Attention: Case Managers and Care Coordinators for Members of MaineCare Benefits Manual Sections 18, 19, 20, 21, and 29, Home- and Community-Based Services (HCBS)

Attention: Case Managers and Care Coordinators for Members of MaineCare Benefits Manual Sections 18, 19, 20, 21, and 29, Home- and Community-Based Services (HCBS)   In January 2014, the Centers for Medicare and Medicaid Services (CMS) announced a requirement for states to review and evaluate current Home- and Community-Based Settings (HCBS) to demonstrate compliance with the new federal HCBS Setting rules that went into effect March 17, 2014. These rules were developed to ensure that individuals receiving long-term services and supports through Medicaid-funded HCBS waiver programs (Sections 18, 19, 20, 21, and 29) have full access to benefits of community living and the opportunity to receive services in the most integrated setting appropriate. The Department of Health and Human Services (the Department) is required to utilize various strategies to assess and validate Maine's HCBS settings for compliance with the HCBS Settings Rule. In November 2019, HCBS providers completed HCBS Self-Assessments of their residential and non-residential settings. The Department's contracted team of experts, Economic Systems (EconSys), is currently analyzing the results of the provider self-assessments. The Centers for Medicare and Medicaid Services requires states to validate provider self-assessment responses. The Department will utilize on-site validation visits for a percentage of HCBS settings to assess compliance with the HCBS Settings Rule. On-site validation visits will be conducted by Disability Rights Maine (EconSys sub-contractors) and Department staff between February and October 2020. For those HCBS residential settings not receiving an on-site validation visit, the Department will utilize the Individual Experience Assessment (IEA) survey to assist in the validation process. Case Managers and Care Coordinators will be instrumental in completing the IEA with members they serve. Individual Experience Assessments will begin February 18, 2020 and be completed by July 31, 2020. A recorded training will be available in early February 2020 for case managers and care coordinators to help with conducting and completing IEAs. The Department believes the IEA will be a valuable tool to assist in the validation process of HCBS settings, and will also be helpful with the person-centered planning process for members receiving HCBS. The Department will communicate with agencies who provide care management and care coordination services about monthly assignments of members in need of IEAs between February and July 2020. The Department believes the face-to-face completion of the IEA with members will be a beneficial exercise for members and their assigned Case Managers and Care Coordinators. The completion of an IEA by a Case Manager/Care Coordinator in the member's presence is a covered service involving assessment and monitoring activities to assure the member's health and welfare, and to assure the individual care plan is effectively implemented and adequately addresses member needs. For additional information regarding the HCBS Settings Rule requirements and Maine's work toward compliance, please visit the Office of Aging and Disability's HCBS webpage at: http://www.maine.gov/dhhs/oads/hcbs/index.shtml With questions regarding HCBS, please utilize our mailbox at HCBS.DHHS@maine.gov 1.24.20 Attention CM and CC providers IEA guidance.pdf   Update your subscriptions, modify your password or email address, or stop subscriptions at any time on your Subscriber Preferences Page. You will need to use your email address to log in. If you have questions or problems with the subscription service, please visit subscriberhelp.govdelivery.com. This service is provided to you at no charge by Maine Department of Health & Human Services. This email was sent to stevenmagallanes520.nims@blogger.com using GovDelivery Communications Cloud on behalf of: Maine Department of Health & Human Services · 109 Capitol St · Augusta, ME 04333