The ‘New’ HCBS Rules and Why Your Input is Important

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In January 2014, the Centers for Medicare & Medicaid Services (CMS) announced new rules that will potentially have a far-reaching and positive impact on the nature of residential and day service settings funded through Medicaid as part of Home and Community-Based Services (HCBS).  

What do the new rules require? 

Importantly, the rules focus on the experiences of HCBS participants and require that they have the same degree of access to their communities as their neighbors who are not receiving services through Medicaid HCBS.

For more specifics on what the rules require click here.

Why are these HCBS rules important?

These rules are an important step forward in federal policy, supporting inclusion and integration of people with disabilities in the community.

The rules reiterate long standing federal law that institutions (such as nursing homes and intermediate care facilities for individuals with intellection and developmental disabilities) cannot be funded as HCBS settings. The rules also describe settings presumed to be institutional in nature or that have characteristics of an institution, and therefore that are not home and community based and not eligible to be funded as HSBS settings.

Which waivers and services will be impacted?

For a list of all HCBS waivers in Colorado that will be impacted by the new rule click here.  For a list of all HCBS services that are covered by the new rule click here.

How will states make sure all HCBS settings comply with the new rule?

The rules were enacted in March 2014 and states have until March 17, 2019 to come into compliance with the rules.  Each state must submit a Statewide Transition Plan to CMS describing how the state will comply with the rules.  The transition plan must be made available for public comment. 

Find more information on the Colorado Department of Health Care Policy and Financing’s Statewide Transition Plan here and here

Here are additional documents referenced in Colorado’s May 6, 2106 Statewide Transition Plan that are not posted on HCPF’s website:

Find Disability Law Colorado’s comments to the May 5, 2016 Statewide Transition Plan here.

Why is your input on these rules important?

The extent to which the rules are a catalyst for positive change regarding the decrease of institutional settings funded by HCBS will depend on the strength of each state’s transition plan, as well as the ability of stakeholders and advocates to influence the plan and monitor its implementation. 

HCPF developed a survey for recipients, guardians, family members and advocates to provide input on their experiences with HCBS.  Your input is crucial to helping HCPF and providers understand to what degree Medicaid home and community-based services already comply with the new rule and where they may need to make adjustments to achieve compliance. 

DLC encourages you to provide your input by completing the state’s survey.

Click Here to Provide Input to the State