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Notice #: 0000949795-01
Public Notices



In accordance with the public notice requirement of Title 42, Section 441.304 of the Code of Federal Regulations, the State of Hawaii, Department of Human Services and Department of Health (the State), hereby notifies the public that it intends to request from the Centers for Medicare & Medicaid Services (CMS), an amendment to the Home and Community Based Services (HCBS) Waiver for Individuals with Intellectual and Developmental Disabilities (I/DD Waiver) authorized in Section 1915(c) of the Social Security Act.


The purpose of this posting is to provide public notice and elicit public input regarding proposed amendments to its current 1915(c) HCBS I/DD Waiver that serves individuals with developmental disabilities or intellectual disabilities who meet institutional level of care, and provided the choice to live in their own home or in the community with appropriate and quality supports designed to promote health, safety and independence.


The State proposes to amend the 1915(c) HCBS I/DD Waiver as follows:
1. Expand services to include:
a. Community Learning Services (CLS) are designed to enable individuals to explore and engage in chosen community activities and social valued roles;
b. Additional Residential Supports will provide short-term staff support when an individual experiences complex medical or behavioral challenges that require an additional staff in a licensed Developmental Disabilities Domiciliary Home (DD Dom), Adult Residential Care Home or Expanded Adult Residential Care Home (E-ARCH) or certified Adult Foster Home (AFH) to meet the individual’s needs and to support the individual’s continued stay in their home;
c. Supports Broker is available for individuals and their families considering Consumer Direction or currently using Consumer Directed arrangements;
d. Elimination of certain limitation for Environmental Accessibility Adaptations and Vehicular Modifications;
e. Additional provider types that are permitted to provide Training and Consultation services;
f. Under Waiver Emergency Services, Crisis Mobile Outreach services will be provided to individuals of any age while the Out-of-Home Stabilization (Crisis Shelter) is provided to adults 18 years and older; and
g. Add Budget Authority to Consumer Direction.

2. Revise and establish payment rates and related items to include:
a. New rate methodology based on the completion of a rate study;
b. A new fifteen (15) minute code for Adult Day Health (ADH); and
c. Elimination of the daily respite code and replace with a fifteen (15) minute code for all respite services.

3. Revise or establish the assessment process for the following services:
a. Environmental Accessibility Adaptations;
b. Vehicular Modifications; and
c. Supports Intensity Scale to be used as part of the person-centered planning process.

4. Establish service limits:
a. Respite Service limited to 760 hours annually with a process for case-by-case review and authorization for requests beyond the limit.

5. Housekeeping changes:
a. Replace the term “Crisis Shelter” with “Out-of Home Stabilization” under Waiver Emergency Services for clarification purposes;
b. Expand the eligibility criteria to include criteria for children age zero (0) to nine (9) years;
c. Clarify limitations for Discovery and Career Planning; and
d. Clarify limitations for Residential Habilitation.


As required by 42 C.F.R. 441.304, the State must establish and use a public input process for any changes in services or operation of the waiver. The opportunity for public comment shall be held open for a minimum of 30 days prior to implementation of the proposed change or submission of the proposed change to CMS, whichever comes first.

Comments will be accepted for consideration from the date when this notice is published through February 3, 2017. Individuals may submit written comments using the following methods:

By email: (Please identify in the subject line: Waiver Amendment)

By mail:

Department of Health
Developmental Disabilities Division
Attention: Community Resources Branch
3627 Kilauea Avenue, Room 411
Honolulu, Hawaii 96816

The 1915(c) HCBS I/DD Waiver amendment is available online at: under News and Events and A copy of the 1915(c) HCBS I/DD Waiver will be available for public viewing at the offices listed below from the first working day that this notice appears in the Honolulu Star Advertiser, Hawaii Tribune Herald, West Hawaii Today, The Maui News, and The Garden Island for a period of at least thirty (30) calendar days after the publication of this notice, from Monday – Friday, exclusive of state holidays, between the hours of 9:00 a.m. to 2:00 p.m.

Department of Human Services Department of Human Services
Med-QUEST Division Eligibility Office – Oahu Section
601 Kamokila Boulevard, Room 506A 801 Dillingham Boulevard, 3rd Floor
Kapolei, Hawaii 96707 Honolulu, Hawaii 96817

Department of Health Department of Human Services
Developmental Disabilities Division Eligibility Office – East Hawaii Section
1250 Punchbowl Street, Room 463 1404 Kilauea Avenue
Honolulu, Hawaii 96813 (586-5842) Hilo, Hawaii 96720 (933-0339)

Department of Human Services Department of Human Services
Eligibility Office – West Hawaii Section Eligibility Office – Kauai Section
75-5591 Palani Road, Suite 3004 4473 Pahee Street, Suite A
Kailua-Kona, Hawaii 96740 (327-4970) Lihue, Hawaii 96766 (241-3575)

Department of Human Services Department of Human Services
Eligibility Office – Lanai Unit Eligibility Office – Maui Section
730 Lanai Avenue 210 Imi Kala Street, Suite 101
Lanai City, Hawaii 96763 (565-7102) Wailuku, Hawaii 96739 (243-5780)

Department of Human Services Department of Health
Eligibility Office – Molokai Unit DDD-Community Resources Branch
65 Makaena Place, Room 110 3627 Kilauea Avenue, Room 411
Kaunakakai, Hawaii 96748 (553-1758) Honolulu, Hawaii 96816 (733-2135)

Special accommodations (i.e., interpreter, large print or taped materials) will be arranged if requested no later than seven (7) working days before the comment period ends. Neighbor island residents requesting special accommodations should contact the appropriate Med-QUEST Division offices on the respective neighbor islands listed above.

(TGI949795 1/3/17)~