Home and community based services (HCBS) provide opportunities for Medicaid participants to receive services in their own home and in the broader community. These programs provide services to a variety of populations, including people with mental illnesses, intellectual or developmental disabilities, and physical disabilities, as well as older adults. The final HCBS settings rule created new requirements for all HCBS settings, including that they provide opportunities for participants to engage in community life, have access the community, control their personal resources, and seek employment and work in competitive settings. These new rules will enhance the quality and definition of HCBS and provide additional protections to individuals that receive services. Starting March 2014, each state had 15 months to draft a Statewide Transition Plan; these need to be finalized and implemented by March 2019. The Centers for Medicaid and Medicare Services have reviewed these plans and given states feedback on needed areas for improvement and next steps. This is an extremely important time for advocates to become involved in providing input into state transition plan development and refinement.