Home and Community Based Services and CMS Final Rule

What Is HCBS?

Home and Community Based Services (HCBS) are services and supports provided in home and community-based settings, with the goal of transitioning individuals from institutional settings into their homes and community. SG/PRC vendors are subject to these changes and should contact the Community Service Department to update their vendorizations as needed. SG/PRC wants to support all providers in achieving compliance with regulation, so that providers may continue to qualify for Regional Center funding.

Update: The timeframe for providers to complete necessary changes has been extended by CMS through March 17, 2023.

What Is CMS Final Rule?

The Centers for Medicare and Medicaid Services (CMS) established the final Home and Community-Based Services (HCBS) regulations in January 2014 affecting services within each state provided through Medicaid. The whole purpose of doing so is to create new requirements that support the following:

  • an enhancement in the quality of HCBS programs
  • adding protection for individuals receiving services
  • ensuring individuals receiving services and supports through Medicaid’s HCBS programs have full access to the benefits of community living and are able to receive services in the most integrated setting

Here are the 10 Federal Requirements (PDF) that make up the HCBS Final Rule (PDF).

As A Service Provider, How Am I Affected?

HCBS are long-term services and supports provided in-home and community-based settings, as recognized under the federal Medicaid (Medi-Cal) Program. DDS has a curated list of service codes (PDF) that they are categorizing as needing to be in compliance. To continue receiving federal funds from CMS, home and community-based settings must comply with the HCBS Final Rule

Where Can I Learn More?

For more information, please contact Lourdes Sanchez, Program Evaluator, at LSanchez@sgprc.org.