HCBS Final Rule

Home and Community Based Services (HCBS)

Final Rule

Overview

What is HCBS?

Everyone benefits when people with disabilities are a part of the fabric of our communities, not locked away in the archaic institutions. Institutions are large, often crowded places that limit people and their choices and force them to live segregated lives away from their family and friends without access to the supports needed to live in their own homes and communities.  

People with intellectual and developmental disabilities are provided many services because of the Lanterman Act. Many services people receive are paid for with state and federal money from the federal Centers for Medicare and Medicaid Services (CMS). Therefore, California must comply with what is called the Home and Community-Based Services (HCBS) Final Rule. This rule sets requirements for HCBS settings, which are places where people live or receive services. Each state has until March 2023 to help providers comply with the HCBS Final Rule

Fact Sheets For Clients, Families, and Service Providers: Home and Community-Based Services (HCBS) Final Rule: Department of Developmental Services:

What is HCBS Final Rule?

CMS issued guidance to states on July 14, 2020, indicating that the transition period for ensuring compliance with the HCBS Final Rule has been extended one year to March 17, 2023, in response to the COVID-19 pandemic.

The guidance from CMS can be found here:
Home and Community-Based Settings Regulation – Implementation Timeline Extension and Revised Frequently Asked Questions

More info: 

DDS Home and Community Based Services Final Rule: Online Information on Assessment, Compliance, Training, and Frequently Asked Questions

HCBS Statewide Transition Plan:

Enclosure A Settings/Services Identified in the Statewide Transition Plan

Enclosure B HCBS Compliance Funding - Provider Evaluation

Virtual Site Assessment

HCBS Virtual Assessment Notification

Service Providers Self Assessment

The California Statewide Transition Plan (STP) outlines the steps the State will take to be in alignment with the HCBS Final Rule. The first step is to review and evaluate current services, including both non-residential and residential programs.

Service Providers were required to submit the HCBS Self-Assessment Survey by August 31, 2020. 

If a provider is not in compliance with all the requirements, there is time to develop a transition plan so the provider can achieve compliance by March 2023, the date by which states have to implement the federal requirements.

Providers of these services that are designed specifically for groups of individuals with developmental disabilities were required to complete a self-assessment.

Service Provider Service Categories for Self Assessment

In January 2014, the federal Centers for Medicare & Medicaid Services issued final regulations, or rules, for Home and Community-Based Services (HCBS)1. The rules require that HCBS programs funded through Medicaid – called Medi-Cal in California – provide people with disabilities full access to the benefits of community living and offer services and supports in settings that are integrated in the community. This could include opportunities to seek employment in competitive and integrated settings, control personal resources, and engage in the community to the same degree as individuals who do not receive regional center services. The HCBS rules focus on the nature and quality of individuals’ experiences and not just the buildings where the services are delivered.