrill Taylorsville Site (97) Evidentiary Package
- St Joseph Villa Site (152) Evidentiary Package
Additional information on Heightened Scrutiny can be found here:
The State will discuss settings that were previously identified as presumptively institutional, but subsequently demonstrated compliance or have submitted a plan to come into compliance with the settings criteria. The virtual meeting has been scheduled for: January 19rd, 2023, 1:00 – 1:30pm.
- Join via Google Meet: https://meet.google.com/byz-uudm-mtd
- Join via a call-in line: (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:
- Via fax: 801-536-0153
- Via Email: HCBSSettings@utah.gov
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?
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.
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.
- New Settings
- Settings located in, on the grounds of, or immediately adjacent to a public institution
- Public Comment
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
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