Revised South Carolina Home and Community-Based Services Statewide Transition Plan

The South Carolina Department of Health and Human Services (SCDHHS) gives notice that the revised South Carolina Home and Community-Based Services (HCBS) Statewide Transition Plan, required per Centers for Medicare and Medicaid Services (CMS) HCBS Rule (42 CFR 441.301(c)(6)), was submitted to CMS for review. It will become effective upon CMS approval.

Revisions 
The following is a summary of the revisions, by section, made in the South Carolina HCBS Statewide Transition Plan (initially approved by CMS Nov. 3, 2016):

Section 1: Introduction

·         Updated table of contents, added appendices (all linked)

·         Pages 3-4: added brief description of each Medicaid waiver provided, including a link to a table of each waiver’s services offered by setting type (linked to website)

Section 2: Communication and Outreach

·         Page 10: inserted current update of this public notice

Section 3: Assessment of System-wide Regulations, Policies, Procedures, Licensing Standards and Other Regulations

·         Updates provided throughout section to indicate completion and/or status of policy updates

·         Pages 18-20: provided updates regarding Residential Personal Care II (RPC II) service

·         Section 3.3, Page 37: provided updates on compliance actions

Section 4: Assessment of Settings

• Significant revisions in section overall to meet CMS requirements for final approval
• Section 4.1, Page 46: updates including services provided in settings

·         Page 49: update regarding RPC II service

·         Page 49: inserted information on technical assistance for community residential care facilities (CRCFs) and HCBS

·         Page 52: created Section 4.2.2. on Beneficiary and Family Surveys

• Separated out the independent site visit processes into two sections, updating each section with the full process provided:
  • Section 4.2.3, Page 53: for adult day health care settings and the pediatric medical day care; and,
  • Section 4.2.4, Page 54: for all South Carolina Department of Disabilities and Special Needs (SCDDSN) settings

·         Section 4.3, Page 57: updated the introduction with dates

·         Section 4.3.2, Page 59: added to reflect Beneficiary and Family Survey outcomes

·         Section 4.3.3, Page 61: updated to reflect aggregate outcomes of site visits into designated CMS compliance categories

• Section 4.4, Page 62: Actions for Facilities Deemed not in Compliance, updated to reflect the following:
  • 4.4.1: review process and compliance actions for adult day health care settings
  • 4.4.2: review process and compliance actions for SCDDSN settings
• Section 4.4.3, Page 65: Relocation of Waiver Participants section updated to include:
  • Updates on settings that have closed
  • Timelines for relocating beneficiaries
  • Current estimated number of beneficiaries that will need to be relocated from non-compliant settings
• Section 4.4.4, Page 69: updated addressing non-disability specific settings
• Section 4.4.5, Page 70: updated addressing monitoring of individual private homes
• Section 4.5, Page 71: Ongoing Compliance section has been expanded to provide greater detail on ongoing compliance actions for HCBS settings

Section 5: Heightened Scrutiny

·         Significant revisions in section overall to meet CMS requirements for final approval

·         Restructured sub-section numbering:

o   Content previously included in Section 5.1 is now part of the introduction of this section

o   Initial C5 Heightened Scrutiny Assessment is now Section 5.1

o   C4 Individual Facilities/Settings Assessment is now Section 5.2

o   Geocode Data Generation is now Section 5.3

o   Consultation with TAC is now Section 5.4

o   Public Input is now Section 5.5

·         Page 81: added Section 5.6 to reflect site visit outcomes; identification of settings for state-level heightened scrutiny

·         Section 5.8, Page 83: section originally titled “Next Steps” has been renumbered and renamed to Section 5.7, “HCB Settings Quality Review Process”

o   Section 5.7.1 details the state-level review process for adult day health care settings to determine if any would be submitted to CMS for heightened scrutiny review and includes the results of that process

o   Section 5.7.2 details the state-level review process for SCDDSN settings which was vetted through targeted stakeholder feedback and included in this section

o   Section 5.7.3 updated with timeline of public notice for CMS heightened scrutiny submissions

·         Section 5.7.4 updated to include submission format for CMS heightened scrutiny

Appendices

·         The following appendices were added to this version (with links to the direct appendices in the document) at https://www.scdhhs.gov/resources/programs-and-initiatives/home-and-community-based-services/providers/hcbs-resources:

o   Appendix J - Adult Day Health Care Assessment Tool

o   Appendix K - Non-residential (day services facilities) Assessment Tool for SCDDSN Settings

o   Appendix L - Residential Assessment Tool for SCDDSN Settings

o   Appendix M - Global Results: SCDDSN Settings Independent Site Visits

The public comment summary is attached to the Statewide Transition Plan as Appendix A-4.

A copy of this public notice and the revised South Carolina HCBS Statewide Transition Plan is available at the following locations:

1.       Website:

a.       scdhhs.gov (under the “Public Notice” section)

b.       scdhhs.gov/hcbs (under “Resources,” “Statewide Transition Plan”)

2.       Hard Copies:

a.       SCDHHS main office, 1801 Main Street, Columbia, SC

b.       All Healthy Connections Medicaid county offices

c.       All Community Long Term Care (CLTC) area offices