Pursuant to 42 C.F.R. §441.301(c)(6)(iii), The Nebraska Department of Health and Human Services (DHHS) asked for feedback on the portion of its draft Statewide Transition Plan related to settings that completed the heightened scrutiny process and the process Nebraska DHHS followed in assessing compliance. The public comment period was April 1, 2022 to April 30, 2022.
For settings presumed to have institutional qualities, CMS requires an assessment process called “heightened scrutiny." Identified settings are required to undergo an additional review by state staff and may be included in a sample reviewed by CMS. Settings subject to heightened scrutiny include settings in a publicly or privately-operated facility providing inpatient institutional treatment; settings on the grounds of, or adjacent to, a public institution; or settings with the effect of isolating people receiving Medicaid home and community-based services from the broader community of people not receiving services.
Settings subjected to heightened scrutiny by DHHS were asked to complete a packet in order to determine compliance. Heightened scrutiny documentation will be sent to CMS when requested. CMS will make the final determination if the identified settings meet HCBS criteria.
Under CMS' definition of what constitutes heightened scrutiny, DHHS identified 66 assisted living facilities (ALFs), which required review. In January 2022, DHHS identified 12 remaining ALFs that met the definition of heightened scrutiny, which still needed to be reviewed in order to determine STP compliance. 11 of the 12 ALFs have already submitted their necessary documentation. As of March 31, 2022, 65 of 66 ALFs have been determined to be fully compliant. 1 ALF is continuing to work to come into compliance.
Pursuant to 42 C.F.R. §441.304(f), the Nebraska Department of Health and Human Services (DHHS) was required to give public notice related to the state's plan to amend the 1915(c) Home and Community Based (HCBS) Waivers for the Aged and Adults and Children with Disabilities Waiver (0187) and Traumatic Brain Injury Waiver (40199).