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Revised Statewide Transition Plan
Home and Community Based Services Settings Requirements

Pursuant to 42 C.F.R. §441.301(c)(6)(iii), notice is hereby given that the New Hampshire Department of Health and Human Services intends to submit a revised Statewide Transition Plan to the Centers for Medicare and Medicaid Services (CMS) to detail its assessment and remediation plan for ensuring that New Hampshire’s Medicaid-funded Home and Community-Based Services (HCBS) are provided in settings whose qualities meet new federal requirements at 42 C.F.R. §441.301(c)(4), which became effective March 17, 2014. All states are required to develop a plan to show how they will establish compliance with the new regulations.

Summary of Updated Draft Statewide Transition Plan
The regulations do not specifically define HCBS settings; rather they describe the required qualities of Medicaid-funded HCBS settings. The regulations require that the “community-like” settings be defined by the nature and quality of the experiences of the individual receiving services and applies to both residential and day services settings.

The purpose of these regulations is to ensure that HCBS recipients are able to live in and have opportunities to access their community as well as to receive services in the most integrated settings. This includes opportunities to seek employment and work in competitive settings, engage in community life, control personal resources, and participate in the community just as people who live in the community, but who do not receive HCBS, do.

New Hampshire has revised its Statewide Transition Plan (STP) based on CMS feedback, to show how it will establish compliance with these new regulations. An executive summary within the STP explains the revisions made to the document.

Got to the Statewide Transition Plan web page to review a copy of the revised draft plan.

Hard copies of the Statewide Transition Plan can be picked-up at:

  • NH Department of Health and Human Services
    105 Pleasant Street, Main Building
    Concord, NH 03301-3857

To learn more about home and community based care settings requirements, please visit the CMS website.

Opportunity for Public Input
Public comments may be submitted until midnight on Friday, February 1, 2019.

Comments may be submitted by email to or by regular mail to:

  • Maureen DiTomaso
    NH Department of Health and Human Services
    105 Pleasant Street, Main Building
    Concord, NH 03301-3857

Response to Public Input
The summary of public comments, including the full array of comments whether in agreement or not with the state’s determination of the system-wide compliance and/or compliance of specific settings/types of settings; a summary of modifications to the Statewide Transition Plan made in response to public comment; and in cases where the state’s determination differs from public comment, the additional evidence and rationale the state used to confirm the determination will be found in Attachment D in the Appendix at the completion of the public comment period.

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New Hampshire Department of Health and Human Services
129 Pleasant Street | Concord, NH | 03301-3852

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