The Garden Island
Notice #: 0001055798-01
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 individual choice and control over waiver resources:
a. Phase-in Supports Budgets, enabling individuals 18 years and older to receive a prospective budget that reflects their support needs and empowers them to make decisions about how to use their budget to access the supports that best meet their unique circumstances.
b. Describe Supports Budgets are based on the individuals’ level of support needs and type of setting where the individual resides, as well as the island where the individual lives.
c. Specify services that are subject to the Supports Budget:
Adult Day Health
Community Learning Services – Group
Community Learning Services – Individual
Personal Assistance/Habilitation (not applicable for individuals living in licensed or certified settings)
Chore (not applicable for individuals living in licensed or certified settings)
Respite (only applicable for individuals living in a family home)
d. All other services may be authorized in addition to the limit established by the individual’s Supports Budget.

2. Expand services to include:
a. Private Duty Nursing (PDN) is a new service that provides nursing on an ongoing basis for those individuals with complex needs and who also participate in at least one habilitative waiver service;
b. Phase-out Skilled Nursing by June 30, 2019, with all individuals currently receiving Skilled Nursing transitioned to supports that best meet their needs;
c. Addition of repairs to service definition of Vehicular Modifications;
d. Additional provider types that are permitted to provide Respite services;
e. Additional language to Community Learning Services to describe how children and adolescents use the service and use of this service for supports at the individual’s job or volunteer site; and
f. Addition of Goods and Services to the responsibility of the Financial Management Services in Consumer Direction to purchase consumer-directed non-medical transportation services from vendors.

3. Revise and establish payment rates and related items to include:
a. New rate for Private Duty Nursing;
b. New rate for Respite provided by a Registered Nurse or Licensed Practical Nurse; and
c. Increase per trip rate for Non-Medical Transportation to $6.00.

4. Revise service limits:
a. Environmental Accessibility Adaptations exclusion of additional square footage is defined;
b. Add exception process to review requests for Adult Day Health and Community Learning Services – Group that exceed 1560 hours annually.

5. Housekeeping changes:
a. Clarify service definition for Adult Day Health;
b. Expand the eligibility criteria to include criteria for blind or disabled individuals under section 1634(c) of the Social Security Act; and
c. Clarify service definition for Assistive Technology.


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 2, 2018. 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.

(TGI1055798 12/15/17)