The Centers for Medicare & Medicaid Services (CMS) approved DHS’ CADI Waiver amendment package, which includes Waiver Reimagine streamlined service changes, effective Jan. 11, 2021. CMS has now approved waiver amendment packages that include Waiver Reimagine streamlined service changes for the following waivers:

• Brain Injury (BI)
• Community Alternative Care (CAC)
• Community Access for Disability Inclusion (CADI)
• Developmental Disabilities (DD).

Of note, the amendment package:

• Adds language that allows current clients of any age who received adult day services as of 12/31/20 to continue receiving this service and limits new people to only start receiving adult day services if they are age 55 or older. 
• Adds new services for the BI, CAC, CADI and DD waivers.
• Updates the service limitation section to limit new customized living settings to people age 55 and older and adds size requirements related to the HCBS settings rule for settings operating before Dec. 31, 2020.
• Updates the service limitation section to exclude authorization of customized living when a person receives community residential services, family residential services or integrated community supports.

With approval of the CADI Waiver amendment, DHS now has the authority to implement the streamlined service menu for all waivers as part of the first phase of the Waiver Reimagine project.

Starting Jan. 11, 2021, a person on the CADI Waiver who receives a service affected by the streamlined service changes will receive the streamlined service during a service change or at their annual reassessment. For more information about changes to service names, updated HCPCs and frameworks, see CBSM – Waiver Reimagine streamlined service crosswalk.

The approved amendments also address the intent of the HCBS settings standards more fully to support community inclusion and expand services to create more options for people.