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About Home and Community Based Services (HCBS)

What are HCBS?

  

Home and Community Based Services (HCBS) are person-centered supports that are offered in the home and community. HCBS support can include health services (like therapies, durable medical equipment, and skilled nursing care) and human services (like employment support, transportation, and personal care). 

How Are HCBS Different than Other Services?

  

HCBS can be more personal, culturally responsive, and inexpensive than traditional supports in group homes or facilities because they are created around what each person needs and wants. 

The HCBS Settings Rule helps define what a “home and community based setting” is for people getting HCBS. The Rule was made to help people getting HCBS fully take part in community life. It makes sure that the services focus on the life the person wants and that people with disabilities can make their own choices and control their goals and lives. The HCBS Settings Rule also helps keep services high quality by requiring states to regularly check on HCBS using surveys, interviews, and other ways to make sure the services are working well.

Important Things to know About HCBS:

  

  • Individualized Support: HCBS helps each person by giving them the support they need for their own goals and needs.
  • Being Part of the Community: HCBS helps people with disabilities be part of their community. That means being in regular places for jobs, social activities, and other places in the community, not just places for people with disabilities.
  • Choice and Control: People getting HCBS should be able to choose where they live, who they live with, and who helps them with their services and supports.
  • Public Funding: HCBS are usually funded by state waivers as part of a state’s Medicaid program. There are different standards to qualify for HCBS in different states and there may be waiting lists to get funding or providers for HCBS in some states. Currently, 47 states and Washington D. C. have approved HCBS waivers.

How HCBS Improves the Lives of People with Disabilities

Download PDF

HCBS Resources for self Advocates

This Rule Rules! The HCBS Settings Rule and You

https://autisticadvocacy.org/wp-content/uploads/2019/11/HCBS-Rule-Toolkit-PL-FULL.pdf

A plain language resource from ASAN

Settings Rule Resources: How Can I Find Out What Rights I Have Under the HCBS Rule?

https://autisticadvocacy.org/wp-content/uploads/2023/03/Setting-Rule-Resource-1-PL.pdf

A plain language resource from ASAN

Settings Rule Resources: Who Can I Talk to if Someone Isn't Respecting My Rights?

https://autisticadvocacy.org/wp-content/uploads/2023/03/Setting-Rule-Resource-2-PL.pdf

A plain language resource from ASAN

Settings Rule Resources: What are My Rights in the type of setting I live in? With Checklists

https://autisticadvocacy.org/wp-content/uploads/2023/03/Setting-Rule-Resource-3-PL.pdf

A plain language resource by ASAN

Understanding the HCBS Settings Rule

https://policyimpactproject.org/wp-content/uploads/2023/05/Settings-rule.pdf

A plain language, two-page brief from the Policy Impact Project describing the HCBS Settings Rule

Access Rules PResentation

https://selfadvocacyinfo.org/wp-content/uploads/2024/06/A-Plain-Language-Introduction-to-the-Medicaid-Access-Rule-6.13.24.pdf

A plain language PowerPoint presentation from Green Mountain Self-Advocates that gives detailed information about HCBS, including payment adequacy, grievances, incident management, and more

HCBS Resources for Service Providers

State Resources Map

https://www.cms.gov/node/180571

Information provided from CMS about long term services and supports, including Medicaid waivers, by state

Key HCBS Provisions in the Medicaid Access Rule

https://www.publicconsultinggroup.com/news-perspectives/key-hcbs-provisions-in-the-medicaid-access-rule/

Information about payment adequacy, quality measure sets, access reporting, and other HCBS requirements

HCBS Training Series from CMS

https://www.medicaid.gov/medicaid/home-community-based-services/home-community-based-services-training-series/index.html

A list of web-based training from CMS about topics related to HCBS, such as health and welfare, person-centered service planning, and rates and fiscal integrity

A Guide to the HCBS Final Settings Rule

https://idrpp.usu.edu/cei/files/resources/manuals/guide-to-home-community.pdf

A guide developed by the Institute for Disability Research, Policy & Practice at Utah State University outlining key historic disability policy and important components of the HCBS Settings Rule

Factors Impacting Access to Community Services by People with Intellectual Disabilities

https://uen.pressbooks.pub/ddnjv3i2/chapter/factors-impacting-access-to-community-services-by-people-with-intellectual-disabilities/

Research article using National Core Indicators survey data from the Developmental Disabilities Network Journal about factors that make it harder to access HCBS services

Click the link below to learn more about our upcoming events and opportunities to get involved with HCBS advocacy in Georgia 

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