Home and Community-Based Services

Home and community-based services (HCBS) provide opportunities for Medicaid beneficiaries to receive services in their own homes or communities rather than institutions or other isolated settings.

These programs serve people with intellectual or developmental disabilities, physical disabilities and/or mental illnesses.

Oregon's Transition Plan Programs Resources Questions, comments and contacts

Oregon's transition plan

All states that operate Medicaid-funded HCBS programs were required to submit HCBS Transition Plans to the Centers for Medicare and Medicaid Services (CMS) to demonstrate how they will bring their HCBS systems into compliance with federal regulations.

Oregon received final approval of its Statewide Transition Plan on Feb. 27, 2019.

In October 2014, ODHS and OHA submitted the first Global Transition Plan to CMS. The Transition Plan defined the key activities that ODHS and OHA would complete to ensure that Oregon’s HCBS delivery systems are in compliance with the regulations. It also defined that the Global Transition Plan will apply to all licensed, endorsed and certified providers. This includes but is not limited to:

Adult Day Programs
Adult Foster Homes
Assisted Living Facilities
Employment Programs
Group Homes
Residential Treatment Homes and Facilities

In February 2015, CMS responded to ODHS and OHA and asked for changes to the Transition Plan. In April 2015, ODHS and OHA submitted the revised Global Transition Plan to CMS. CMS requested additional revisions in September 2015 and November 2015. ODHS and OHA submitted the requested revisions in October and November 2015. Oregon received further requests from CMS for additional information and OHA/ODHS submitted revisions in April and October 2016.

On Nov. 2, 2016, Oregon received initial approval of its Statewide Transition Plan.

In May 2017, CMS afforded states the opportunity to extend the transition timeline for three additional years. Oregon amended its plan to capture current transition processes, extend its compliance timeline, and answer questions raised by CMS to obtain final approval of the transition plan. Also included were ODHS Aging and People with Disabilities' (APD), ODHS Office of Developmental Disabilities Services' (ODDS), and OHA Health Systems Division's (HSD) evidence packages of sites identified as requiring CMS’ heightened scrutiny. This amended plan and the heightened scrutiny evidence packages are posted below.

On Nov. 15, 2018, Oregon updated its Statewide Transition Plan and posted the amended draft for public comment. This draft version of the Transition Plan included a reorganization of the information within the plan to make it easier to understand. Additionally, this version addressed questions raised by the public, partners and CMS suggestions for clarification. The draft Transition plan was posted on ODHS and OHA websites, and paper copies were provided upon request. Public comments on this version were requested through Dec. 17, 2018.

On Dec. 27, 2018, Oregon submitted the amended Statewide Transition Plan, with public comments and their responses, to CMS for review and approval.

On Feb. 27, 2019, CMS approved Oregon’s Statewide Transition Plan.

*CMS received copies of all Statewide Interested Parties Meeting Agendas along with the Summary document. The Summary is provided on this webpage; if anyone would like a copy of the agendas, they may be requested by emailing hcbs.oregon@odhsoha.oregon.gov.

Programs

Timeline

APD HCBS Timeline 2023 - 2024

Public Input

Individually-Based Limitation (IBL) Tools

Provider Specific

Provider Attestation: Completed Training 2024
HCBS-IBL Online Training – January 2024

Provider Alerts

Residency Contract

Training Materials
This section will be updated as new materials are developed.

OHCA Fall Conference 2023 – September 2023

Transmittals

Provider Status Reports

Public Input Request

Templates

Transmittals

Individually-Based Limitation Memo - June 2018

Training and Presentations

Children's Services

Children in Residential Settings Brochure

General Information

Q and A: General Information about HCBS

Heightened Scrutiny

Heightened Scrutiny Evidence Worksheet

Individually-Based Limitations (IBLs)

Onsite Assessments

Provider Status Reports

Residency Agreements

Request for Additional Time for Sheltered Workshop Providers

Trainings and Technical Assistance

Resources

Information for Oregonians who want to know how Oregon is implementing HCBS, tools to help providers move toward full compliance with the new regulations, guidance from Centers for Medicare and Medicaid Services (CMS) and national advocacy resources.

Oregon Administrative Rule

HCBS Overarching Rules OAR 411-004 - July 2017

Fact Sheets

FAQ

Frequently Asked Questions (September 2017)
Oregon is committed to answering questions about the new HCBS rules and supporting providers and individuals in successfully implementing these new federal regulations. If you have questions not answered in this document, email us.

Provider Information

Fact Sheet - 1915(c): Summary of key provisions of the 1915(c) HCBS Waivers Final Rule.
Fact Sheet - 1915(i): Summary of key provisions of the 1915(i) HCBS State Plan Option.
FAQs - Memory Care: CMS guidance on how regulatory requirements can be met by settings providing HCBS to individuals who exhibit unsafe wandering or exit-seeking behavior; also describes options for education and consideration.
FAQs - HCB Settings: FAQs regarding final regulations of the HCBS Public Notice and Comments.
FAQs: Planned Construction and Person-Centered Planning - Mods to HCBS Settings Criteria: FAQs regarding HCBS settings on (a) Planned Construction of Presumed Institutional Settings and (b) Person-Centered Planning Provisions and Modifications to HCBS Settings Criteria.
Final Regulations: Describes Medicaid coverage of the optional state plan benefits to furnish HCBS and draw federal matching funds.
Final Rule Webinar: Presentation of the final Medicaid HCBS rule.
Final Rule Q&A: covers State Plan HCBS, Five-Year Period for Waivers, Provider Payment Reassignment, Setting Requirements for Community First Choice, and HCBS Waivers.
HCBS 1915(c) Compliance Flowchart: Steps to compliance for HCBS requirements in a 1915(c) waiver and 1915(i) SPA.
Heightened Scrutiny Process: Incorporation of heightened scrutiny in standard waiver process.
Information Bulletin on Employment Services: Updates 1915(c) waiver instructions and technical guide on employment and employment-related services.
Information Bulletin on Extension of HCBS: Extension of transition period for compliance with HCBS criteria.
Information Bulletin on Final Regulations: Final rule on State Plan HCBS, Five-Year Period for Waivers, Provider Payment Reassignment, Setting Requirements for Community First Choice, and HCBS Waivers.
Overview of Regulation: Overview and key provisions of final rule.
Questions to Assist State Assessments of Non-Residential HCBS: Optional tool to assist states assess non-residential HCBS settings.
Questions to Assist State Assessments of Residential HCBS: Optional tool to assist states assess whether characteristics of HCBS are present.
Requirements for HCB Settings: Regulatory requirements for HCBS affecting 1915(c) and 1915(i) and listing Settings that are not HCBS and Settings that are presumed to have the qualities of an institution.
Settings that Isolate: Guidance on settings that have the effect of isolating individuals receiving HCBS from the broader community.
Statewide Transition Plan Toolkit: for Alignment with the HCBS Final Regulation's Setting Requirements.

DOJ Civil Rights Division: Works to uphold civil and constitutional rights of all Americans, particularly some of the most vulnerable members of our society.
HCBS Advisory Coalition: Posts from aging and disability communities on HCBS setting rule information and resources/steps each state is making to comply with the new rules.
Just Like Home: An Advocate's Guide to Consumer Rights in Medicaid HCBS: Provides consumers and advocates with information regarding multiple facets of the new standards, including consumer rights, and guidelines for determining which settings are disqualified from HCBS reimbursement.
Justice in Aging: A national non-profit legal advocacy organization that fights senior poverty through law.
The Arc's "What You need to Know": What you need to know about the 2014 HCBS regulation.

Questions, comments and contacts

While Oregon's final Transition plan was approved on Feb. 27, 2019, all individuals receiving HCBS services, family members, advocates, providers, delivery system representatives and the broader community may send comments or concerns to ODHS or OHA at any time. Email us at hcbs.oregon@odhsoha.oregon.gov.

Contacts by topic:

Adult Foster Homes - apd.afhteam@odhsoha.oregon.gov
Community-Based Care - cbc.team@odhsoha.oregon.gov
General questions - hcbs.oregon@odhsoha.oregon.gov
Policy questions - chris.s.angel@odhs.oregon.gov
For all other questions or for people who don't have email access, contact Chris Angel, HCBS Project Manager and Policy Analyst, by phone at 971-332-0416.

HCBS providers of services to individuals covered by Medicaid with questions about a resident's IBL should contact the resident's Medicaid Case Manager directly.

Home and Community-Based Services

Oregon's transition plan

Approved plan

Process history

Past plans

Compliance

Programs

Aging and People with Disabilities (APD)

Health Systems Division (HSD)

Office of Developmental Disabilities Services (ODDS)

Resources

Oregon-specific resources

CMS resources

National and other resources

Questions, comments and contacts

General questions and comments

APD contacts