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CMS Home and Community-Based Services (HCBS) Regulations
This webpage contains information on the federal Centers for Medicare & Medicaid Services (CMS) regulations (or rules) for Home and Community-Based Services (HCBS). These federal rules, effective March 17, 2014, require homes and programs where HCBS are delivered to meet new criteria in order to qualify for federal funding under the Medicaid program (called "Medi-Cal" in California). Each state must write a plan for how its HCBS programs meet these new rules. States have until March 17, 2019, to implement the requirements for home and community-based settings in accordance with CMS-approved plans.
Everyone who receives, or provides, HCBS services may be affected by the new CMS rules. Activities are happening now to help California meet these new requirements, before the implementation deadline of March 17, 2019.
OPPORTUNITY FOR REGIONAL CENTER VENDORS TO APPLY FOR HCBS COMPLIANCE ACTIVITIES FUNDING.The 2016 Budget Act (SB 826, Chapter 23, Statutes of 2016) contains $15 million to help fund changes necessary for regional center service providers to come into compliance with the HCBS rules. The letter and accompanying enclosures sent to regional centers are available below.
- August 3, 2016 letter (Spanish | Tagalog - PDF)
Questions, comments, and concerns can be emailed to HCBSregs@dds.ca.gov.
What Are Home and Community-Based Services (HCBS)?
HCBS are long-term services & supports provided in home and community-based settings, as recognized under the federal Medicaid (Medi-Cal) Program. These services can be a combination of standard medical services and non-medical services. Standard services can include, but are not limited to: case management (i.e. supports and service coordination), homemaker, home health aide, personal care, adult day health services, habilitation (both day and residential), and respite care. States can also propose "other" types of services that may assist in diverting and/or transitioning individuals from institutional settings into their homes and community.
The New HCBS Rules Affect More Than Just DDS
The California Department of Health Care Services (DHCS) has been working with partner agencies, including the Department of Developmental Services (DDS), the California Department of Aging (CDA), the California Department of Public Health (CDPH), other entities, and public and stakeholder input to develop a 5-year Statewide Transition Plan (STP) to bring California into compliance with new rules. This plan has to be approved by CMS.
On November 23, 2016, DHCS, as the single state agency for the Medi-Cal program, submitted the revised Statewide Transition Plan (STP) for home and community-based settings to CMS for approval. The initial STP was submitted on August 14, 2015. The STP covers all existing California programs that are affected by the home and community-based settings requirements, including the HCBS Waiver for Californians with Developmental Disabilities and the DDS 1915(i) State Plan program.
New HCBS programs are not covered by the Statewide Transition Plan. New programs, such as the proposed Self-Determination Program Waiver, must be in compliance with the HCBS rules when they are implemented.
DDS HCBS Advisory Group
On January 16, 2015, in a letter to All Interested Parties regarding the HCBS regulations, DDS announced its efforts to establish an HCBS Advisory Group to guide the transition process for the home and community-based settings requirements in the developmental disabilities service system: Letter regarding the HCBS regulations dated January 16, 2015
In early February, 2015, a number of individuals accepted invitations from Director Santi Rogers to participate on the HCBS Advisory Group (Advisory Group). The Advisory Group provides greater depth and breadth of analysis on the focused issues and processes impacted by, or necessary for, developing, implementing, and continuing compliance with the federal HCBS requirements. Members represent the various interests and perspectives impacted by the HCBS regulations by including consumers, family members, providers, regional centers, and advocates. Interested individuals are welcome to attend meetings.
A 4-page overview of the Federal Requirements for Home and Community-Based Settings.
The CMS website for various communications and fact sheets that help explain the new HCBS rules.
The Statewide Transition Plan and related information on the DHCS website.
For questions, or information on future meetings, email to HCBSregs@dds.ca.gov. If you want to be notified when updates are made to this page, please email HCBSregs@dds.ca.gov and ask to be included on the notification list.