BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Home and Community Based Settings Requirements (Section 501.1)

What this rule requires your agency to do

• 1When a setting no longer meets the Integrated Settings Rule standards, the case manager must engage the member to develop a remediation plan within 30 days of discovery, the member has 30 additional days to complete it, and the case manager has an additional 30 days to visit and verify completion (§501.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Home and Community Based Settings Requirements (Section 501.1))
• 2The agency must notify BMS within 15 days of any change in the status of settings it owns, leases, or operates, and when a new setting is added BMS or its designee must review the site for compliance before any HCBS services may be billed (§501.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Home and Community Based Settings Requirements (Section 501.1))
• 3All HCBS settings must be integrated in and support full access to the greater community, be selected by the member, ensure privacy, dignity, respect, and freedom from coercion and restraint, optimize autonomy, and facilitate member choice of services and providers (§501.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Home and Community Based Settings Requirements (Section 501.1))
• 4All provider-controlled settings and members receiving services there must be evaluated at least annually by BMS or its designee, up to 90 days prior to the annual anchor date, against the listed provider-controlled setting standards (§501.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Home and Community Based Settings Requirements (Section 501.1))
• 5The member's case manager must assess member-controlled settings annually, up to 90 days prior to the member's anchor date, against the 42 CFR 441.301(c)(4) settings standards (§501.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Home and Community Based Settings Requirements (Section 501.1))
• 6The case manager must complete mandatory STP training prior to completing member-controlled assessments, and personal attendant staff must also receive mandatory STP training; if brochure-based, the agency must develop competency-based training and testing with the paid caregiver passing at 80% (§501.1).(BMS Provider Manual, Chapter 501 Aged and Disabled Waiver (ADW) — Home and Community Based Settings Requirements (Section 501.1))