STP for Compliance with the CMS HCBS Community Rule Approved by CMS
Final Approval Letter from CMS
STP for Compliance with the CMS HCBS Community Rule Submission for Final Approval
Initial Approval Letter from CMS
On December 27, 2022, the Centers for Medicare & Medicaid Services (CMS) granted Massachusetts initial approval of the Statewide Transition Plan (STP) to bring settings into compliance with the Community Rule. Following the conclusion of the current public comment period we will resubmit an updated version of the STP to CMS for consideration of final approval.
Heightened Scrutiny
As part of the HCBS Community Rule, CMS requires settings in the following categories to be submitted for Heightened Scrutiny review. Heightened Scrutiny is a process for states to demonstrate to CMS that certain settings meet Community Rule criteria. This allows states to maintain access to Medicaid funding.
CMS established three groups of settings, which they refer to as “prongs”:
- Prong 1 settings: Located in a hospital, nursing facility, intermediate care facility for the developmentally disabled (ICF-DD) or institution for mental disease (IMD)
- Prong 2 settings: Located adjacent to a public hospital, nursing facility, ICF-DD or IMD
- Prong 3 settings: Have the effect of isolating people from the broader community of people who do not receive HCBS.
Massachusetts does not have any waiver settings in Prongs 1 or 2. If a provider was not in full compliance with Prong 3 of the Community Rule by July 1, 2021, CMS requires that the state submit additional information for Heightened Scrutiny review. Massachusetts has completed Heightened Scrutiny packages for two providers in Prong 3 as required.
Program Instructions
These Program Instructions (PIs) are issued by the Office of Elder Affairs and provide required procedures, protocols, and instructions to ASAPs in their operation of the Frail Elder Waiver and do not apply to participants in any other HCBS waiver.
Materials Previously Submitted to CMS as part of Initial Statewide Transition Plan
In response to new rules issued by the Centers for Medicare and Medicaid Services (CMS) related to home and community based settings for Medicaid-funded HCBS waivers, the Commonwealth of Massachusetts submitted the materials found below. These materials include our initial Statewide HCBS Transition Plan, agency-specific Transition Plans related to waiver-operating agencies, a summary of the comments received through the public input process and the state’s responses to these comments. Massachusetts submitted these materials to CMS in a letter dated March 2, 2015.
You will find further information about the new CMS rule through the links below.
- The Massachusetts Statewide Transition Plan for Compliance with the CMS Home and Community Based Services Community Rule (July 2016 Revised Draft) PDF | Word
- Cover Letter PDF | Word
- Massachusetts Statewide HCBS Transition Plan PDF | Word
- Attachment A – The Massachusetts Department of Developmental Services Transition Plan PDF | Word
- DDS Appendix A – Summary of Tasks and Timelines PDF | Word
- DDS Appendix B – Blueprint for Success (Employment Supports) PDF | Word
- DDS Appendix C – Positive Behavioral Supports Policy and Guidelines PDF | Word
- DDS Appendix D – DDS Criteria for review of Provider Transition Plans PDF | Word
- Attachment B – The Massachusetts Rehabilitation Commission Transition Plan PDF | Word
- Attachment C – The Massachusetts Executive Office of Elder Affairs Transition Plan PDF | Word
- Attachment D – Responses to Comments Received on the Massachusetts Transition Plan PDF | Word
- Summary of Revisions made to the Statewide HCBS Transition Plan PDF | Word
- CMS summary of new federal requirements PDF | Word
Addendum to the STP for Non-residential Services Compliance with the HCBS Community Rule
Click on the links below to find the Massachusetts’ HCBS Transition Plan Addendum for non-residential services as well as agency-specific information for DDS, MRC and EOEA. Massachusetts submitted the addendum to CMS in a letter dated September 3, 2015.
- Cover Letter PDF | Word
- Massachusetts Statewide HCBS Transition Plan – Addendum for Non-residential Services PDF | Word
- Attachment A – DDS Transition Plan Addendum for Non-residential Services PDF | Word
- DDS Appendix A – Summary of Tasks and Timelines PDF | Word
- DDS Appendix B – Blueprint for Success (Employment Supports) PDF | Word
- DDS Appendix C – Positive Behavioral Supports Policy and Guidelines PDF | Word
- DDS Appendix D - Employment Progress Report PDF | Word
- DDS Appendix E Revised Guidance Criteria to Assist Providers in Compliance with HCB Setting Requirements PDF | Word
- DDS Appendix F – Survey of Community Based Day Services PDF | Word
- Attachment B – MRC Transition Plan Addendum for Non-residential Services PDF | Word
- Attachment C – EOEA Transition Plan Addendum for Non-residential Services PDF | Word
- Attachment D – Responses to Comments Received on the Addendum for Non-residential Services PDF | Word
Materials Submitted to CMS as part of the October 2019 Statewide Transition Plan
Massachusetts submitted its Statewide Transition Plan (STP) to CMS in October of 2019, along with a summary of public comments received on the proposed plan. Use the links below to access these documents.
| Last updated: | June 27, 2023 |
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