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Waivers

Waiver programs help people who are elderly or have disabilities and need help to live in their home or community instead of an institution such as a nursing home or ICF-MR. Each program offers several "core" services:

  • service coordination (help with managing care needs and services)
  • personal support (assistance with daily living activities, i.e. bathing, dressing, meals and housekeeping)
  • home health services (nursing, home health aide, and occupational, physical and speech therapy)
  • emergency response systems
  • respite care (caregiver relief)

Additional services are available under each program. The following is a list of waiver programs in Georgia.


HCBS Transition Plan

Georgia begins process to address new regulations issued by CMS for Home and Community Based Services

The Centers for Medicare & Medicaid Services (CMS) have issued regulations that define the settings in which it is permissible for states to pay for Medicaid Home and Community-Based Services (HCBS), otherwise known as waiver services. The purpose of these new regulations is to ensure that individuals receive Medicaid HCBS in settings that are integrated and that support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services in the community to the same degree as individuals who do not receive HCBS.

Please see the HCBS Settings Rule and Transition Plan Fact Sheet for more information.

For more details about the requirements of the new regulation, please see this Issue Brief on the Final Rule by the Association of University Centers on Disabilities.

Georgia has begun to look at how our waivers may need to be modified to comply with the new regulations. The process for how we plan to review waiver policies and service settings must be outlined in a written Transition Plan. A waiver-specific transition plan is required to be submitted to CMS with each amendment request. Georgia is planning to submit amendments for the Elderly & Disabled Waiver, New Options Waiver, Comprehensive Supports Waiver and the Independent CareWwaiver Program. Before submitting to CMS, stakeholder comment must be gathered to assure the public has had an opportunity to inform the Transition Plan.

In addition, once the first waiver amendment is submitted, Georgia has 120 days to complete a Statewide Comprehensive Transition Plan to address all waivers regardless of whether an amendment was submitted or not.

In each of the waiver amendments to be submitted by the end of August 2014, a waiver-specific transiton plan will be submitted with it outlining high level planning needed to ensure compliance with the new HCBS rules. Department staff, with operating agency stakeholder input, has developed a draft Transition Plan for each waiver population which is available for public comment before the plan is finalized for submission with each waiver amendment:

The official Public Notices supporting these activities are available for viewing, as well.

We invite the public to make comment.

There are several ways to submit comment:

  1. Comments may be submitted using the survey available at this link
  2. Public Comment may be orally provided at a public hearing at the DCH Offices, 2 Peachtree St., NW, 5th Floor, Atlanta, GA 30303. See Public Notice for details.
  3. Written Comments may be mailed per the instructions on Public Notice.
  4. Comments may be submitted to this email address: HCBSTransition@dch.ga.gov

Periodic updates will be made to this website as the Department of Community Health (DCH) and its partner agencies work to ensure compliance with the regulations for each waiver and for the required Statewide Transition Plan.  Please save this page address as your link to the most current information on this process.

Overview of Regulations HCBS -- The Basics -- Posted 08/27/14

Statewide Transition Plan

As described above, DCH has submitted four Transition Plans to CMS, required under the HCBS Rule which requires a waiver-specific transition plan to be submitted with each waiver amendment a state submits. Georgia needed to submit four waiver amendments to increase certain rates and add slots as well as make other changes per legislative appropriations and implementation of the state’s Balancing Incentive Program grant. DCH is still awaiting written approval of the Elderly and Disabled plan which was the first waiver/transition plan to be submitted to CMS.

The HCBS Rule also requires development of a Statewide Transition Plan to be submitted 120 days from the time that the first waiver transition plan was submitted. This places the due date for this plan on December 15, 2014.  DCH has transferred the waiver-specific transition plans to a statewide, cross-waivers comprehensive transition plan. The Statewide Transition Plan requires a minimum of 30 days public input.

To achieve public input, DCH will hold four face-to-face meetings. The locations are Marietta, Athens, Fayetteville and Macon. We will also hold three virtual meetings the second and third week of November here at DCH. Flyers for each set of public forums are posted to the DCH waiver page website (www.dch.georgia.gov/waivers) and have been distributed to all stakeholders. DCH is also planning to use an automated phone-calling service to conduct a conference call to review the plan with waiver recipients who are not able to attend the face-to-face or virtual meetings.

This is the presentation used at the public "Focused Workgroup" meetings.

Summary

The goal of the Statewide Transition Plan is to establish the steps that will be required for all waiver services and supporting infrastructures and policies to come into compliance with the HCBS Settings Rule. The Statewide Transition Plan has four major sections:

  1. Identification – describes how the state will identify all the HCBS settings, policies, standards, etc., that will need to be assessed
  2. Assessment –  describes how the assessment will be performed
  3. Remediation – if the assessment results in findings that indicate a setting, policy, standard, etc., that does not conform to the new HCBS rule, the remediation section will describe how that discrepancy will be corrected.
  4. Outreach and Engagement – describes who will be included and how they will be included in the development and implementation of the Transition Plan

Please see the draft Statewide Transition Plan for your review and feedback. 

Statewide Transition Plan - FINAL Draft -- Updated 11/04/14

Statewide Transition Plan -- Revised per Public Comment -- Posted 12/16/14

GEORGIA PUBLIC NOTICE - HCBS Settings Statewide Transition Plan -- Posted 10/31/14

FACT SHEET-- HCBS Settings Rule and Transition Plan -- Posted 11/04/14

Assessment Tools for Surveying Providers and Individuals


Per the CMS Rule regarding Transition Planning, the state has summarized comments received through public comment. At this link, you will find the summary and state’s response regarding impact to the Transition Plan. The same summary is applicable to the initial Transition Plans submitted with each waiver amendment. 

Posted 07/02/14 - Updated 10/24/14