These HCBS settings are required to meet the Centers for Medicare & Medicaid Services (CMS) regulation 42 C.F.R. §441.301(c)(4). The purpose of this public notice is to ensure Medicaid beneficiaries receiving HCBS in these settings meet the quality requirements specified in the final rule and are appropriately based on the needs of the individual as indicated in their person-centered service plan. The final rule provides the State the opportunity to evaluate settings through a heightened scrutiny process if the setting:

(i) “is located in a building that is also a publicly or privately operated facility that provides inpatient institutional treatment,”
(ii) is located “in a building on the grounds of, or immediately adjacent to, a public institution,” or
(iii) otherwise “has the effect of isolating individuals receiving Medicaid HCBS from the broader community of individuals not receiving Medicaid HCBS,”

The State identified 4 settings that required heightened scrutiny. The State determined that a setting overcame the institutional presumption by verifying that the setting met (or had an accepted plan of correction) for meeting each requirement of the HCBS Settings Final Rule. The State hereby notifies the public of the opportunity to comment on these settings. The HCBS Heightened Scrutiny Settings Summary (described below) includes the list of settings, summary of findings, and supporting evidence.

The State will hold a public forum to seek input as described in this notification. All interested parties are invited to join the public forum and to state their views regarding these settings.