The State Transition Plan

Previously, what defined a setting as home and community based or as institutional was less clearly defined by the rules that regulate how and where services are provided to people with developmental disabilities.

In March 2014, the Centers for Medicare and Medicaid Services (CMS) implemented new regulations to ensure that people receiving services and supports through Medicaid HCBS programs are assured full access to community living. CMS also required all states to submit a transition plan describing the actions that will be taken to ensure compliance with the new regulations. After an extensive stakeholder process, Ohio Medicaid submitted a final HCBS transition plan that CMS initially approved in June of 2016.




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What the rule requires of waiver providers What the rule DOES NOT require
Providers are required to offer opportunities for all individuals served to get involved in their communities. This could include community employment and/or participating in community-based events/activities.All workshops and day programs will close.
Providers must offer opportunities that are meaningful to individuals and support their personal interests/outcomes.100% of all day program supports must be provided in fully integrated, community-based settings.
Providers must provide necessary services/supervision to maintain health and welfare, as identified in person-centered plans, while individuals are involved in community-based
events/activities.

All providers must provide community employment services.
What the rule means for people receiving waiver services What it DOES NOT mean for people receiving waiver services
People have greater opportunities to try new things.Everybody is required to work in community-based settings.
People are able to make informed choices, based on experiences, about community employment and what community-based activities/involvement they may enjoy.Individuals cannot spend time during the day with other people with developmental disabilities.
People may get involved in community employment and/or other community-based activities based on their interests and desired level of involvement.When not working in the community, no other day program options will be available.
People who do not want to receive waiver services in disability-specific settings, such as workshops, day programs, group homes, etc. cannot be made to do so.
People are required to spend a specific amount of time in or participate in a certain number of community-based activities each day/week/month.
Read An Overview of the Home and Community-Based Settings Regulation (DODD, March 2016)  for more.

Additional Resources
Home and Community-based Setting Requirements
October 2016
HCBS Waiver Standards and Residential and Adult Array Settings
​October 2016
State of Ohio Process for Submitting Heightened Scrutiny Request to CMS October 2016
Ohio's State Transition Plan, as approved by CMS October 2015
Previous draft of the plan and summary of changesMarch/October 2015
Letter of Initial Approval, CMS, Press ReleaseJune 2016
Overview of Home and Community-Based Settings RegulationMarch  2016
Home and Community-Based Settings EvaluationMarch  2016
Home and Community-Based Settings Remediation PlanOctober 2015


GM.pngSee all of DODD's memos about the Transition Plan

Timeline for Modified Waiver Services