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Saturday, April 25, 2015 Federal agency allows community‐based services and housing on the grounds of an institution From the VOR Weekly News Update for April 24, 2015 North Dakota recently received approval from the Centers for Medicare & Medicaid Services (CMS) to provide Medicaid Home and CommunityBased Waiver funded residential housing and day services on the grounds of the North Dakota Life Skills and Transition Center (LSTC), a state funded intermediate care facility (ICF/IID). [IID = Individuals with Intellectual Disabilities] Federal approval for housing and day services on the ICF/IID campus came after a heightened scrutiny review by CMS, as required by the federal "community" regulation which requires all HCBSfunded services meet specific criteria. The proximity of the housing and day services on the campus of an ICF triggered "heightened scrutiny." This is believed to be the first ruling under a heightened scrutiny review. The North Dakota Protection and Advocacy Project, North Dakota Center for Persons with Disabilities, and The Arc of North Dakota sent a letter registering their significant upset and opposition to the ruling and for not being involved as “stakeholders.” Read their letter to CMS here . ********************************************** From Questions and Answers Regarding Home and CommunityBased Settings [page 7] Question: Are settings on the grounds of or adjacent to “private” institutions considered not to be home and communitygassed (HCB)? Answer: It depends. Settings that are on the grounds of or adjacent to a private institution are not automatically presumed to have the characteristics of an institution. However, if the setting isolates the individual from the boarder community or otherwise has the characteristics of an institution or fails to meet the characteristics of a home and communitbased setting, the setting would not e considered to be compliant with the regulation. States will need to assure that these settings fully comply with the requirements…to Favorite Blog Posts Contact info for Michigan US and State legislators Aacorn Farm , Kalamazoo, MI When community care fails a person with severe DD Legal Guardians : HCBS rule confirms decisionmaking authority Ben's Hope : Bringing People Together MI DD Council "Community Conversations " statewide meetings Medical Necessity Criteria for Medicaid services let's talk Blog Archive 2015 (34) May (3) April (11) Washtenaw County, MI : 2nd Town Hall Meeting on Co... From Upstate NY : “Our families will not be silenc... More on ND : Rationale for approving communitybas... Federal agency allows community based services and... MI Mental Health System, Including Services to DD,... Benefit Events for High Point School, Ann Arbor, M... Summary of 4/14/15 meeting on community living ser... Washtenaw County, MI : CMH to announce rate decrea... Groundbreaking Survey of Families of Adults with D... Michigan: Aacorn Farm Expanding Choices, Buildi... 0 More Next Blog» Create Blog Sign In The DD News Blog News, information, and commentary for families and friends of people with developmental disabilities.

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5/11/2015 The DD News Blog: Federal agency allows communitybased services and housing on the grounds of an institution

http://theddnewsblog.blogspot.com/2015/04/federalheightenedscrutinyreview.html 1/5

Saturday, April 25, 2015

Federal agency allows community‐based services and housingon the grounds of an institution

From the VOR Weekly News Updatefor April 24, 2015 North Dakota recently receivedapproval from the Centers forMedicare & Medicaid Services (CMS)to provide Medicaid Home andCommunityBased Waiver fundedresidential housing and day serviceson the grounds of the North DakotaLife Skills and Transition Center

(LSTC), a state funded intermediate care facility (ICF/IID). [IID = Individualswith Intellectual Disabilities] Federal approval for housing and day services on the ICF/IID campus cameafter a heightened scrutiny review by CMS, as required by the federal"community" regulation which requires all HCBSfunded services meetspecific criteria. The proximity of the housing and day services on thecampus of an ICF triggered "heightened scrutiny."  This is believed to be the first ruling under a heightened scrutiny review. TheNorth Dakota Protection and Advocacy Project, North Dakota Center forPersons with Disabilities, and The Arc of North Dakota sent a letterregistering their significant upset and opposition to the ruling and for notbeing involved as “stakeholders.” 

Read their letter to CMS here. 

**********************************************

From Questions and Answers Regarding Home and CommunityBasedSettings 

[page 7] Question: Are settings on the grounds of or adjacent to “private”institutions considered not to be home and communitygassed (HCB)?

Answer: It depends. Settings that are on the grounds of or adjacent to aprivate institution are not automatically presumed to have the characteristicsof an institution. However, if the setting isolates the individual from theboarder community or otherwise has the characteristics of an institution  orfails to meet the characteristics of a home and communitbased setting, thesetting would not e considered to be compliant with the regulation. States willneed to assure that these settings fully comply with the requirements…to

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