Learn About the New Rule

Use this page to find official resources and information from the federal government regarding the rule.

Centers for Medicare and Medicaid Services

The Centers for Medicare and Medicaid Services have provided fact sheets, webinar slides, informational bulletins, and toolkits on Medicaid.gov/hcbs. These resources are copied below. Visit Medicaid.gov/hcbs for the most up-to-date information from CMS on the HCBS settings rule.

Final Regulation Announcement

The final Home and Community-Based Services regulations set forth new requirements for several Medicaid authorities under which states may provide home and community-based long-term services and supports. The regulations enhance the quality of HCBS and provide additional protections to individuals that receive services under these Medicaid authorities.

Settings Requirements Compliance Toolkit

CMCS is pleased to share with State Medicaid Agencies, Operating Agencies, and other stakeholders a Home and Community-Based Settings Toolkit to assist states develop Home and Community-Based 1915(c) waiver and 1915(i) SPA amendment or renewal application(s) to comply with new requirements in the recently published Home and Community Based Services’ (HCBS) regulations. The toolkit includes:

Administration on Community Living three-part Setting Rule Webinar Series
HCBS Settings Webinar Series: Promising Practices in State Approaches to Implementing Federal Criteria. ACL, in partnership with the Centers for Medicare & Medicaid Services (CMS) and other national partners, is hosting a three-part technical assistance webinar series highlighting innovative strategies and approaches states are taking to effectively implement the federal settings criteria for home and community-based services (HCBS). The webinar series is intended to help ACL’s networks, partners, and external stakeholders identify strategic ways to engage in their state’s ongoing HCBS systems transformation efforts.
Slide deck from part one of this 3 part webinar series held on November 8, 2018: Innovative State Approaches to Promoting Compliance with the Federal HCBS Settings Criteria

HHS-Wide Guidance on Person-Centered Planning and Self Direction

On June 6, the Secretary of Health and Human Services issued guidance regarding person-centered planning and self-direction. The guidance is applicable across HHS offices, including in HCBS.

  • Read the Administration for Community Living blog postPerson-Centered Planning and Self-Direction regarding the HSS Guidance on Implementing Section 2402(a) of the Affordable Care Act.

Additional Resources

Office of Disability Employment Programs

Archived Webinar: Implications of HCBS Final Rule on Non Residential Settings
The U.S. Department of Labor’s Office of Disability Employment Policy, in collaboration with the Disability & Elderly Public Health Group within the Centers for Medicare and Medicaid Services, presented this webinar for state policy-makers and disability policy stakeholders to discuss recent Federal policy guidance issued by CMS. The webinars included a brief presentation by CMS followed by a highly interactive dialogue to address questions on the impact of these Federal policy developments on state systems-change efforts related to improving integrated employment and community-based engagement of citizens with significant disabilities.

7 thoughts on “Learn About the New Rule

    […] by creating restrictive parameters for the choices of settings where HCBS waivers can be used. Government guidelines specifically label farmsteads, gated/secure “communities” for people with disabilities, and […]

    […] accountable and quality care in hand with treatment based, client centered services. New remote monitoring tools (released by CMS this past March) enable those providers offering transitional, supervisory, and […]

    Laura Smart said:
    September 10, 2015 at 4:14 pm

    Was there any changes regarding social workers? Specifically I’m asking if there were any changes with long-term care and social workers. I know the federal regulation for the amount of Social Workers per nursing home is 1 / 120 residents (which is actually a shocking ratio it should be 4 social workers per 120 residents). I’m wondering if this federal regulation impacts that at all. Thank you.

    douglas shumway said:
    May 3, 2016 at 2:31 am

    I don’t know exactly why some get HCBS and others do not but without it I cannot pay for wheelchair repairs, suppositories, and relief of the pain my broke body has had for 22 years. I’ve waited almost 3 years for help and it’s finally here but I cannot afford $40 a month more but I will try keeping my head up.So just please if I have any chance at all HCBS will help more than a lot hoping you try to understand not getting help can hurt very mentally
    Thank You

    […] am part of a large work group negotiating a rough consensus about how Michigan should implement the CMS HCBS Community Services Rule. This set of requirements for services to people with disabilities through Medicaid is the most far […]

    […] disability rights and inclusive education. The Centers for Medicare and Medicaid Services issued an HCBS settings rule in 2014  that aims to give people with disabilities support in real community settings. Lindt […]

    Janemarie Sowers said:
    September 18, 2017 at 2:08 am

    On July 5 2016 Ohio Dept of Medicaid Bureau of Long Term Care had Carestar (the case management company they contract with) remove my daughter’s HCBS Waiver nurse that my daughter had for 9 1/2 year. The reason they gave for the removal of the nurse was the nurse co-owned the property with her husband that we live in. We have a legally enforceable lease and are on section 8 voucher. A settings evaluation was never done , our free choice of provider was violated, and I was told by Care star we did not have rights to a state hearing for the nurses removal which also violates cms rules.

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