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Message from DMS Re: Heightened Scrutiny

Dear Provider Associations-
Thank you for your support of providers as heightened scrutiny site visits have occurred over the last few months. As the Cabinet for Health and Family Services (CHFS) moves through the process of coming into compliance with the Home and Community Based Services (HCBS) Final Rules, the federal Centers for Medicare and Medicaid Services (CMS) continue to provide guidance on what it means to be presumed not to be home and-community based (Category 4). After additional conversations with CMS, we have determined that approximately 20 providers and 100 settings are no longer Category 4, presumed not to be home and community-based.  We started notifying these providers of this change on Friday, October 14th.
This means that these settings are not required to be submitted to CMS for heightened scrutiny to overcome the presumption that they are not home and community based.
Please Note: If providers are unsure of the status of their settings, they should send their questions to
At this point in the process, no further action is required by providers for the settings that are no longer Category 4. As you are aware, even though a setting does not require heightened scrutiny, the setting still needs to come into compliance with the other HCBS Final Rules (Autonomy, Choice, Integration, Locks, etc.) in accordance with Kentucky regulations. We will be in contact with impacted providers in the coming months about these settings to ensure that all settings are working to achieve full compliance with the HCBS Final Rules.
Thank you,
Note from Shannon* – If you are unsure of your category, email, copy and me.  

Shannon McCracken is a leader when it comes to supporting the needs of people with developmental and intellectual disabilities. After a decade of experience at the two largest SCL agencies in Kentucky, she made the decision to embrace a new opportunity and start her own company, Commonwealth Case Management. While in the field, Shannon has won numerous national awards and served in multiple leadership positions, most recently with the Kentucky Association of Private Providers (KAPP). From November 2009 - 2012, she served as the Vice-President of Public Policy for the KAPP Board of Directors and served as President from 2012-2015. In 2016, KAPP made a significant investment in its future and offered Shannon a full-time position as the State Executive Director. Being so involved has enabled Shannon to stay at the leading edge and have a great understanding of what it takes to support people with disabilities.

Shannon is a graduate of Western Kentucky University...wife to Tony, mom to Davis (19) & Caroline (17.)

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