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���ϲ����� Note: Following the Centers for Medicare & Medicaid Services final rule around home and community based services (HCBS), the Bazelon Center for Mental Health Law, along with several other groups, recently issued a toolkit to help advocates push for strong implementation of the HCBS Settings Rules in their states. This new toolkit provides advocates with detailed information about the HCBS Settings Rule and provides action steps for advocates to impact implementation of the new rules in their states.

The toolkit contains three documents:

• “The Medicaid Home and Community-Based Services Settings Rules: What You Should Know,”
• “Home and Community-Based Services Regulations Q&A: Settings Presumed to be Institutional & the Heightened Scrutiny Process,” and
• “The Home and Community- Based Settings Rules: How to Advocate for Truly Integrated Community Settings” (unabridged and abridged).

Please see the links below for more information

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New Toolkit To Help In Advocating For Implementing HCBS Rule

Mental Health Weekly February 1, 2016

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It’s been two years since the Centers for Medicare & Medicaid Services (CMS) issued its final rule for home- and community-based services (HCBS) settings to ensure that individuals receiving long-term services and supports through HCBS have full access to the benefits of community living and the opportunity to receive services in the most appropriate integrated settings.

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In order to receive Medicaid reimbursement from the federal government for providing home- and community-based services, states must ensure that the services are delivered in settings that meet the new definition of home- and community-based setting.

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States have until March 2019 to transition their HCBS programs into full compliance with the new settings requirements.

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Meanwhile, the Bazelon Center for Mental Health Law, along with other advocacy groups, on January 25 issued a toolkit to help advocates push for strong implementation of the new HCBS Settings Rules in their states. This new toolkit provides advocates with detailed information about the HCBS Settings Rule and provides action steps for advocates to impact implementation of the new rules in their states.

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“We think it’s important for stakeholders to have a say and know how to advocate for strong implementation of the rule,” Alison Barkoff, director of advocacy for the Bazelon Center, told MHW. “Every state had to develop or initiate a statewide plan.” CMS has provided feedback to states about needed improvements and next steps for amending and implementing those initial transition plans. All states have gone back and made changes to their plans, Barkoff said.

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Undoubtedly, such questions as “What is our process for evaluation?” and “What settings are or aren’t in compliance?” may come up, Barkoff said. The toolkit is an important resource, she noted. “We want to give stakeholders action steps on how to engage in transitioning [their] disability services systems into services that will become more integrated and provide more individual services,” Barkoff said. The rule gives people up to five years to fully bring their systems into compliance, she added.

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Key documents

The toolkit contains three documents: (1) “The Medicaid Home and Community-Based Services Settings Rules: What You Should Know,” (2) “Home and Community-Based Services Regulations Q&A: Settings Presumed to be Institutional & the Heightened Scrutiny Process” and (3) “The Home and Community- Based Settings Rules: How to Advocate for Truly Integrated Community Settings” (unabridged and abridged).

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Additional work by states is needed before CMS gives approval to their plans, she said. “CMS requires input from the public,” she said. “There are going to be ongoing opportunities for public comment.”

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Bazelon developed the toolkit with a coalition of other disability and aging advocacy groups, including the National Association of Councils on Developmental Disabilities, the National Alliance on Mental Illness, The Arc, the National Council on Independent Living, and the National Consumer Voice for Quality Long-Term Care. “There are a broad range of national organizations that support strong implementation of this rule and want to help state advocates make a difference in their states,” Barkoff said.

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“We’re trying to keep up to date with every individual state’s information,” she said. “As soon as we learn [which] state plans are open for public comment, we’ll put it up on our HCBS site ( and on ).