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Public Notice

Home and Community-Based Services (HCBS) Settings Transition Plan

Public Notice

The U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) published regulations in the Federal Register (42.CFR 441.301(c)(4)-(6)) on January 16, 2014, effective March 17, 2014, which changed the definition of home and community-based services (HCBS) settings for section 1915(c) Medicaid Waivers and approved state plans providing HCBS under section 1915(i). These new rules require a transition plan, allowing up to five years for full compliance. The new rules also require states to develop and submit a transition plan identifying how the HCBS Waivers will be brought into compliance with the new outcome-oriented definition of HCBS settings. The transition plan is required in conjunction with any waiver amendment or renewal submitted following the implementation of the new regulation. 
The Montana Department of Public Health and Human Services DPHHS) is required to give public notice related to the state’s transition plan. HCBS waivers and state plan to which these regulations apply include:

  • 1915(c) 0208 HCBS Comprehensive Home and Community-Based Waiver for Individuals with Intellectual Disabilities;
  • 1915(c) 0667 HCBS Children’s Autism Waiver;
  • 1915(c) 1037 HCBS Supports for Community Working and Living for Individuals with Intellectual Disabilities;
  • 1915(c) 0455 HCBS for Adults with Severe Disabling Mental Illness (SDMI);
  • 1915(c) 0148 HCBS Big Sky Waiver for Elderly and Individuals with Physical Disabilities;
  • 1915(c) 05.R02 HCBS Montana Bridge Waiver for Youth with Serious Emotional Disturbance (SED); and
  • 1915(i) HCBS State Plan Program for Youth with Serious Emotional Disturbance (SED).

The state must submit a plan detailing actions to achieve compliance with the setting requirements. A 30-day public notice and comment period is required for the proposed transition plan. 
The state’s transition plan will be developed with stakeholder input to include public comment. This public notice, the transition plan, transition planning activities and other related information for participating in and submitting comment is posted on the DPHHS website at: http://dphhs.mt.gov/hcbs. Written comments can be submitted from October 10, 2014, to November 10, 2014.
The state, upon request, will make available hard copies of the transition plan to any participant or applicant to the waivers. In addition to the schedule of other comment submission options, an opportunity for public comment will be held at a public meeting on October 28, 2014, 9:00 a.m. to noon, at the DPHHS Auditorium, 111 N. Sanders Street, Helena, Montana. Individuals who need assistance to participate during this meeting should call 406-444-2584. The public meeting can also be accessed via webinar. The link is: 
The call in number and access code are:
Toll free # is 1-877-668-4490
Access code: 579 271 849

Comments and other input on this proposed plan should be submitted by November 10, 2014, by phone at (406) 444-2584; email at MKulawik@mt.gov with “Transition Plan” in the subject line; or via mail to:

Mary Eve Kulawik,
Department of Public Health & Human Services
111 N. Sanders St., Room 301
PO Box 4210
Helena, MT 59620