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DATES AND DEADLINES
All states were required to submit a plan for transitioning their current Home and Community-Based Services (HCBS) system into compliance with the new rule to the Center for Medicare and Medicaid services (CMS) by March 17, 2015. States submitting a 1915(c) waiver renewal or amendment before March 17, 2015, had to include a transition plan in that submission. States were given 120 days from that submission date to submit a transition plan for the remainder of their HCBS system.
On May 8, 2014, Oregon Department of Human Services (DHS) and Oregon Health Authority (OHA) posted a call for public comments on transition plans for these three waivers. Comments were due June 9, 2014. On June 23, 2014, Oregon posted a second call for public comments on a transition plan and proposed amendment for the Medically Involved Children’s Waiver. Comments were due July 23, 2014. In October 2014, DHS and OHA submitted the first Global Transition Plan to CMS. They also posted their comments and responses to public comments on the Initial Transition Plan. The Transition Plan defines the key activities that DHS and OHA will complete to ensure that Oregon’s HCBS delivery systems are in compliance with the regulations. It also defines that the Global Transition Plan will apply to all licensed, endorsed and certified providers. This includes but is not limited to:
- Adult Day Programs
- Adult Foster Homes
- Assisted Living Facilities
- Employment Programs
- Group Homes
- Residential Treatment Homes and Facilities
Oregon also posted the HCBS Global Scorecard – July 2014 for assessing settings.
In February 2015, CMS responded to DHS and OHA and asked for changes to the Transition Plan. On April 24, 2015, DHS and OHA submitted the revised Global Transition Plan to CMS. CMS requested additional revisions in September 2015 and November 2015. DHS and OHA submitted the requested revisions on October 1, 2015, and November 18, 2015. Oregon received further requests from CMS for additional information and OHA/DHS submitted revisions in April 2016 and October 2016. On 11/02/16, Oregon received initial approval of its Statewide Transition Plan. On 05/09/17, CMS afforded states the opportunity to extend the transition timeline for three additional years.
On June 15, 2017, Oregon posted its amended plan for public comment. This plan captures current transition processes, Proposes an extension to Oregon’s compliance timeline, and answers questions raised by CMS to obtain final approval of the transition plan. Also included are each program area’s Heightened Scrutiny Evidence Packages containing the sites identified by each program as requiring CMS’ heightened scrutiny: DHS Aging and People with Disabilities (APD), DHS Office of Developmental Disabilities Services (ODDS), and OHA Health Systems Division’s (HSD). DHS APD also posted documents they used in their heightened scrutiny process, including an onsite review template and Provider Letter and Worksheet. This amended plan and the heightened scrutiny evidence packages are posted on their web page and available for Public Comment for 30 days, ended July 17, 2017. Oregon sent their amended plan to CMS August 1, 2017.
All documents listed in this section may be viewed by going to either of these Oregon HCBS-specific web pages:
- HCBS Global Scorecard – July 29, 2014
- Initial Statewide Transition Plan – October 13, 2014
- Response to Comments on draft Statewide Plan – October 8, 2014
- Revised Statewide Transition Plan – April 23, 2015
- Non-Residential Provider Status Reports– September 23, 2015
- Revised Statewide Transition Plan – October 1, 2015
- Revised Statewide Transition Plan – November 20, 2015
- Revised Statewide Transition Plan – April 27, 2016
- Revised Statewide Transition Plan – October 31, 2016
- Revised Statewide Transition Plan – August 1, 2017
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 Oregon on August 20, 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. November 2, 2016
Transition Plan Documents for Public Comment
- Press Release on Transition Plan and Public Comments June 16, 2017
- Statewide Transition Plan Open for Public Comment June 15, 2017
- APD Heightened Scrutiny Evidence Package June 2017
- APD Heightened Scrutiny Onsite Review Template Nov 2016
- APD Heightened Scrutiny Provider Letter and Worksheet Sept 2016
- ODDS Heightened Scrutiny Evidence Package June 2017
- HSD Heightened Scrutiny Evidence Report June 2017
More information about the request for comments, where to send them, and the deadline may be found on Oregon’s HCBS Transition Plan webpage.
- Oregon has adopted Oregon Administrative Rules that apply to all three program areas (DHS APD, DHS ODDS and OHA HSD); they are referred to as Oregon’s “Overarching HCBS Rules” (OAR 411-004-0000 through 411-004-0040). The Oregon-Specific HCBS Resources webpage has a link to these rules.
- Oregon’s HCBS webpages have two options for those who have questions or comments. One way is to email them at Oregon@state.or.us. Additionally, anyone may subscribe to GovDelivery Notifications to receive email notifications of site updates.
- Oregon has a page dedicated to Federal and Other Resources.
- Oregon has created an Oregon-Specific HCBS Resources webpage that houses Fact Sheets, FAQs, Consumer and Provider Educational/Training Materials, and a link to Oregon’s HCBS Oregon Administrative Rules. From here, website visitors may leave comments or questions via the HCBS Feedback Form; it was created to ensure that people who do not have email accounts can still ask questions and leave feedback.
Each of Oregon’s programs have their own webpage where documents and materials specific to that program are located:
On the DHS Aging and People with Disabilities (APD) site you will find
- APD HCBS Provider Status Reports
- APD HCBS Heightened Scrutiny Process Flowchart – Aug 2016
- APD HCBS Training Materials
- APD Consumer Comments from HCBS Individual Experience Survey
- APD Adult Foster Home Medicaid Residency Contract Template
- APD Transmittals
- APD Survey Response Summary 2015
On the DHS Office of Developmental Disabilities Services (ODDS) site you will find
- ODDS HCBS Provider Status Reports
- ODDS Children’s Residential Service Settings Brochure
- ODDS Individually-Based Limitations (IBLs)
- Training and Technical Assistance
- Onsite Assessments
- ODDS Q and A: General Information about the HCBS
- Residency Agreements
- ODDS HCBS Heightened Scrutiny Evidence Worksheet
On the OHA Health Systems Division (HSD) site you will find
- HSD HCBS Provider Status Reports
- HSD HCBS Presentation FAQ – 12/2016
- HSD Stakeholder Meetings
- HSD Templates
- HSD Training and Presentations
Comment period for revised statewide transition plan closed July 17, 2017. Oregon sent their amended plan to CMS August 1, 2017.
Comments will be incorporated and an Amended Statewide Transition Plan that includes each program area’s Heightened Scrutiny Evidence Packages.
Some of the HCBS State Partners that have been involved with the implementation of HCBS regulations include:
[Note: Not all partners are listed; e.g., names of individual providers or self-advocates]
- AARP Oregon
- ADDUS HomeCare Inc
- Adult Learning Systems of Oregon
- Alzheimer’s Association, Oregon Chapter
- Association of Oregon Community Mental Health Programs
- Cascadia Behavioral Healthcare
- Columbia Care
- Disability Rights Oregon (the State’s Protection and Advocacy Agency – P&A)
- Eames Consulting
- Governor’s Commission on Senior Services
- Independent Adult Care Home Association
- LeadingAge Oregon
- Legal Aid Services of Oregon
- Long-Term Care Ombudsman
- Oregon Adult Care Home Association
- Oregon Law Center
- Oregon Resources Association
- Oregon Council on Developmental Disabilities
- Oregon Health Care Association
- Oregon University Centers for Excellence in Developmental Disabilities (UCEDD)
- Partnerships in Community Living
- Renew Consulting
- SEIU Local 503
- State Independent Living Council
- Shangri-La Corp
- Telecare Corp