NOTICES
DEPARTMENT OF
HUMAN SERVICES
Request for Public Comment on Office of Long-Term Living Heightened Scrutiny Sites
[52 Pa.B. 7218]
[Saturday, November 19, 2022]The Department of Human Services (Department) is making available for public review and comment the Office of Long-Term Living's (OLTL) proposed Home and Community-Based Services (HCBS) provider sites qualifying for heightened scrutiny under the requirements set in the Centers for Medicare & Medicaid Services (CMS) HCBS Rule (Rule) at 42 CFR 441.301(c)(6) (relating to contents of request for a waiver).
Background
As of January 16, 2014, CMS established requirements in 42 CFR 441.301 which detail acceptable qualities and characteristics of settings for Medicaid HCBS provided under 1915(c) waivers. On December 28, 2016, the OLTL issued Bulletin # 59-16-14, Home and Community-Based Settings Requirements, which provided guidance to HCBS providers on the requirements they must satisfy to receive payment for HCBS. Among other things, that bulletin included a list of specifically-excluded settings. The settings listed in 42 CFR 441.301(c)(5) specifically exclude the following settings as acceptable HCBS settings:
(i) A nursing facility;
(ii) An institution for mental diseases;
(iii) An intermediate care facility for individuals with intellectual disabilities;
(iv) A hospital; or
(v) Other locations that have qualities of an institutional setting as determined by the Secretary of the Federal Department of Health and Human Services. In addition, 42 CFR 441.301(c)(5) further clarifies that any setting that is located in a building that is also a publicly or privately operated facility that provides inpatient institutional treatment, or in a building on the grounds of, or immediately adjacent to, a public institution, or any other setting that has the effect of isolating individuals receiving Medicaid HCBS from the broader community of individuals not receiving Medicaid HCBS will be presumed to be a setting that has the qualities of an institution. The heightened scrutiny process is applicable to settings presumed to have the qualities of an institution and able to be approved by the Federal government for the provision of HCBS.
The OLTL identified enrolled congregate sites where HCBS is provided and conducted onsite assessments at these sites. Sites whose settings fell into the previously listed categories were evaluated and assisted to correct elements which were able to be corrected to be compliant with requirements of the Rule. Sites who have completed corrections or are currently working on corrections and remain in an unallowable setting are required to be submitted for heightened scrutiny. These sites are available for review and public comment at https://www.dhs.pa.gov/Services/Assistance/Pages/HCBS-Statewide-Transition-Plan.aspx or by contacting the Department of Human Services, Office of Long-Term Living at (717) 857-3280.
Further information on the Statewide Transition Plan for compliance with the Rule can be found at https://www.dhs.pa.gov/Services/Assistance/Pages/HCBS-Statewide-Transition-Plan.aspx.
Fiscal Impact
There is no fiscal impact associated with this notice.
Public Comment
Interested persons are invited to submit written comments regarding the proposed HCBS Rule provider sites to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Janice Bickel, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department at RA-PWHCBSFinalRule@pa.gov. Comments received within 30 days of publication of this notice will be reviewed and considered.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania Hamilton Relay Service by dialing 711 or by using one of the toll-free numbers: (800) 654-5984 (TDD users); (800) 654-5988 (voice users); (844) 308-9292 (Speech-to-Speech); or (844) 308-9291 (Spanish).
MEG SNEAD,
Acting SecretaryFiscal Note: 14-NOT-1550. No fiscal impact; (8) recommends adoption.
[Pa.B. Doc. No. 22-1795. Filed for public inspection November 18, 2022, 9:00 a.m.]
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