What is the Home and Community-Based Services (HCBS) New Rule?
The purpose of the rules is to ensure that individuals receive services in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services to the same degree as individuals who do not receive regional center services. It means that settings need to focus on the nature and quality of individual's experiences and not just about the buildings where the services are delivered. Individuals have an active role in the development of their plan, the planning process is person-centered, and the plan reflects the individual service and supports and what is important to them.
Home and community-based settings are places where individuals with disabilities live and spend their days; for example, licensed community care facilities and other residential settings, work activity programs, and day programs. The new rules explain what these settings should be like.
What Does This Mean To Me?
If you are an individual who receives services, it means that you may have different options to choose from regarding services and service providers. There will be a focus on individuals being involved in the community; for example, shopping, attending church, dining out, employment, etc.
If you are a service provider, it means that you may need to make changes in how you operate in order to meet the new federal rules by modifying policies and program designs, where and how your service is delivered, and providing training to assure that your staff members understand the expectations of the rules.
Regional Center's Role:
The federal government helps pay for most of the services regional centers provide to individuals with developmental disabilities. In March 2014 new federal rules became effective describing how home and community-based services are provided.
All services in every state must follow the new rules by March 2022. After March 2022, the federal government will not provide funding for services that do not meet the new rules. Assessing all services and settings and making necessary changes takes time. In order to meet the 2022 deadline ELARC is currently developing plans and strategies with Service Providers and Stakeholders.
- DDS's Informational Piece in English (Spanish / Mandarin / Tagalog / Vietnamese / Arabic / Russian / Hmong / Punjabi).
- Overview of the Federal Requirements
- HCBS Fact Sheet
- Frequently Asked Questions
- Regulatory Requirements
Statewide Transition Plan:
Heightened Scrutiny Process: The Centers for Medicare and Medicaid Services (CMS) have released updated guidance regarding the heightened scrutiny process for home and community-based services, which can be found on the CMS website.
California drafted a Statewide Transition Plan to describe how it will move forward and ultimately achieve compliance with the new rules. Because the federal rules are new, states are being allowed some time to come into compliance. States have to assess their laws, regulations, policies, and settings where services are provided to see if they are reflective of the new rules. Each state must develop Transition Plans to describe how it will meet the new rules, how it will change the areas that do not comply, and how it will sustain the review process to assure ongoing compliance.
To view California's current proposed statewide transition plan, please view the Department of Health Care Services webpage. To view all the Statewide Transition Plans, visit the Medicaid website here.
For more information please visit these websites:
For Service Providers Only:
In February 2017, ELARC staff and service providers underwent training with Laura Brackin to introduce and elaborate on the HCBS Final Rule put forth by the Center for Medicaid Services in 2014.
Evaluations/surveys collected from both ELARC staff and services providers following that training, requested for continuous education, resources and consistency.
In efforts to support this request and ensure that ELARC staff and service providers are all discussing the HCBS Final Rule consistently, topics will be distributed each month within the regional center and to service providers via the VAC, for discussion at monthly department meetings. View the topics of discussion here.
To ensure that all parties are interpreting the topics consistently, and to assist ELARC in further developing informational resources and tools, service providers are to take notes following each meeting and submit to the HCBS Program Evaluator, Maribel Garcia at firstname.lastname@example.org. Service providers may also contact their Community Services Specialist for any assistance needed or for topics beginning in January of 2018.
Fiscal Year 2018/2019:
- DDS October 31, 2018 Letter
Funding Guidelines FY 18/19 (Enclosure A and B included)
- Compliance Evaluation and Concept Form, Enclosure C
Fiscal Year 2017/2018:
- DDS November 1, 2017 Letter
- Settings/Services list, Enclosure A
- Regional Center Contact Information, Enclosure B
- Compliance Evaluation and Concept Form, Enclosure C
Fiscal Year 2016/2017:
- DDS April 25, 2017 Letter
- HCBS Compliance Activities Funding Provider Approval List
- HCBS Compliance Activities Funding Summary Table
- DDS August 3, 2016 Letter
Are you in compliance with HCBS? Use these tools to assess your program:
- Compliance Evaluation
- STP On-Site Assessment Tool - Residential
- STP On-Site Assessment Tool - Non-Residential
- STP Provider Self-Survey Tool - Residential
- STP Provider Self-Survey Tool - Non-Residential
- Assessment of Residential Settings
Training and Resources:
- Training Materials from the Medicaid website
- The Learning Community for Person Centered Practices
- Laura Brackin & Associates training materials