What is the HCBS 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.

Due to COVID-19, CMS has recently updated the Final Rule and has allowed states an additional year to demonstrate compliance, through March 17, 2023. Here are the 10 Federal Requirements that make up the HCBS Final Rule: https://www.dds.ca.gov/wp-content/uploads/2020/09/CADDSHCBSProviderSelfAssessment.pdf

As a service provider, how am I affected?

  • According to the most recent directive, the California Department of Developmental Services has asked providers to submit their respective remediation plans with their supporting documents to RCEB. Please make sure to download a copy of the RCEB HCBS Remediation Template here.We look forward to receiving your remediation plan submission no later than 12/5/2022.


  • 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 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

How do Person-Centered Practices align with this?

A huge component of the HCBS Final Rule is utilizing a person-centered approach to the way services are provided. RCEB and other community partners are currently offering training in Person-Centered Thinking (PCT), which can be found here.

Where is RCEB as it relates to being in full compliance with the Final Rule?

At this time, this is the level of compliance that service providers have attained within the RCEB catchment area based on their self-assessments. Currently, we are following the CA Statewide Transition Plan (STP) guidelines as we continue to work towards compliance as a state. Additionally, CA DDS has been providing multiple rounds of compliance funding, so that providers have the ability to meet compliance through different projects.


Where can I learn more?

For more information, please contact RCEB’s HCBS Specialist:
Fruc Menchavez III