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The Centers for Medicare and Medicaid Services (CMS) has called for significant changes in the delivery and structure of Medicaid home-and-community-based services (HCBS) for people with disabilities.

States must meet certain requirements for home and community based settings. The intent of these changes is to promote choice, participation, and independence. These new rules require that the state identify all settings that are used for waiver services and those settings that do not fit the new definition be identified. The new rules encourage the public and those receiving services to be an important part of the transition process.

Specifically, these changes will impact those who receive services under Nebraska’s waiver programs including: the Aged & Disabled Waiver, the Traumatic Brain Injury Waiver, the Adult Developmental Disability Waiver, the Children’s’ Developmental Disability Waiver and the Autism Waiver.

States are to review how and where these services are provided and develop a plan, a State Transition Plan, for these required modifications.

Under the new rules, the places where people with disabilities and seniors who receive these services through Medicaid must meet certain guidelines, such as:

• An individual’s primary residence cannot be on the property of or adjacent to an institution.
• Person Centered Planning must be used, enabling the individual receiving services to describe his/her needs.
• Processes must be in place to ensure an individual’s right of privacy, dignity, respect and freedom from coercion and restraint.
• In situations where the individual is living in a home or apartment owned by a provider, there needs to be a lease, residency agreement or another written agreement that approximates or is consistent with landlord tenant law.

To find out more about the new rule, please visit the HCBS Advocacy website. To learn about Nebraska’s transition plan, take a look at the Nebraska Department of Health and Human Services website.

Upcoming Plan Activities and Dates