Home and Community Policy Rule
Executive Office of Health and Human Resources/Department of Developmental Services
In September, the Department of Developmental Services (DDS) released a new HCBS (home and community based settings) policy. The policy is in response to a new rule from the Center on Medicare and Medicaid Services (CMS) which funds a significant part of all long term supports regardless of their setting. The Arc supports the general thrust of the new policy which we stated is “consistent with the evolution of community services over the past 50 years and more specifically with the Americans with Disabilities Act”. The policy not only sets out new standards which reflect respect for individuals served but more self-direction.
The new federal rule evolved after a multi-year period of public discussions. The Arc publicized these discussions and outreach by CMS in 2009 and 2012. CMS accepted testimony on the new rule prior to its final decision. You can view the rule on the CMS website.
The new CMS rule emphasizes personal autonomy, community integration, and choice in HCBS. In that context, it establishes more stringent requirements for provider owned or controlled residential settings. States must work with CMS to develop transition plans to bring non-compliant programs into compliance and must provide opportunities for public input into those transition plans. The state compliance plan can and does take place gradually through 2019. We expect DDS to assist providers who have housing that doesn’t comply with the new rule to transition successfully.
As we state in our testimony below, “CMS has implemented regulations that will challenge our home and community services to offer supports at the most integrated level possible. It is a challenge to state officials, provider leaders and advocates alike. CMS authors have stated: ‘…regardless of age or type of disability, [individuals]…offered HCBS in the most integrated setting appropriate to their needs and preferences, …focus [should be] on the qualities of ‘home’ and ‘community’ that assure independence and integration from the perspective of the individuals’. CMS also emphasizes “person-centered plans.” There are other links that you can use to learn more about this issue.