Transition Plan - New York State Department of Health
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1915(k) authorities and understand that CMS does intend to apply the rule to 1115 demonstration
waivers upon renewal or amendment through negotiation of the terms and conditions of approval.
Most individuals receiving services through these waivers are living in their own homes or those of
family members, certain group homes or other adult care facilities where they enjoy the qualitative
benefits of receiving services in the community as opposed to in an institution. However, there are
individuals who live in congregate housing, adult care facilities and supportive housing where their
autonomy, independence and community integration may be less apparent, including children and
youth where their rights are delegated to their parents or guardians. New York has affirmed its
commitment to serving individuals with disabilities in the least restrictive environment under Governor
Andrew Cuomo’s leadership. In 2012, the Governor introduced legislation to establish the Justice
Center to ensure protection against abuse and neglect of individuals with special needs. The Justice
Center became operational in 2013. Also in 2012, he convened the Olmstead Development and
Implementation Cabinet, which met with over 160 stakeholder groups and reviewed over 100 position
papers before releasing its report in October 2013 laying out recommendations for New York
policymakers to continue efforts to ensure that individuals with disabilities are provided the services and
supports they need that reflect their choice and support their goals to live an independent and fully
integrated life in the community.
Consistent with these efforts, New York State convened an interagency workgroup in 2014 to address
how best to comply with the requirements of the new settings rule. The group met a number of times
to ensure that a cohesive statewide transition plan was developed to address the unique needs of
individuals across a wide variety of community-based settings. The interagency workgroup includes
representatives from the Executive Chamber, DOH, OMH, OPWDD, OCFS, and OASAS. Four meetings
were held between January and June to develop the transition plan that follows.
New York State’s Statewide Transition Plan for Community Based Settings
42 CFR §441.530 requires that all settings in which individuals receiving Medicaid-funded home and
community based services live must have the following characteristics and qualities:
(i) The setting is integrated in and supports full access of individuals receiving Medicaid HCBS to the
greater community, including opportunities to seek employment and work in competitive integrated
settings, engage in community life, control personal resources, and receive services in the community,
to the same degree of access as individuals not receiving Medicaid HCBS.
(ii) The setting is selected by the individual from among setting options, including non-disability specific
settings and an option for a private unit in a residential setting. The setting options are identified and
documented in the person-centered service plan and are based on the individual's needs, preferences,
and, for residential settings, resources available for room and board.
(iii) Ensures an individual's rights of privacy, dignity and respect, and freedom from coercion and
restraint.
(iv) Optimizes but does not regiment individual initiative, autonomy, and independence in making life
choices, including but not limited to, daily activities, physical environment, and with whom to interact.
(v) Facilitates individual choice regarding services and supports, and who provides them.
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