HCBS Settings Rule

It took nearly 10 years to implement, but Medicaid’s “new” Home- and Community-Based Services (HCBS) Settings Rule is finally in effect. What does this mean for you and your loved ones? Let’s break it down.

HCBS is a Medicaid waiver program providing opportunities for beneficiaries to receive services in their own home or community, such as in group homes, rather than in institutions or other isolated settings.

The new standards, first set in 2014, clarify what counts as home-based and community services, and the rights of those accessing them. They were put on hold for a variety of reasons, including the pandemic, and then implemented on March 17, 2023. Not all states are prepared to meet all the new standards, in some cases despite their best efforts. (For example, new regulations concerning direct support professionals [DSPs] may be unduly affected by the current crisis in available DSPs.)

So how prepared is New York? A thorough and easy-to-understand NYC Fair Town Hall on the new standards, see below, can help you understand both the regs and the challenges the state faces. (Thanks to Tara Klein and Lynn Decker for pointing me to this YouTube video.)

Also, the Autistic Self Advocacy Network has posted resources that might help. They cover:

  • What is the HCBS Settings Rule?
  • How can I find out what rights I have under the HCBS Rule?
  • What do I do if my rights are violated?
  • What are corrective action plans?
  • When am I getting my rights?

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