ADDP NEW BANNER 2011
Families Express Unease with CMS Transition Plan

ADDP CMS Comments and Recommendations

 

In written testimony submitted to Mass Health and DDS, ADDP has expressed the following concerns:
  •  The criteria for DDS to determine compliance may not reflect the full range of options as allowable under the CMS rules;
  • There is insufficient time for providers to adequately develop a compliance plan;
  • The process under which compliance will be determined is unclear and needs to be clarified so that (a) providers have a reasonable opportunity to implement their compliance plans by March 2019, CMS' deadline for compliance and (b) other exigencies are addressed.

ADDP believes CMS allows qualification of a community setting based on outcomes, if the setting and the participants' aggregate experience:

  • supports enhanced and predominate access to the greater community;
  • is selected by the individual from setting options;
  • ensures privacy dignity, respect and freedom from coercion and restraint, and
  • provides individual choice regarding services and supports.
Thus ADDP requests future DDS/Provider engagement on the CMS regulations include specific and transparent criteria that the department will use in determining compliance with the HCBS Community Rule.

 

 

For more information contact:

Tara Hopper Zeltner

ADDP Director of Government Affairs and Attorney

tarazeltner@addp.org 
Employment Blueprint Progress Report Released
 
 

In November 2013, "Blueprint for Success: Employing Individuals with 

Intellectual Disabilities in 
Massachusetts was released. The 
Blueprint served as a mutual plan 
developed by representatives
from ADDP, The Arc of Massachusetts, and Massachusetts Department of 
Developmental Services (DDS) to increase integrated employment 
opportunities for adults with intellectual 
disabilities (ID) served by DDS.

 

Over the past year, the Employment Work Group and others have worked together to implement the plan. The newly released progress report provides an update on efforts made to expand integrate 

employment in Massachusetts 

since the plan detailed in "Blueprint for 

Success" was released in November 

2013. 

 
Several accomplishments have been 
made since release of "Blueprint for 
Success," such as 19 family and five 
self-advocate forums were hosted to 
provide information about the Blueprint 
and respond to questions and concerns of individuals and families. 
In addition, 19 provider agencies have received technical assistance services 
to assist in efforts to increase 
integrated employment outcomes 
and to assist in the transformation 
process. Numerous trainings have also been provided. 
 

 
Families Ask Community Transition Plan Be Outcome Based

 

Numerous families, self advocates and providers urged Mass Health and DDS officials to move cautiously in implementing new Medicaid federal regulations that seek to define community in a more inclusive and consistent manner in order to have programs qualify for Home and Community Based Waiver Funding.

Specific new federal guidelines call upon all HCBS funded programs to:
  • include full access to the greater community
  • provide choice within the context appropriate for the individual
  • ensure the protection of privacy, dignity and freedom from coercion or restraints
  • optimization of autonomy & independence

Additionally all residential programs, including state operated properties, are expected to comply with the following no later than March 16, 2019:

  • lease agreements for residents
  • lockable bedroom doors and privacy for residents, unless proven clinically inappropriate
  • choice in determination of roommates
  • the ability to have visitors
  • a physically accessible setting if needed by the resident

DDS has said that exceptions to these regulations would be subject to the individual's ISP.  

 

Individuals testifying at the public hearing on Thursday, November 6, 2015, at Mass Bay Community College, expressed fear the new regulations may eliminate all congregate home sites, close residential settings with over 5 individuals or eliminate behavioral controls needed for some individuals.  Some worried that there loved ones might go without service and be homeless, though the DDS and Mass Health have stated on multiple occasions that no individual will lose service as programs work over the next five years to come into compliance with the federal CMS regulation.

 

 In prior briefings with ADDP and other stakeholder groups, DDS had sought to clarify that it is not the intent of DDS to close all residential settings with over five people.    

 

DDS estimates that 7,406 individuals are in private provider residential programs that are already deemed in compliance with the CMS regulations (or will be with minimal adjustments); and that 199 are in 14 various provider programs that DDS has suggested must make more substantive changes to their program design. 

 

The degree of change expected by these 14 programs impacting 199 individuals is the source of much consternation and anxiety.

Last night conferees, such as Gail Brown, CEO of New England Village in Pembroke, requested that the state's transition plan be revised to reflect an aggregate outcome based approach that focuses more on the totality of the individual's inclusive life, rather than the location or configuration of their residence.

ADDP President & CEO Gary Blumenthal, called upon Mass Health and DDS to not pre-judge the intention of CMS on the 14 at risk sites and work collaboratively with providers to develop a transparent and clear articulation of the standards that will be used to demonstrate adherence to the new federal regulations.

At risk for the State, should these programs not comply would be approximately $10 million in federal matching funds.