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The federal Centers for Medicare & Medicaid Services (CMS) issued a final rule effective March 2014 to ensure that the provision of Home and Community Based Services (HCBS) occurs in settings that meet certain criteria. The rule ensures that HCBS participants have access to the benefits of community living and that services are true alternatives to those provided in an institutional setting and are delivered in the most integrated setting possible.
The rule went into effect in March 2014, and states originally had five years - until March 2019 - to ensure that their HCBS settings are compliant with the rule. In May 2017, CMS issued an Informational Bulletin extending the transition period for compliance with the Settings Final Rule by three years, to March 17, 2022. In light of this bulletin, the Colorado Department of Health Care Policy and Financing (HCPF or 'the Department') has adjusted the statewide compliance deadline below by one year, from March 2019 to March 2020.
The following documents and information relate to Colorado's implementation of the Final Settings Rule.
Colorado Statewide Transition Plan (STP.4)
The Department has developed a Statewide Transition Plan (STP) for bringing Colorado’s home-and-community-based services into compliance with the Final Settings Rule. The STP outlines the Department’s process and timelines for working with interested parties to implement requirements of the rule for all home-and-community-based services.
Current version of the STP is STP.4 - December 2016
Prior versions of the Statewide Transition Plan:
Waiver-specific transition plans are included in Colorado's affected HCBS waivers.
In August - September 2014, the Department released for public notice waiver-specific transition plans under the HCBS Final Settings Rule. The publicly noticed documents from that time period are available below.
Federal rule requires States to submit individual, waiver-specific transition plans to meet new Federal criteria for all relevant HCBS programs under 1915(c), 1915(k), and 1915(i) when the state amends that waiver. These transition plans will outline how the final rule will be implemented over the next 5 years for individuals waivers and will provide assessment, strategies, and timelines for meeting the requirements of the new rules.
The Department of Health Care Policy and Financing will be submitting amendments for six out of the seven Long Term Services and Supports waivers to the Centers for Medicare and Medicaid Services (CMS) on September 30, 2014.
Under the STP, the Department has conducted a comprehensive review of the kinds of settings in which home-and-community-based services are provided in Colorado and the state statutes, regulations, and waivers that govern the provision of home-and-community-based services in these settings. The results of this systemic review and the Department’s plan for proposing changes to relevant authorities are set forth in a crosswalk.
Current version of Crosswalk - December 2016
Prior versions of the Crosswalk:
The Department is conducting a voluntary survey for individuals receiving home-and-community-based services, as well as their family members and advocates, to provide input on the settings where they live and/or receive such services. The Department will keep the IFA Survey open for individuals and their families/advocates to take as often as they like, through at least the end of the transition period.
Participate in IFA Survey - Updated August 2017
Online Survey - For individuals, family, friends, and advocates
Complete and submit using your
computer or electronic device
Paper Survey for IndividualsPaper Survey for Family and FriendsPaper Survey for Advocates
Complete and submit using paper and US Mail - see instructions below for sending
Completar y enviar utilizando su computadora
o dispositivo electrónico
Paper Survey for Individuals - (encuesta para personas que reciben servicios)Paper Survey for Family and Friends - (encuesta para familiares y amigos de personas que reciben servicios)Paper Survey for Advocates - (encuesta para abogados que representan a personas que reciben servicios)
Complete y envíe utilizando papel y correo de los Estados Unidos - vea las instrucciones a continuación para enviar
Заполните и отправьте с помощью своего компьютера или электронного устройства
Paper Survey for Individuals - (Опрос для представителей лиц, получающих услуги по программе Medicaid)Paper Survey for Family and Friends - (Опрос для представителей лиц, получающих услsуги по программе Medicaid)Paper Survey for Advocates - (Опрос для представителей лиц, получающих услуги по программе Medicaid)
Заполните и отправьте с помощью бумаги и почты США - см. Инструкции ниже для отправки
To request a hard copy of the survey be mailed to you, and/or to submit a completed hard-copy survey, contact:
Email: Lori.Thompson@state.co.us or Sarah.Hoerle@state.co.usMail/In Person: 1570 Grant Street, Denver, CO 80203, Attention: Statewide Transition Plan TeamFax: 303-866-3991, Attention: Statewide Transition Plan TeamPhone: Lori Thompson, 303-866-5142 or Sarah Hoerle, 303-866-6113
Results of IFA Survey - August 2017 - analysis of results from first two years of the survey
During each public comment period, the Department receives valuable feedback from stakeholders.
The Department has received relevant questions and comments and/or expects to receive relevant questions and comments at the following meetings:
Meetings regarding the work of the Division for Intellectual and Developmental Disabilities (DIDD):
Meetings regarding the work of the Long-Term Services and Supports Division (LTSS):
Meetings of the HCBS Settings Residential and Non-Residential Stakeholder Workgroups - These workgroups met from November 2015 through March 2016. They discussed concerns, best practices, and other issues for implementing the Final Settings Rule. The workgroups focused on expanding community integration opportunities, informed choice and, participant rights.
Colorado Statewide Transition Plan Initial Approval from CMS - November 2017
Colorado Milestone Template - October 2017
Statewide Transition Plan Quarterly Update to CMS - Quarter ending December 31, 2017
Statewide Transition Plan Quarterly Update to CMS - Quarter ending September 30, 2017
Statewide Transition Plan Quarterly Update to CMS - Quarter ending June 30, 2017
Statewide Transition Plan Quarterly Update to CMS - Quarter ending March 31, 2017
CMS’s response to STP.4, the revised crosswalk, and related materials - February 9, 2017
Statewide Transition Plan Quarterly Update to CMS - Quarter ending December 31, 2016
Department's submission of STP.4, revised crosswalk, and related materials to CMS - December 16, 2016
Quarterly Update to CMS - Quarter ending September 30, 2016
CMS's response to STP.3, crosswalk, and related materials - August 30, 2016
Department's submission of STP.3, initial crosswalk, and related materials to CMS - June 30, 2016
For earlier correspondence, please contact the Department.
The PTP is completed by the provider to assess its compliance with the HCBS Settings Rule, assess the potential application of heightened scrutiny, and set out a remedial action plan and timeline. When submitting its PTP, the provider attaches relevant evidence (e.g., leases, photographs). The completed PTP and attached evidentiary materials are subject to review and approval by the Department.
The Department is updating the PTP templates, the PTP User Manual, and the Protocol for Site Visits and Heightened Scrutiny. The revised materials will be posted here when finished. As an interim measure to provide guidance while the Department prepares a web-based PTP system, a sample updated PTP template for adult residential settings is posted below. The final web-based PTP forms for adult residential, children's residential and nonresidential may vary somewhat from this sample.
Adult Residential PTP - SharePoint Template - August 2017
The Department conducted a two-stage provider survey to assess settings where waiver participants live and/or receive home and community based services. The results of the provider self-assessment surveys are summarized in the scorecards below, which were updated in February/March 2016.
Communication Brief - Department Responses to June 2016 Public Comments on HCBS Statewide Plan and Systemic Assessment Crosswalk - November 2017
Communication Brief - Compliance Requirement for New Settings under the Home and Community Based Services (HCBS) Settings Final Rule - November 2017
Communication Brief - Department Adjusts Timelines for Statewide Transition Plans - June 2017
Fact Sheet for Individuals and Families - August 2015
Fact Sheet for Providers - August 2015
Sarah.Hoerle@state.co.us, LCSW - Community First Choice, Long Term Services and Supports Division
Lori.Thompson@state.co.us, HCBS Specialist, Division of Intellectual and Developmental Disabilities