ALERT: Continuation of Services During HCBS Rule Implementation

State Officials, Providers, and Disability and Aging Groups Issue Joint Statement Praising CMS’ Clarification About Continuity of Services During Implementation of its Home and Community Based Services Rule

January 15, 2015:  Today APSE and other disability and aging groups, state officials, and providers issued a joint statement regarding guidance recently released by the Centers for Medicare & Medicaid (CMS) services about its Home and Community Based Services (HCBS) rule.  This guidance — Questions and Answers Regarding Home and Community-Based Settings — directly addresses a misunderstanding that people are at immediate risk of losing services as a result of the rule.

In January 2014, the CMS released a final rule establishing requirements for settings that are funded under Medicaid Home and Community-Based Services (HCBS) programs.  The rule requires HCBS settings to, among other things, 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.  The rule, which became effective in March 2014, allows states time to transition their HCBS programs into compliance with the new settings requirements.  States are required to submit “transition plans” by March 17, 2015, and plans may be up to five years in length.

Some people mistakenly thought that people could lose services by March 17, 2015 if they were receiving them in settings that did not currently meet the new rule’s requirements.  In answer to a question that asks “If a state determines that a current HCB setting is not compliant with a new regulation, does it have to stop providing services in that setting immediately,” CMS unequivocally states “No.”  The guidance also makes clear that states can continue receiving Medicaid funding for such settings during the transition period.

“We are pleased that CMS has provided clarification to address this confusion, which was causing unnecessary fear for people with disabilities, seniors and their families,” says the Joint Statement.  “Our organizations look forward to working together with CMS, state officials, providers and HCBS program participants and their families as states begin implementing the new HCBS rules.”

APSE is joined in this statement by the National Association of State Directors of Developmental Disabilities, the provider association of the American Network of Community Options and Resources, and a coalition of other disability and aging advocates working together with Bazelon around implementation of the rule – the Association of University Centers on Disabilities, Autistic Self-Advocacy Network, Coalition to Promote Self-Determination, National Association of Councils on Developmental Disabilities, National Disability Rights Network, National Health Law Program, National Senior Citizens Law Center, and TASH.

To learn more about the HCBS rules, see, a website maintained by several member organizations in the coalition.

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