Home and Community Based Services Provider Self-Assessments Webinar, March 23, 2016

Presentation in PDF | Webinar Recording

Carrie Bruns, Department of Aging and Disability Services

Kate Layman & Clare Seagraves, Health and Human Services Commission


  • Background on rules for Home and Community Based Services (HCBS) settings
  • Information on provider self-assessments
  • Questions

HCBS Settings


  • 1915(c) waivers
    • Community Living Assistance and Support Services (CLASS)
    • Deaf-Blind with Multiple Disabilities (DBMD)
    • Home and Community-based Services (HCS)
    • Medically Dependent Children Program (MDCP)
    • Texas Home Living (TxHmL)
    • Youth Empowerment Services (YES)
  • 1915(i) state plan services.
  • Community First Choice (1915(k) state plan services).
  • HCBS State of Texas Access Reform (STAR+PLUS) Waiver (1115 demonstration waiver).
  • Ensure individuals receive services in settings that are integrated in and support full access to the community.
  • Give individuals the opportunity to:
    • Seek employment in competitive and integrated settings;
    • Take part in the community;
    • Be in control of personal resources; and
    • Get the same access to services as those not receiving HCBS.

Requirements (includes DADS day programs)

  • Ensure individual's rights of privacy, dignity, and respect;
  • Improve individual's independence;
  • Protect individuals from limitations and being forced to choose a particular program, company, service or residential setting; and
  • Give individuals options including non-disability specific locations that have private residential units.

Provider-owned or Controlled Settings Rules

  • Ensure individuals have:
  • The same responsibilities and protections from eviction as other tenants have under state and local law;
  • Privacy in his or her sleeping and living unit, including locking doors;
  • Choice of roommates;
  • Freedom to furnish and decorate sleeping and living areas; and
  • Freedom and support to control their own schedules and activities.

HCBS Transition Plan: Requirements & Phases

  • Review of existing settings (including whether they comply).
  • Strategies and a plan for remediation.
  • Public and stakeholder input into the assessment and remediation strategies.
  • Assessment Phase
  • Internal Assessment
  • External Assessment
  • Remediation Phase

HCBS Assessment Phase

  • All states must do assessments to ensure that their program settings follow HCBS rules.
  • If there are settings that are found to not follow the HCBS rules, those settings will be addressed through the remediation phase.
  • DADS, HHSC, and DSHS have all completed the internal assessment phase.
  • DADS and HHSC have developed assessments for residential and non-residential providers, service coordinators/case managers, and participants based on CMS guidance.

Provider Participation

  • Provider participation is essential to a successful assessment process.
  • The assessment process results will assist the state with the next phase of our transition plan.
  • In order to comply with the Statewide Transition Plan, sampled providers need to respond to the survey to ensure validation as outlined in the plan.

DADS 1915(c) Provider Assessments

HCBS Assessment Phase: DADS External Assessment

  • Five types of DADS assessments:
    • Provider Residential
    • Participant Residential
    • Provider Non-Residential
    • Participant Non-Residential
    • Service Coordinator/Case Manager
  • Provider residential self-assessments will be submitted to a sample of HCS providers, all DBMD providers, and CLASS providers whose individuals receive support family services.
  • DADS External Assessment
  • DADS will be sending out an email to providers that have been chosen to complete the Provider Residential self-assessment.
  • The Provider Residential self-assessment contains objective questions with required documentation uploads.
  • Length of self-assessment will depend on whether the provider is a legal entity or at the setting level.
  • Will be offered via Survey Gizmo (paper copy upon request).
  • These surveys are not anonymous.
  • Self-assessment must be completed and submitted, along with any supporting documentation, to DADS within 14 days of notification of being chosen to participate.
  • Supporting documentation must not include any confidential/identifying information about individuals in your program.
  • Questions about the DADS assessments may be submitted to HCBSSurvey@dads.state.tx.us

HHSC 1115 STAR+PLUS HCBS Provider Assessments

HCBS Assessment Phase: HHSC Surveys

  • HHSC has finished its internal assessment.
  • Assisted Living Facility and Adult Foster Care providers and MCO service coordinators will be surveyed.
  • Will survey a sample of members receiving HCBS STAR+PLUS waiver services.
  • The HHSC survey tool asks a series of questions about the manner in which assisted living or adult foster care services are provided by the specific provider completing the survey.
  • There will be a place at the end of each section of the survey for the provider to upload documentation supporting the responses in that section.
  • These surveys are not anonymous.
  • One survey must be completed for each provider-operated residence.
  • The survey tool is approximately 100 questions.
  • Surveys will be completed online via Survey Monkey.
  • Providers will have 60 days from the date the survey tool is released to complete the survey.

HCBS Resources

Ongoing Feedback

Please submit any additional questions or feedback on this topic to: Medicaid_HCBS_Rule@hhsc.state.tx.us

Please make sure you are signed up for alerts as additional information on surveys and additional information about upcoming webinars will be sent out using web alerts.