Purpose

The purpose of this Informational Bulletin is to remind providers of the need to comply with the Centers for Medicare and Medicaid Services' (CMS) published final regulations that pertain to Home and Community-Based Services (HCBS) programs, as well as provide a status of the State's activities.

Background

In January 2014, the Centers for Medicare and Medicaid Services (CMS) published final rules that require all Medicaid HCBS settings to demonstrate the characteristics of a community-based, rather than an institutional, setting. Under the federal rule, settings that do not demonstrate those characteristics cannot participate in Medicaid HCBS programs. Federal CMS requires states to assess their current HCBS settings.

Additional information regarding the federal rule and Statewide Transition Plan can be found at: https://www.illinois.gov/hfs/MedicalClients/HCBS/Transition/Pages/default.aspx

All HCBS provider agencies in Illinois were asked to complete a self-assessment of their compliance to these rules. Developmental Disabilities agencies cooperated with this request and submitted their self-assessments. Agencies that assessed sites to not be in compliance, and a sample of those agencies assessing sites to be in substantial compliance, received on-site visits by the Bureau of Accreditation, Licensure, and Certification (BALC).

Staff continues to review and address issues with the Plans of Correction from these site visits. The Division is requiring remediation for deficiencies resulting from a provider agency's on-site assessment. BALC will complete follow up on agencies' corrective action plans during regular surveys.

As this activity continues with providers that received on-site visits, we remind all providers through this notice of the need that all sites must be compliant with the federal rule. Newly licensed or certified providers must be in compliance as they first initiate services.

Process and Procedures

The On-Site Assessment Tool that was utilized during recent visits at locations around the State can be found at: https://www.illinois.gov/hfs/MedicalClients/HCBS/Transition/Documents/On-Site%20Assessment%20Tool.pdf .

The questions utilized within this document will be integrated into future compliance visits by the BALC. It is imperative that your residential and day program locations be compliant with the new federal rule and that when your regular licensure or certification visit occurs, you are able to demonstrate adherence to the new federal rule.

As the Division implements the Person-Centered Planning changes, now being tested by the Independent Service Coordination agencies, effective July 1,2017, the BALC surveys will be adjusted to reflect those changes in the instruments for the Community Integrated Living Arrangements and Developmental Training reviews as well.

The Bureau of Quality Management (BQM) also will incorporate the federal rule into their visits and offer technical assistance and support to assist providers to be in full compliance with the rules.

Effective Date

This draft is being circulated for stakeholder comment. The final Information Bulletin will be effective immediately upon posting.