Home and Community Based Services Final Rule

The Home and Community Based Settings (HCBS) Final Rule, a federal policy change announced by the Centers for Medicare and Medicaid Services (CMS), provides new opportunities for people with disabilities to have the kinds of community services they want.

Find information about the HCBS Final Settings Rule and resources in Pennsylvania and nationally to help you get the community life you want.

New Resource: HCBS Illustrated Guides

In the News

• CMS extends HCBS Final Settings Rule Implementation Date to March 2023 Due to Pandemic

  Statement by HCBS Advocacy Coalition Regarding Further Delay of the Home and Community Based Settings Rule (7/14/2020):

  "While CMS invokes the COVID-19 pandemic as justification for extending the Settings Rule, we disagree. In fact, the current crisis makes the need for strong implementation of the Rule, and the provision of home and community-based services, even more clear. The COVID-19 pandemic has laid bare the risks of large congregate settings and made the Rule's focus on more individualized supports in smaller and non-disability specific settings more important than ever."
  Download PDF of full statement

• CMS Issues New Heightened Scrutiny Guidance

  Updated guidance on Home and Community-Based Services regulation bulletin via Medicaid.gov 3/22/2019
  Statement of HCBS Advocacy Coalition Regarding Guidance from the Center for Medicare and Medicaid Services Regarding the HCBS Settings Rule (PDF)
  "Even as we are pleased to see CMS reaffirm its intent to preserve and faithfully implement the HCBS Settings Rule, we are disappointed by the agency's decision to modify prior guidance regarding the heightened scrutiny process for 'settings that isolate.' The prior guidance used evidence-based guidelines..."

• HCBS Settings Rule: Approaching The Original Deadline (via Council on Quality Leadership)

What does community inclusion look like?

Visit the #Inclusion4AllPA campaign photo gallery

CMS Resources

• Getting to Know the HCBS Final Rule (PowerPoint)
• Strategies to Meaningfully Engage Medicaid HCBS Beneficiaries Webinar (ACL/CMS Promising Practices Training Series recorded September 3, 2020)
• CMS Publication - HCBS Final Rule: Current Issues and Future Direction August 2017 (PDF)

Pennsylvania Resources

• Pennsylvania's Home and Community-Based Services (HCBS) Settings CMS Final Rule - Statewide Transition Plan (PDF)
• PA Transition Plan - Section 1: Identification (PDF)
• Pennsylvania's Home and Community-Based Services (HCBS) Settings CMS Final Rule Statewide Transition Plan - Public Comments
• Provider Self-Assessments (download zip file)
• Office of Developmental Programs (ODP) - HCBS Final Rul

National Resources

• Changes to the HCBS Settings Rule webinar, recorded March 2023
• HCBS Advocacy Coalition
• ASAN's HCBS Setting Rule Resources - Easy Read and Plain Language versions
• ASAN: Home and Community-Based Services Regulations Q&A: Settings Presumed to be Institutional & the Heightened Scrutiny Process (PDF)
• HCBS Advocates Toolkit: ASAN Toolkit on Improving Home and Community-Based Services

Videos: What do self-advocates need to know about the HCBS Final Rule?

HCBS Overview - overview video about the Home and Community Based Settings Services rule and its various components

More Videos

• About the Rule - essential information about how the rule will promote choices, independence, and community for people receiving supports
• Residential Settings - learn about the various requirements placed on providers involving residential settings
• Rights Restrictions - the impact of the HCBS Settings Rule on rights restrictions and modifications for people

Article

Council on Quality and Leadership's The Realities of House Rules

Other States

Delaware

• Presentation: The Home Community-Based Services (HCBS) Final Rule and Delaware's Transition Plan (Delaware Division of Medicaid and Medical Assistance)

Indiana

• Online Trainings (Family and Social Services Administration)

Kentucky

• HCBS Advocacy Coalition - Information for Advocates

Michigan

• Presentation: MDHHS Home and Community Based Services Rule Project Implementation Update (PDF)
• Outreach and Education: Michigan Department of Health & Human Services - Home and Community-Based Services Program Transition

New Jersey

• Home and Community Based Settings Rule - Resources for Consumers, Providers, and Stakeholders (State of New Jersey Department of Human Services)
• Guide: Getting the Community Life You Want A Guide to Home and Community Based Services Advocacy (Boggs Center on Developmental Disabilities)

Tennessee

• HCBS Waivers - Comprehensive Website
• HCBS Settings Rule - FAQ for Individuals and Families (PDF)
• Presentation for Individuals and Families: "Renewal and Redesign of Tennessee's Long-Term Services and Supports Delivery System for Individuals with Intellectual and Developmental Disabilities" (PDF)
• Presentation for Providers: "Renewal and Redesign of Tennessee's Long-Term Services and Supports Delivery System for Individuals with Intellectual and Developmental Disabilities" (PDF)

Utah

• HCBS Transition Planning - Comprehensive Website (Utah Department of Health)
• HCBS Webinar (Disability Law Center)
• Report: Evaluating Utah's Transition Process - an Opportunity for Inclusion (Disability Law Center) (PDF)

This project is supported by a grant from the Pennsylvania Developmental Disabilities Council; in part by grant #1901PASCDD-02, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects with government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy.

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