DHS Shares Impact of HCBS Settings Rule Timeline Extensions for Minnesota

Posted on August 26, 2020 by Bobbie Guidry

On July 14, 2020, the Centers for Medicare & Medicaid Services (CMS) released guidance in a letter [PDF] announcing an extension to the implementation of the HCBS regulation timelines.

In this letter, CMS extended the deadline for states to bring their systems into compliance with the HCBS settings requirements by a year—from March 17, 2022, to March 17, 2023.

CMS also delayed several other requirements in its announcement:

• It issued a one-year delay of the deadline for when settings determined to have isolating characteristics (Prong 3) can remediate themselves without being submitted to CMS for heightened scrutiny. The original timeline was July 1, 2020. The new timeline is July 1, 2021.
• It also issued a one-year delay for states to submit to CMS settings that isolate (Prong 3) for a heightened scrutiny review if those settings have not completed necessary remediation by July 1, 2021. The original timeline was Oct. 31, 2020. The new timeline is Oct. 31, 2021.
• It requests that states submit information on settings located in the same building as a public or private institution (Prong 1) or on the grounds of or adjacent to a public institution (Prong 2) by March 31, 2021. The original timeline was March 31, 2020.

What does this mean for Minnesota?

Minnesota intends to stay on track with the timelines and milestones in Minnesota's approved statewide transition plan (STP) (PDF). However, Minnesota’s plans could be affected if CMS does not have the capacity to align our STP timelines with the heightened scrutiny review process.

Several months ago, DHS submitted all settings located in the same building as an institution (Prong 1) or on the grounds of or adjacent to a public institution (Prong 2) to CMS for heightened scrutiny. DHS is awaiting feedback from CMS on these settings. Setting-specific feedback will help DHS work with the provider to remediate any areas CMS identifies as non-compliant.

DHS is also working with settings that were determined to have isolating characteristics (Prong 3) and only plan to submit settings that cannot remediate themselves by July 2021.

See the HCBS settings heightened-scrutiny process page for more information and links to the setting-specific evidentiary packages. If you have questions on the Settings Rule and how it applies to your organization, contact Bobbie Guidry, bguidry@leadingagemn.org.