Dates and Deadlines

All states must submit to CMS a plan for transitioning their current HCBS system into compliance with the new rule by March 17, 2015. States submitting a 1915(c) waiver renewal or amendment before March 17, 2015 must include a transition plan in that submission. States then have 120 days from that submission date to submit a transition plan for the remainder of their HCBS system.

Delaware operates an 1115 waiver called the Diamond State Health Plan, which supports multiple populations who are in need of long-term services and supports including people with physical disabilities, developmental disabilities, and older adults. It was approved and implemented in 2012. CMS has indicated that HCBS delivered through 1115 waivers must be compliant with the rule.

On February 6, 2015 the State posted a Statewide Transition Plan. Comments were due March 6, 2015.

State Documents

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  • New! CMS letter granting Final Approval of Delaware Plan Final Approval is the communication CMS sends to the state notifying the state that public comment, input and summary requirements are met, the STP has provided all necessary information including but not limited to; systemic assessment, site specific assessment, settings presumed to have institutional characteristics, information regarding heightened scrutiny or the state’s decision to let the presumption stand, and clear remedial steps with milestones are delineated.
  • Delaware HCBS homepage
  • Letter from CMS to Delaware regarding HCBS Rules and 1115 Waiver: HCBS letter to Delaware
  • March 13, 2016 Statewide Transition Plan
  • July 17, 2015 State Self-Assessment 
  • August 2015 Comment Summary 
  • September 17, 2015 Statewide Transition Plan
  • February 6, 2015 Statewide Transition Plan
  • March 2015 Comment Summary
  • Clarifications and/or Modifications required for Initial Approval (CMIA): This letter notifies states that public comment, input and summary requirements are met, but CMS has identified issues that must be resolved in the Statewide Transition Plan (STP) prior to initial approval. CMS sent this letter to Delaware on September 24, 2015.
  • NEW Initial Approval with Milestones and a Resubmission Date. This letter is the communication CMS sends to the state notifying the state that public comment, input and summary requirements are met, the STP is sufficient, but systemic and/or site-specific assessments are not yet completed.  The response to the state will vary dependent on whether the state has or has not identified settings that are presumed to have institutional characteristics and any information the state may wish CMS to consider under the heightened scrutiny process (sent to Delware on July 14, 2016).

ResourcesBack to TOP

Presentation by Brian Hartman about the rule: 2014 CMS Medicaid HCBS Regulation – Community Legal Aid Society in Delaware

Delaware P&A Comments on HCBS Transition Plan

The Delaware Developmental Disabilities Council has created three surveys to help people comment on the plan:

Center for Disabilities Studies at University of Delaware Responds to Proposal on CMS Rule

NewsBack to TOP

Dr. Mineo addresses the town hall meeting04/21/2014
Delaware UCEDD Director Gives Radio Interview on New Rule

Center for Disabilities Studies Director Beth Mineo brought clarity to complex new federal Medicaid rule in an interview on News Raio 1410 WDOV and 1450 WILM in Delaware. The rule will increase community living and employment opportunities for people with disabilities.

Listen to the audio of Dr. Mineo’s interview or read a transcript.


Andrew Imparato, executive director of the Association of University Centers on Disabilities, addresses the audience Monday04/21/2014
Rule would change options for people with disabilities

More than 100 people gathered at an event on April 21, 2014 organized by the University of Delaware’s Center for Disability Studies to learn about the new rule. Andy Imparato, Executive Director of AUCD, and Jennifer Mathis, Deputy Director of the Bazelon Center for Mental Health Law, presented at the town-hall style meeting. CONTINUE READING …

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