Home and Community-Based Services (HCBS) Final Rule

Assessment Information

HCBS Compliance Funding

Training & Information

Frequently Asked Questions

Home and Community-Based Services (HCBS) were developed to offer support to individuals in community settings, as an alternative to institutional care. In 2014, new federal rules were released by the Centers for Medicare & Medicaid Services (CMS), requiring homes and programs where HCBS are delivered to meet new criteria. The Department and its partners are working to implement the requirements for home and community-based settings in accordance with this Final Rule.

Everyone who receives, or provides, HCBS services may be affected by the CMS Final Rule. Activities are happening now to help California meet these new requirements.

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 can be found here: https://www.medicaid.gov/Federal-Policy-Guidance/Downloads/smd20003.pdf.

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 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 multi-year Statewide Transition Plan (STP) to bring California into compliance with new rules. This plan has to receive final approval from CMS before March 2023, and was initially approved on February 23, 2018.

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.

As of May 2021, updates have been made to the STP, and it has been posted to the DHCS website. The public comment period for all stakeholders and members of the public ran from October 14, 2022, through November 13, 2022.

More information regarding public comment can be found on the Department of Health Care Services (DHCS) website.

Additional information including guidance and training from CMS on the HCBS Final Rule, or to access other state’s transition plans, can be found on the CMS HCBS webpage.

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.

Advisory Group Meeting Materials


Last modified: January 22, 2024