Ohio Department of Medicaid submits compliance plan for HCBS regulations

Wednesday, April 15, 2015

The US Centers for Medicare and Medicaid Services (CMS) has published new regulations affecting service providers of Home and Community Based Services (HCBS) who participate in Medicaid waiver programs. The regulations are intended to protect individuals receiving the services and promote independence and person-centered care. Care settings are expected to meet these regulations to be eligible for reimbursement through Medicaid HCBS waivers.

The State of Ohio administers nine HCBS waiver programs and Council on Aging either administers or provides a service in the administration of four of these programs – Assisted Living, MyCare Ohio, Ohio Home Care and PASSPORT.

The majority of the regulations affecting COA programs are specific to Assisted Living Waivers or those receiving Adult Day services through other waiver programs. Highlights include:

  • Protection of an individual’s rights to dignity, privacy, respect, and freedom from coercion and restraint in a care setting. 
  • Protection of autonomy and independence in life choices including but not limited to physical environment and daily activities.
  • Protection of the choice of service providers. 
  • Freedom of choice of furnishings, roommates, schedules, and more. 
  • Regulations ensuring the safety and security of residents of a facility.

The regulations also require that each state create and share a transition plan for compliance. The Ohio Department of Medicaid worked closely with the Ohio Departments of Aging and Department of Developmental Disabilities to create a plan for compliance. The plan, along with a more detailed explanation of the regulations can be found here.