Is there a deadline for when we should hear back with an email or letter on remediation determinations? Is there a date we should contact someone by if we do not hear anything?
The target date for completing desk reviews and notifying everyone is September 1, 2020. If you have not heard anything by then, you can email HCBS.Teams@wichita.edu or use the Live Chat feature on the Community Connections website.
There were two CPA trainings completed in June 2020 and it concludes planned general CPA remediation guidance trainings. KDADS and WSU will conduct upcoming learning collaboratives in late summer or early fall 2020. Please contact us through email or the Community Connection website to request additional training/guidance that you might need. KDADS will review requests and respond accordingly.
Many case managers have attended all if not most of the remediation trainings and other trainings/public forums by KDADS. A TCM specific meeting was scheduled to allow further discussion but was canceled due to COVID-19. KDADS is in the process of rescheduling this meeting. TCMs have signed up for emails and updates from KDADS and Community Connections to be notified.
Where can I go to have more information on the requirements of the HCBS Settings Final Rule? I feel that I need a refresher on what it is and what it involves.
The Community Connections website has information about the HCBS Settings Final Rule, including a bulleted list of settings requirements.
How many CPAs have received notification back on the assessment they submitted and how many need to submit policies for remediation?
KDADS is working through assessments in the order they were received. The CPA assessment was opened later than the general provider assessment. If you have not received anything in a few months, reach out to KDADS with an email. KDADS is working to process Provider self-assessments as fast as it can.
I completed two assessments, one as a CPA and one as a Children’s Residential Center. I was told my Children’s Residential assessment will be cancelled, is that correct?
That is correct. CPAs only need to complete one assessment for the agency. If there is a CPA that feels they need to complete more than one assessment based on the services they offer, please contact us through email or chat. If a CPA completed more than one assessment and thinks one needs to be removed, please contact us through email or chat for that as well.
Can you clarify for CPA agencies who provide children residential voluntary placements and use homes who are licensed with DCF whether or not we are going to take two assessments, and will both follow the training guidelines for CPA?
No, you would just need to do one CPA assessment for your agency.
Yes, KDADS sees this need coming, we will have the learning collaboratives later in the year. If you have additional training needs, please send those into the CHAT at Community Connections website because we look at that data which helps us define a need to change intended trainings or provide further guidance to help providers remediate.
One of the places I seem to get stuck, as a CPA we are contracted to look at the environment of the home. A lot of the reference being made is in case plans and PCSPs, we do not have the contract with DCF to do those and we are often uninvited to case plans and PCSP meetings. What accountability or expectation is there to get all of those to work together?
This really is going to apply for the children that are receiving waiver services, those children will have two different plans, a permanency plan for case management providers. For a child that is on an IDD waiver, they will have their person-centered service plan and those restrictions would be on that service plan. I think what we are looking at is that your policy is going to state this is how you are going to ensure that your home and settings will meet the final rule compliance. The PCSP will come into effect if there is a restriction that causes you to not meet final rule.
PCSPs and other plans do not have to impact the way the site is intended to run. If there is a measure to protect a person, it does not have to change the aim of policies intended for final rule. When policies are cited, the CPA can have a caveat that states PCSPs can impact this when there are restrictions.
Heightened Scrutiny FAQ
Does KDADS have to submit Heightened Scrutiny categories to CMS by July 1, 2020? How will this happen when KDADS has stated that initial reviews and validation might extend beyond this date?
Currently, the July 2020 date is flexible due to the mounting concerns of COVID 19. At this point, KDADS has identified all settings that have triggered heightened scrutiny based off assessment answers and is currently looking into a review method that satisfies CMS requirements, but also upholds provider and client safety. Those who have triggered heightened scrutiny will receive an email from KDADS as well as a remediation email.
KDADS has asked CMS if there is any potential that these dates and deadlines might change and there has not been a definitive response yet. The decision on timelines ultimately lies with CMS as it impacts all states. An extension to meet final rule compliance has been updated to 3/17/2023 as of July 2020.
The on-site assessment or equivalent is only planned for settings that are in Category 1 and/or 2 of heightened scrutiny. If a setting is not in Category 1 and/or 2 of heightened scrutiny, KDADS is not planning to do an on-site assessment. If an assessment is needed KDADS will contact the provider to schedule a site visit or other virtual activities.
If a setting has also triggered Category 3, then these questions can be remediated via the “remediation tab” at communityconnectionsks.org. Category 3 will only require a site visit if deemed necessary due to submitted evidence, lack of evidence or public response. Otherwise, Category 3 settings can make necessary remediation that will be presented to CMS if the state determines it does/can overcome heightened scrutiny presumptions. KDADS will contact the provider to schedule a site visit or other virtual activities.
If the provider self-identified these answers, it was flagged during the assessment. If it was found during validation and desk review that a setting might require heightened scrutiny attention, the provider will be contacted by the Heightened Scrutiny Director or Team to schedule an on-site visit for Category 1 and 2. KDADS has developed a color-code under the remediation tab to help identify what level of heightened scrutiny each setting might be under. Heightened scrutiny Categories 1 and 2 will be in red and heightened scrutiny 3 will be in orange. Categories 1 and 2 are more urgent than 3. There is a color legend to help providers decipher the remediation table.
No, Category 3 does not require an on-site. However, an on-site might be necessary by KDADS if evidence or lack of evidence and/or public comment initiates further review to ensure the setting complies with the Final Rule. Only those in heightened scrutiny Category 1 and/or 2 will require an on-site assessment. KDADS is asking those in Category 3 to remediate. Settings will only need an on-site if they are Category 1 or 2. If a setting has also triggered Category 3, then those questions can be remediated via the “remediation tab” at communityconnectionsks.org.
Would any heightened scrutiny on-site visits be before or after the remediation process? If we have an on-site visit is the remediation process still online?
Yes, the remediation process is all done online. The remediation process will be the same regardless of heightened scrutiny definition. It does need to be accomplished while heightened scrutiny is being addressed. Due to Covid-19 all site visits have been put on hold as KDADS works to develop strategies to accomplish on-site reviews.
For additional clarification, all settings flagged for heightened scrutiny must either already be complying or have established plans to comply with Final Settings Rule requirements. These plans will be uploaded to the remediation tab until completed. The state can submit heightened scrutiny packets to CMS prior to full implementation of plans. However, those plans must be implemented prior to the 3/17/2023 date.
There is one email stating initial validation has been completed and the second email is stating the review phase is completed and the setting is now in remediation. If a setting is triggered for heightened scrutiny the provider will also receive an additional email from KDADS.