Transition Plans

In response to the new federal rules, the Texas Department of Aging and Disability Services has developed draft transition plans for all of its Medicaid waivers.

Medicaid Waiver Draft Plans

Community Based Alternatives

People receiving CBA services from DADS were transferred to the Texas Health and Human Services Commission (HHSC) STAR+PLUS waiver program on Sept. 1, 2014.

To ensure compliance with the new federal rules, HHSC has:

  • Released public notice of the CBA settings transition plan as part of the Texas Healthcare Transformation and Quality Improvement Program 1115 demonstration waiver transition plan, pending guidance from CMS.
  • Received public input on the transition plan.
  • Reviewed and included appropriate revisions to the CBA transition plan based on public input and submitted the settings transition plan in the waiver amendment.

Written comments on transition or remediation activities, as well as questions, can be sent via email to CBA@dads.state.tx.us.

Community Living Assistance and Support Services

The CLASS transition plan identified 2 services provided outside of a person's home as well as non-residential services, such as prevocational and employment services, which are subject to the new regulations.

The CLASS transition plan below outlines the steps DADS will take to ensure these services comply with federal regulations. Public comments or questions about the CLASS transition plan can be sent via email to class@dads.state.tx.us.

CLASS Settings Transition Plan: High Level Timeline

Click here to view the transition plan in PDF.

Assessment and Public Input
Action Items Proposed Initiation Proposed Completion

Conduct assessment of settings in the CLASS waiver to ensure compliance with new HCBS rules:

CLASS offers two services outside an individual's home: Support Family Services (SFS) and Continued Family Services (CFS). Both are offered in a Department of Family and Protective Services (DFPS) licensed or Child Placing Agency verified foster home or provided by a home and community support services agency.

Explore DFPS licensure rules, CLASS Program rules and DADS Chapter 49 contracting rules to determine support for new HCBS requirements.

March 2014

June 2014

Develop high level settings transition plan with timeline for remediation of any CLASS settings.

June 2014

June 2014

Release public notice for review of CLASS settings transition plan.

July 2014

July 2014

Period for public input on assessment and transition plan.

July 2014

August 2014

Review and include appropriate revisions to the CLASS settings transition plan based on public input and submit settings transition plan in waiver renewal.

August 2014

August 2014

Remediation Activities
Action Items Proposed Initiation Proposed Completion

Amend CLASS program rules and Chapter 49 contracting rules governing SFS and CFS to ensure the services comply with the new HCBS guidelines.

November 2014

November 2015

Revise the CLASS manual to further outline HCBS requirements for SFS and CFS.

April 2015

November 2015

Deliver educational webinars for CLASS providers about new HCBS guidelines.

November 2014

January 2015

Develop a new contract monitoring tool for SFS and CFS services and incorporate HCBS setting requirements.

June 2015

November 2015

Submit CLASS amendment updating the settings transition plan.

November 2015

November 2015

Home and Community-based Services

The draft transition plan identifies HCS services provided outside of an individual's home as well as non-residential services, such as employment and day habilitation, that are subject to the new regulations. Public comments or questions about the HCS transition can be sent via email to HCS@dads.state.tx.us.

HCS Settings Transition Plan: High Level Timeline

Click here to view the transition plan in PDF.

Assessment and Public Input
Action Items Proposed Initiation Proposed Completion

Conduct assessment of settings in the HCS waiver to ensure compliance with new HCBS rules:

HCS offers several services outside an individual's home: Residential Support Services, Supervised Living and Host Home/Companion Care Services. All services are provided by the HCS provider or under contract with a host home/companion care provider.

Explore HCS principles in rule to determine support for new HCBS requirements.

HCS offers day habilitation and employment services. These services will be assessed as a part of the larger HCBS transition plan due in December 2014. The State is awaiting guidance from CMS regarding non-residential HCBS services.

March 2014

June 2014

Develop high level settings transition plan with timeline for remediation of any HCS settings.

June 2014

June 2014

Release public notice for review of HCS settings transition plan

July 2014

July 2014

Period for public input on assessment and transition plan.

July 2014

August 2014

Remediation Activities
Action Items Proposed Initiation Proposed Completion

Amend HCS rules governing residential services, employment services and day- habilitation to ensure the services comply with the new HCBS guidelines.

November 2014

May 2016

Revise the HCS manual to further outline HCBS requirements for residential services, employment services and day-habilitation.

June 2015

May 2016

Deliver educational webinars for HCS providers about new HCBS guidelines

January 2015

December 2015

Revise waiver survey process to incorporate HCBS setting requirements for residential services, employment services and day-habilitation.

June 2015

May 2016

Submit HCS amendment updating the settings transition plan.

June 2016

June 2016

Medically Dependent Children Program

In response to the new federal rules, DADS has developed a draft transition plan for the Medically Dependent Children Program (MDCP).

Public comments and questions about the transition plan can be submitted via email to MDCP@dads.state.tx.us.

MDCP Settings Transition Plan: High Level Timeline

Click here to view the transition plan in PDF.

Assessment and Public Input
Action Items Proposed Initiation Proposed Completion

Conduct assessment of settings in the MDCP waiver to ensure compliance with new HCBS rules:

MDCP offers non-residential services: flexible family supports and employment services.

Explore MDCP rules to determine support for new HCBS requirements.

March 2014

June 2014

Develop high level settings transition plan with timeline for remediation of any MDCP settings.

June 2014

July 2014

Release public notice for review of MDCP settings transition plan

July 2014

July 2014

Period for public input on settings assessment and transition plan

July 2014

August 2014

Revise MDCP settings transition plan based on public input and submit settings transition plan in waiver amendment.

August 2014

August 2014

Public input on larger HCBS settings transition plan which will include assessment of non- residential settings if additional CMS guidance is received.

October 2014

November 2014

Description of public input process, public comment and state responses to public comment and the larger HCBS transition plan will be completed.

November 2014

December 2014

Remediation Activities
Action Items Proposed Initiation Proposed Completion

Amend MDCP rules governing non-residential services: employment services and flexible family support to ensure the services comply with the new HCBS guidelines.

November 2014

November 2015

Revise the MDCP manual to further outline HCBS requirements for non-residential services.

April 2015

November 2015

Deliver educational webinars for MDCP providers about new HCBS guidelines

November 2014

January 2015

Revise contract monitoring process to incorporate HCBS setting requirements for non-residential services.

June 2015

November 2015

Submit MDCP amendment updating the settings transition plan.

November 2015

November 2015