On June 2, 2017, CMS granted South Dakota initial approval of its Statewide Transition Plan (STP) to bring settings into compliance with the federal home and community-based services (HCBS) regulations. The state submitted its draft plan in April 2016, making subsequent changes following a public comment period, stakeholder feedback and CMS technical corrections.

The state needs to complete the following remaining steps in order to:

  • Complete comprehensive site-specific assessments of all home and community-based settings, implement necessary strategies for validating the assessment results, and include the outcomes of these activities within the STP
  • Draft remediation strategies and a corresponding timeline that will resolve issues that the site-specific settings assessment process and subsequent validation strategies identified by the end of the home and community-based settings rule transition period
  • Outline a detailed plan for identifying settings that are presumed to have institutional characteristics, including qualities that isolate HCBS beneficiaries, as well as the proposed process for evaluating these settings and preparing for submission to CMS for review under Heightened Scrutiny
  • Develop a process for communicating with beneficiaries that are currently receiving services in settings that the state has determined cannot or will not come into compliance with the home and community-based settings criteria by March 17, 2022
  • Establish ongoing monitoring and quality assurance processes that will ensure all settings providing HCBS continue to remain fully compliant with the rule in the future

Final approval won’t be granted until these steps are completed and CMS believes all issues are resolved. Prior to submitting an updated version of the plan for final approval, the state is required to provide a minimum 30-day public comment period.

More information on the HCBS Settings Final Rule can be found here: http://sdaho.org/2017/02/23/hcbs-settings-rule/