Learn more about the federal rule on Home and Community-Based Services

In January 2014, the federal agency that regulates Medicaid (CMS), issued a new rule for the funding of Home and Community-Based Services. The rule may help some people with disabilities obtain appropriate services in settings more to their liking, but it has the potential of unnecessarily displacing many others from residential and service settings that work for them but are deemed not sufficiently integrated into “the community” despite the needs of the individual.

The best place to find information about the HCBS settings rule is at the HCBS Advocacy Website. All federal documents relating to the rule can be found under “Learn About the New Rules”. State Transition Plans, opportunities for public comment, and other state-related topics are covered under “State Resources”.

It is up to individual states to determine how they are going to assess settings for compliance with the new rule. This makes it especially important for people affected by the rule to follow the state’s progress in implementation and take advantage of opportunities to comment.

What else do you need to know?

• If a setting is found to be out of compliance with the new rule, there must be an opportunity to bring it into compliance. Even if that is not possible, HCBS funding may continue until March of 2019.
• There are no specific requirements in the rule that mandate a maximum size for settings or that prohibit funding of congregate settings (more than 3 people with disabilities served together) or that prohibit a setting from serving all or primarily people with disabilities. Certain settings described in the rule will come under “heightened scrutiny” for compliance, but there is no outright prohibition of them.
• The rule does not change the authority of court-appointed guardians to make decisions for their wards.
• You may contact CMS directly through this email address for clarifications of the rule or to report problems with implementation. That may include misinformation that is being distributed by state or local agencies or federally-funded advocacy organizations, a lack of transparency by the state, and insufficient opportunities for public comment.

See The DD News Blog for posts related to the HCBS rule