FSSA Announcement – July 7, 2025
To ensure continued alignment among all DDRS HCBS Waivers in support of the ongoing BDS Waiver Re-set project the Division of Disability and Rehabilitative Services Bureau of Disabilities Services would like to announce a public comment opportunity for upcoming amendments to the Community Integration and Habilitation waiver, Family Supports waiver, Health and Wellness waiver and Traumatic Brain Injury waivers.
Public notice and comment occur prior to submitting amendments to the Centers for Medicare and Medicaid Services (CMS) and ensure that everyone can share thoughts, concerns, or questions about the proposed amendments. With a projected effective date of December 2025, the public comment period will be open beginning July 9 through August 8, 2025. Many of the changes and updates being implemented are the result of active stakeholder engagement and feedback the bureau has received from individuals, families and our Home and Community Based Services providers as well as working to build a sustainable system of services and support.
Waiver specific fact sheets with the proposed changes are currently posted on the BDS Waiver Reset webpage. The complete waiver amendments will be posted on July 9, 2025 to align with the public comment period. A separate announcement will be released on that date with instructions on where to submit public comments.
Highlights of the proposed amendments across all HCBS waivers include:
- Add Benefits Counseling Service
- Combine Home Modification and Home Modification Assessment Services
- Implement new self-direction options for select services
- Implement limit for services to a maximum of forty (40) hours per week per paid caregiver that may be provided by Relatives and Legal Guardians.
- Make technical changes to support alignment across multiple HCBS waivers operated and administered by the Division of Disability and Rehabilitative Services (DDRS)
CIH and FSW:
- Implement use of new ICF/IID LOC assessment tool
- Reconfigure Behavior Support Services, including the elimination of Intensive Behavioral Intervention service
- Implement new limits for Music Therapy service and Recreational Therapy service
- Discontinue Enrollment in Facility-Based Prevocational Services
- Add DSP Registry and Training Requirements required by state legislation
Health and Wellness:
- Add Extended Services
- Implement limit for services to a maximum of forty (40) hours per week per paid caregiver that may be provided by Relatives and Legal Guardians.
- Discontinue the Participant Directed Home Care Services (PDHCS) pilot and implement an updated model for select services
- Remove the Home Health Agency license requirement from Attendant Care, Home and Community Assistance, Integrated Health Care Coordination, Specialized Medical Equipment and Supplies, and Transportation
- Remove the Personal Service Agency license requirement from Integrated Health Care Coordination, Specialized Medical Equipment and Supplies, and Transportation
TBI:
- Revise Residential-Based Habilitation service to allow individuals living with housemates to use a shared staffing model
- Implement limit for services to a maximum of forty (40) hours per week per paid caregiver that may be provided by Relatives and Legal Guardians.
- Revise and rename Supported Employment services definition to align with Extended Services definition on other waivers operated and administered by the Division of Disability and Rehabilitative Services (DDRS)
- Remove the Home Health Agency license requirement from Attendant Care, Home and Community Assistance, Integrated Health Care Coordination, Specialized Medical Equipment and Supplies, and Transportation
- Remove the Personal Service Agency license requirement from Integrated Health Care Coordination, Specialized Medical Equipment and Supplies, and Transportation.
As required by Federal Law (42 CFR 441.304) there will be a 30-day notice for public comment to ensure timeliness.
Your comments are VALUABLE in developing and implementing waiver changes!