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    Home and Community-Based Programs Rule Change Overview

    ​​​​​​​​​​​​​​​​The Centers for Medicare and Medicaid Services (CMS) issued a Home and Community-Based Services (HCBS) final rule on January 16, 2014, which came into effect on March 17, 2014. The new rule applies to both residential and non-residential settings and changes the standards by which states are allowed to pay for HCBS. Highlights of the new rule include the following:
    1. Ensuring that individuals have been given choices regarding their setting options.
    2. Guaranteeing individuals’ rights of privacy, dignity, respect, and freedom from coercion and restraint.
    3. Optimizing autonomy and independence in making life choices
    4. Facilitating choice in services and those who provide it.


    Community Settings Regulation Compliance -

    Review of Senior Center Plus Sites and Determination: No Sites Submitted to CMS for Heightened Scrutiny Review 

    The Maryland Department of Health has reviewed the  Senior Center Plus sites in the state and has found that currently all of the sites are community based and meet the criteria of the Community Settings regulations. The Maryland Department of Health invites public comment on the Senior Center Plus providers. A public comment period will be open from May 25, 2018 to June 25, 2018. Once the public comment period is complete, this information and the comments will be submitted to CMS for review. Please send all comments to mdh.hcbssetting@maryland.gov or Rebecca Oliver, Health Policy Analyst Advanced, Room 134, 201 W Preston St, Baltimore, MD 21201.

    Community Settings Regulation Compliance-

    List of Adult Medical Day Care Sites to be Submitted CMS for Heightened Scrutiny Review

    The following Medical Adult Daycare (MADC) sites were identified as falling under the heightened scrutiny (HS) designation due to the reasons listed. A public comment period was implemented from May 25- June 25, 2018.
    Please note that although the public comment period prior to the submission of the list to CMS has ended, MDH will accept comments about this list and providers at all times and include them in future updates of the STP and to CMS. Please email mdh.hcbssetting@maryland.gov and include “Public Comment-HS” in the subject line.
    Sites That are Heightened Scrutiny (HS) County Address Reason for HS/nearly HS
    Arc of Washington County MDCC Washington 838 Florida Ave Day Hab on site
    Delmarva Daybreak Hurlock Dorchester 6210 Shiloh Church/Hurlock Rd Day Hab on site
    Diakon ADS @ Ravenwood Washington 1109 Luther Dr ALF within 1/4mile
    Evergreen Medical Adult Day Svcs Allegany 1 Baltimore St ALF on site
    Gallager Adult Medical Day Baltimore Co 2520 Pot Spring Rd Day Hab on site
    Helping Hands - Capitol Heights Prince Georges 5400 Norfield Rd ALF within 1/4mile
    Human Development Council-Frederick Frederick 5430 Mt. Zion Rd Day Hab on site
    Joyful Adult Medical Day Care Ctr. Baltimore City 6650 Belair Rd ALF on site
    Keswick Adult Services Baltimore City 700 W 40th St Nursing home on site
    New Life AMDC Baltimore Co 7600 Clay's Lane, Ste. #C ALF within 1/4mile
    Sagepoint Adult Day Services Charles 10200 La Plata Rd ALF within 1/4mile
    Stella Maris ADC Center Baltimore Co 2300 Dulaney Valley Rd Nursing home on site
    The League for People w Disabilities Baltimore City 1111 E Cold Spring Lane Day Hab on site
    Washington HDC-ADC Washington 433 Brewer Ave Day Hab on site
    We Care Adult Services Prince Georges 1717 Largo Rd ALF on site
    Winter Growth-Howard Howard 5460 Ruth Keeton Way ALF on site
    Winter Growth-Montgomery Montgomery 18110 Prince Philip Dr ALF within 1/4mile

    Additional Resources

    The following links describe HCBS programs in more detail:
    Links to informational webinars are below:
    Content Type
    Folder: 2017 Community Settings Meeting Minutes
    4/18/2017 3:22 PMFolder
    Folder: A - Transition Advisory Team Meetings
    6/11/2015 1:41 PMFolder
    Folder: Appendices 1-14
    5/10/2017 9:07 AMFolder
    Folder: Appendices A-M
    5/10/2017 9:08 AMFolder
    Folder: B - HCBS Final Rule Transition Plan Comments
    9/6/2016 10:21 AMFolder
    Folder: C - Draft Transition Plan
    6/24/2015 1:25 PMFolder
    Folder: D - Introductory Final Rule Discussion
    6/11/2015 2:05 PMFolder
    Folder: DDA
    4/18/2017 3:20 PMFolder
    Folder: E - Preliminary Survey Information
    6/11/2015 2:08 PMFolder
    Freedom of Choice Form 11.15.pdf
    7/14/2017 3:13 PMDocument
    Folder: May 19, 2017 Webinar Follow-Up
    5/25/2017 8:46 AMFolder
    MD Initial Approval Letter.pdf
    8/2/2017 3:00 PMDocument
    MD State Transition Plan 7.26.17.pdf
    7/26/2017 2:17 PMDocument
    MDCTransmittalNo.86_Freedom of Choice.pdf
    7/14/2017 3:13 PMDocument
    Medicaid HCBS Codebook and Analysis Scheme.xls
    1/27/2017 9:41 AMDocument
    Memo Brain Injury Providers Community Settings 0417.pdf
    4/24/2017 4:07 PMDocument
    Folder: Provider Transformation
    4/27/2017 8:37 AMFolder
    Sample CSQ Current.pdf
    7/5/2017 1:32 PMDocument
    Folder: Stakeholder Notes
    9/20/2016 11:16 AMFolder
    State Transition Plan August 2016.pdf
    7/21/2017 1:13 PMDocument
    Folder: Workgroups
    4/25/2017 4:36 PMFolder
    Rebecca Oliver, MPA, JD
    Health Policy Analyst Advanced
    Office of Health Services
    Maryland Department of Health and Mental Hygiene