Heightened Scrutiny Settings

Overview

In accordance with federal rules set forth by the Centers for Medicare & Medicaid Services (CMS), the New York State Office for People With Developmental Disabilities (OPWDD) is required to publish for public comment a list of Heightened Scrutiny settings that deliver Home and Community-Based Services (HCBS). 

Strategies to Identify Settings

Heightened Scrutiny is a review of certain settings that, according to CMS, are presumed to be institutional in nature but do, in fact, demonstrate qualities of home and community-based settings. These settings overcome the presumption that the setting is institutional. OPWDD has completed on site reviews of OPWDD certified settings where HCBS are delivered and has identified those settings which require a Heightened Scrutiny review. OPWDD’s review process aligns with HCBS federal and state standards. The review process utilizes OPWDD protocols and tools which  incorporate the CMS “Exploratory Questions to Assist States in Assessment of Residential Settings” and “Exploratory Questions to Assist States in Assessment of Non-residential HCBS Settings”. The protocols and tools allowed OPWDD to determine the Heightened Scrutiny status and category of a setting. In addition, OPWDD used mapping technology to cross reference the location of settings with the results of the OPWDD site assessments to further determine the Heightened Scrutiny status of a setting.

More information can be found on the OPWDD HCBS Toolkit website: https://opwdd.ny.gov/providers/hcbs-settings-toolkit.

Strategies to Review Settings

OPWDD worked with the providers of settings requiring a Heightened Scrutiny review to achieve HCBS compliance or to develop a plan to achieve HCBS compliance. Using the OPWDD protocols and review tools, OPWDD was able to verify compliance with HCBS Settings standards or verify remediation that was required in order to meet HCBS Settings standards.  OPWDD provided training and guidance to providers on all aspects of HCBS Settings standards including person-centered supports and community integration. In addition, the New York State Department of Health offered extensive training on person-centered planning practices for all HCBS providers in New York State. Through the ongoing monitoring process using OPWDD protocols and review tools, OPWDD will ensure all settings that receive a Heightened Scrutiny review will remediate and comply with federal regulations by March 17, 2023. The ongoing monitoring process will also ensure continued compliance for settings already in compliance.

Heightened Scrutiny Categories of Settings

CMS has identified three categories of settings that are presumed to have qualities of an institution. The categories are described below as well as the number of settings in each category that have been identified by OPWDD as requiring a Heightened Scrutiny review.

Heightened Scrutiny Category Number of OPWDD Sites in Category
Category 1- Settings in this category are located in a building that is also a publicly or privately operated facility that provides inpatient institutional treatment. For settings in this category, there is a link to a summary for each setting that describes compliance, or any steps needed to achieve HCBS compliance by March 17, 2023. 2
Category 2 - Settings in this category are located in a building located on the grounds of, or immediately adjacent to, a public institution.  0
Category 3 - Settings in this category have the effect of isolating individuals receiving HCBS from the broader community of individuals not receiving HCBS. Category 3 has two lists—3A and 3B.:  
Category 3A - For settings in this category, there is a link to a summary for each setting that describes compliance, or any steps needed to achieve HCBS compliance by March 17, 2023.  5
Category 3B - Settings in this category achieved HCBS compliance on or before July 1, 2021, and do not require a summary. Information supporting remediation for settings in this category is available upon request. 70
Settings that will be unable to achieve HCBS compliance by March 17, 2023: 0
Total number of settings requiring Heightened Scrutiny in all categories: 77

Stakeholders may provide public comment on the Heightened Scrutiny settings. To view OPWDD’s summaries for Categories 1 and 3A, please click on the site name link. For individuals with limited online access or who require special accommodation, paper copies will also be available at OPWDD Regional Offices. Site addresses have been excluded to protect the federal privacy rights of individuals receiving services. Each site has the following label format: Name of Provider, City/Town, Provider Site Number.

To submit a public comment, please send it via one of the following options no later than May 27, 2022:

By email: [email protected]. Include the site label in the email subject line as follows: [Site Label] – Heightened Scrutiny Public Comment.

By mail: OPWDD, Division of Policy and Program Development, 44 Holland Ave., Albany, NY 12229.

OPWDD will consider all timely submitted public comments during its final review of the settings for HCBS compliance.

Process for Applying CMS Feedback on Specific Settings

Heightened Scrutiny summaries, including public comment and supporting evidence, may later be selected for review by CMS as a part of a random sample. OPWDD will use any feedback from the CMS random sample review to inform whether additional review and/or remediation of settings not included in the CMS review sample is necessary.

Heightened Scrutiny Evidence Summaries

Settings OPWDD has identified as requiring a Heightened Scrutiny review that are in HCBS compliance, or will come into HCBS compliance by March 17, 2023, are listed below by category.

Category 1

Settings in this category are located in a building that is also a publicly or privately operated facility that provides inpatient institutional treatment. For settings in this category, there is a link to a summary for each setting that describes compliance, or any steps needed to achieve HCBS compliance by March 17, 20.

Site Label
Finger Lakes DDSOO, Phelps, Site 1
Suffolk County NYSARC Inc., Shoreham, Site 1

Category 2

Settings in this category are located in a building located on the grounds of, or immediately adjacent to, a public institution. 

There are no OPWDD settings in this category.

Category 3

Presumptively Institutional Settings Due to Isolation- Settings that have the effect of isolating individuals receiving HCBS from the broader community of individuals not receiving HCBS. 

Category 3A

For settings in this category, there is a link to a summary for each setting that describes compliance, or any steps needed to achieve HCBS compliance by March 17, 2023. 

Site Label
ADAPT Community Network (DBA), Bronx, Site 1
ADAPT Community Network (DBA), Bronx, Site 2
Hillside Children's Center, Rochester, Site 1
Ontario County NYSARC, Inc., Canandaigua, Site 1
Oswego Industries, Fulton, Site 1

Category 3B

Settings in this category achieved HCBS compliance on or before July 1, 2021, and do not require a summary. 

Site Label
ASPIRE OF WESTERN NEW YORK, Buffalo, Site 1
BROOME DDSOO, Oneonta, Site 1
BROOME DDSOO, Endwell, Site 2
BROOME DDSOO, Ithaca, Site 3
BROOME DDSOO, Freeville, Site 4
BROOME DDSOO, Waverly, Site 5
CENTRAL NEW YORK DDSOO, E. Syracuse, Site 1
CENTRAL NEW YORK DDSOO, Rome, Site 2
CENTRAL NEW YORK DDSOO, Rome, Site 3
CENTRAL NEW YORK DDSOO, Rome, Site 4
CENTRAL NEW YORK DDSOO, Rome, Site 5
CENTRAL NEW YORK DDSOO, Rome, Site 6
CENTRAL NEW YORK DDSOO, Rome, Site 7
CENTRAL NEW YORK DDSOO, Rome, Site 8
CENTRAL NEW YORK DDSOO, Auburn, Site 9
FINGER LAKES DDSOO, Newark, Site 2
FINGER LAKES DDSOO, Newark, Site 3
FINGER LAKES DDSOO, Newark, Site 4
FINGER LAKES DDSOO, Newark, Site 5
FINGER LAKES DDSOO, Newark, Site 6
FINGER LAKES DDSOO, Newark, Site 7
FINGER LAKES DDSOO, Newark, Site 8
FINGER LAKES DDSOO, Newark, Site 9
FINGER LAKES DDSOO, Newark, Site 10
FINGER LAKES DDSOO, Newark, Site 11
FINGER LAKES DDSOO, Newark, Site 12
FINGER LAKES DDSOO, Newark, Site 13
FINGER LAKES DDSOO, Newark, Site 14
FINGER LAKES DDSOO, Newark, Site 15
FINGER LAKES DDSOO, Newark, Site 16
FINGER LAKES DDSOO, Perry, Site 17
HUDSON VALLEY DDSOO, White Plains, Site 1
HUDSON VALLEY DDSOO, White Plains, Site 2
HUDSON VALLEY DDSOO, White Plains, Site 3
LOCHLAND SCHOOL, INC., Geneva, Site 1
PATHFINDER VILLAGE, INC., Edmeston, Site 1
PATHFINDER VILLAGE, INC., Edmeston, Site 2
PATHFINDER VILLAGE, INC., Edmeston, Site 3
PATHFINDER VILLAGE, INC., Edmeston, Site 4
PATHFINDER VILLAGE, INC., Edmeston, Site 5
PEOPLE, INC., Buffalo, Site 1
PEOPLE, INC., West Seneca, Site 2
PEOPLE, INC., Orchard Park, Site 3
PEOPLE, INC., Tonawanda, Site 4
PEOPLE, INC., Williamsville, Site 5
SASI, Derby, Site 1
SPRINGBROOK NY, INC., Oneonta, Site 1
SPRINGBROOK NY, INC., Sidney, Site 2
SPRINGBROOK NY, INC., Sidney, Site 3
STATEN ISLAND DDSOO, Staten Island, Site 1
STATEN ISLAND DDSOO, Staten Island, Site 2
STATEN ISLAND DDSOO, Staten Island, Site 3
STATEN ISLAND DDSOO, Staten Island, Site 4
STATEN ISLAND DDSOO, Staten Island, Site 5
STATEN ISLAND DDSOO, Staten Island, Site 6
STATEN ISLAND DDSOO, Staten Island, Site 7
STATEN ISLAND DDSOO, Staten Island, Site 8
STATEN ISLAND DDSOO, Staten Island, Site 9
STATEN ISLAND DDSOO, Staten Island, Site 10
STATEN ISLAND DDSOO, Staten Island, Site 11
STATEN ISLAND DDSOO, Staten Island, Site 12
STATEN ISLAND DDSOO, Staten Island, Site 13
STATEN ISLAND DDSOO, Staten Island, Site 14
STATEN ISLAND DDSOO, Staten Island, Site 15
UCPA OF NASSAU COUNTY., INC., Roosevelt, Site 1
WESTERN NY DDSOO, West Seneca, Site 1
WESTERN NY DDSOO, West Seneca, Site 2
WESTERN NY DDSOO, West Seneca, Site 3
WESTERN NY DDSOO, West Seneca, Site 4
WESTERN NY DDSOO, West Seneca, Site 5

Settings that Cannot Overcome the Institutional Presumption-Settings that OPWDD determined will not achieve HCBS Compliance by March 17, 2023:

There are no OPWDD settings in this category.

Public Notice
Heightened Scrutiny Evidence Summaries
In compliance with 42 CFR §441.301(c)(5)(v), the Office for People With Developmental Disabilities (OPWDD) is pleased to announce that it will conduct a public comment period, to allow members of the public to provide comments on its Home and Community-Based Services (HCBS) Final Rule related Heightened Scrutiny evidence summaries, developed by OPWDD and New York State entities that oversee HCBS.