OLTL Waiver Amendment, Renewals and Accompanying HCBS Transition Plans

The Office of Long-Term Living (OLTL) administers five 1915(c) Waivers; the Aging Waiver, the Attendant Care Waiver, the CommCare Waiver, the Independence Waiver, and the OBRA waiver. This page houses all of the documents submitted to the Centers for Medicare and Medicaid Services (CMS) regarding the HCBS Final Rule.

2016 Amendments 

All documents related to the 2016 Aging, Independence, OBRA and Attendant Care Waiver Amendments are located in Related Topics.

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2014 HCBS Final Rule

CMS published the HCBS final rule amending regulations contained in 42 CFR 441.301 on January 16, 2014. The rule supports enhanced quality in the HCBS programs and adds protections for individuals receiving services. In addition, this rule reflects CMS’ intent to ensure that individuals receiving services and supports through Medicaid’s HCBS programs have full access to the benefits of community living and are able to receive services in the most integrated setting. For more information on the Final Rule, go to: http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html

OLTL Transition Plans

Transition plans are documents in which states and waivers determine their compliance with the regulatory requirements for home and community‚Äźbased settings and describe to CMS how they will comply with the new requirements. The HCBS final rule requires that a transition plan be submitted with each waiver amendment and that public comment be obtained on the transition plans. OLTL originally released draft transition plans for the Aging, AIDS, Attendant Care, and Independence waivers for public comment on November 26, 2015. Those transition plans have been approved by CMS and can be found below.

Approved by CMS

Aging Waiver Transition Plan and Settings Analysis Chart

Attendant Care Transition Plan and Settings Anaylsis Chart

Independence Transition Plan and Settings Analysis Chart

CommCare Transition Plan and Settings Analysis Chart

OBRA Transition Plan and Settings Analysis Chart

Per CMS requirements, OLTL created the following document that reflects summaries of the comments received during the public comment period of November 26, 2015 through December 29, 2015, reasons why comments were not adopted, and any modifications to the transition plan based upon those comments. Multiple comments that convey the same meaning were consolidated. The Plan Comments document reflects comments received for the Aging, Attendant Care, AIDS, and Independence waiver transition plans.

Assessment Activities 

CMS Approval Pending

OBRA Transition Plan March 2016

OLTL created the following document that reflects summaries of the comments received during the public comment period of December 20, 2015 through February 3, 2015, reasons why comments were not adopted, and any modifications to the transition plan based upon those comments. Multiple comments that convey the same meaning were consolidated. The Plan Comments document reflects comments received for the CommCare and OBRA waiver transition plans.

Plan Comments 

OLTL Education and Outreach

OLTL will post Transition Plan education and outreach events as they are developed:

OLTL Transition Plan Stakeholders

OLTL is committed to stakeholder involvement in the development of its Transition Plans, as well as in the assessment of provider settings and the remediation processes. A representative list of waiver participants, providers and advocates can be found here.

May 7th Stakeholder meeting:

OLTL held a Stakeholder Meeting on May 7, 2015 to discuss CMS’ Final Rule related to Home and Community Based settings. There were 35 attendees representing various associations, participants, advocates, providers, and Department of Human Services’ staff. The meeting was facilitated by Dering Consulting Group.

OLTL CMS Final Rule Stakeholder Meeting-Final Report

Provider Survey Power point

OLTL CMS Final Rule Stakeholder Meeting Power point

May 7th Stakeholder Meeting Agenda

May 7th Stakeholder Meeting 

OLTL Tools

CMS requires that states undergo activities to assess whether or not their waiver providers are in compliance with the new rule and to incorporate continued provider compliance into their overall monitoring activities. To begin the assessment process in Pennsylvania, the Department of Human Services’ Office of Developmental Programs (ODP) and Office of Long-Term Living (OLTL) developed a web-based survey to be completed by all ODP and OLTL providers. For OLTL, this includes providers supporting individuals within the Aging, AIDS, Attendant Care, COMMCARE, Independence, and OBRA Waivers. The intent of the survey is to assist the Department to get an overall understanding of the settings in which waiver services are being provided and help to determine the specifics of future assessment activities and inform policy development.

Provider Survey Tool

Provider Survey Outcome Data

Transition Plans

OLTL will also be submitting waiver-specific Transition Plans for the CommCare and OBRA waivers in accordance with guidance from the Centers for Medicaid and Medicare Services (CMS) relating to the provisions of the final Home and Community-Based Services regulations. Information on the federal rule can be found at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html.

Public Input

The public notice announcing waiver amendments to the Aging, Attendant Care, and OBRA waivers, the CommCare and Independence waiver renewals and Transition Plans for CommCare and OBRA can be viewed in the December 20, 2014 issue of the Pennsylvania Bulletin.

OLTL is seeking public comment on all of these documents. Interested persons are invited to submit written comments regarding the amendments, renewals, and Transition Plans announced in the December 20, 2014 public notice to the Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Jennifer Hale, P.O. Box 8025, Harrisburg, PA 17105-8025.  Comments can also be sent to RA-waiverstandard@pa.gov. The public comment period ends on February 3, 2014. Comments received within the 45-day comment period will be reviewed and considered for revisions to the amendments, renewals and the Transition Plans.

The Office of Long-Term Living will offer two webinars in January for public input and discussion.  The webinar’s will be held on Webinars January 6 and January 8, 2015

Webinar information for January 6th
Webinar information for January 8th

Webinar PowerPoint Presentation