HCBS Waivers Final Rule

(CMS 2249-F/2296-F)

The HCBS Final Rule became effective on March 17, 2014 and applies to the Person-Centered Planning Process and Home and Community Based Service Settings. In this rule, CMS clearly outlines expectations for the Person-Centered Planning Process, which increases the person’s input in how services are planned and what is included in the plan of care. It also describes expectations for Home and Community Based Services Settings, which increases protections relating to where people receive Home and Community Based Services and ensures people are afforded opportunities to be fully integrated into their communities.

Person Centered Planning

The rule describes the minimum requirements around person centered planning, which includes the process being driven by the person receiving services, choosing who participates in the planning process and the delivery of services, as well as individually identified goals and achievement of outcomes in the most integrated community setting. Services should be delivered in a way that reflects the person’s individual choices and contributes to their overall health and welfare.  

HCBS Settings

The rule establishes requirements for Home and Community Based Settings which will maximize the opportunities for people receiving services to have access to the community in the most integrated settings. This rule allows provisions for states to develop transition plans to ensure all settings will meet compliance with the final rule. CMS expects states to transition into compliance in as brief a period as possible to demonstrate substantial progress, allowing a period of up to five years, subject to CMS approval. The rule also includes requirements around provider-owned or controlled HCBS settings and specific requirements around leases, privacy, schedules, visitors, food access and accessibility.

The final rule requires that all HCBS Settings meet certain qualifications which include:

  • The setting is integrated in and supports full access to the greater community;
  • Is selected by the individual from among setting options;
  • Ensures individual rights of privacy, dignity and respect, and freedom from coercion and restraint;
  • Optimizing autonomy and independence in making life choices; and
  • Facilitates choice regarding services and who provides them.

Provider Self-Assessment Tools and State Transition Plan

Click here to be directed to the Bureau of TennCare website for Transition Plan Documents for New Federal Home and Community Based Services Rules which includes provider self assessment tools, recorded webinars and presentations as well FAQs for completing the provider self-assessment, person centered planning assessment and individual experience assessment.

The following are resources regarding the HCBS Settings Final Rule