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COVID-19 Emergency Declaration Blanket Waivers for ICFs/IID

Dana Ritchie 

Today, CMS released additional blanket waivers to the healthcare community in order to provide the flexibilities needed to take care of patients during this public health emergency. Staffing and training modifications in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID) were included in this release. More waivers are yet to come down the way for ICF/IID providers.  A summary can be found below of what flexibilities are being provided for these providers in the release from CMS today. 

• Staffing Flexibilities. CMS is waiving the requirements at 42 CFR §483.430(c)(4), which requires the facility to provide sufficient Direct Support Staff (DSS) so that Direct Care Staff (DCS) are not required to perform support services that interfere with direct client care.
• Suspension of Community Outings. CMS is waiving the requirements at 42 CFR §483.420(a)(11) which requires clients have the opportunity to participate in social, religious, and community group activities.
• Suspend Mandatory Training Requirements. CMS is waiving, in-part, the requirements at 42 CFR §483.430(e)(1) related to routine staff training programs unrelated to the public health emergency.  CMS is not waiving 42 CFR §483.430(e)(2)-(4) which requires focusing on the clients’ developmental, behavioral and health needs and being able to demonstrate skills related to interventions for inappropriate behavior and implementing individual plans.
• Modification of Adult Training Programs and Active Treatment. CMS recognizes that during the public health emergency, active treatment will need to be modified. The requirements at 42 CFR §483.440(a)(1) require that each client must receive a continuous active treatment program, which includes consistent implementation of a program of specialized and generic training, treatment, health services and related services. CMS is waiving those components of beneficiaries’ active treatment programs and training that would violate current state and local requirements for social distancing, staying at home, and traveling for essential services only.

The full overview of the waivers CMS released today can be found here. 

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