Home and Community-Based Services (HCBS) Settings Criteria and Impacts of COVID-19

Since the implementation of the HCBS settings rule in 2014, states have worked on meeting compliance with the federal regulations and demonstrating completion of all elements, for final approval. Despite states’ diligent work, the COVID-19 pandemic has negatively impacted all aspects of HCBS programming, including their progress towards full settings compliance. Settings criteria included in federal regulation, were impacted by COVID-19 transmission mitigation protocols, state stay-at-home orders, and social distancing requirements.

The Centers for Medicare & Medicaid Services (CMS) hosted two recent webinars providing updates regarding the implementation of HCBS settings regulations. In the webinar hosted on January 27th, CMS acknowledged HCBS settings criteria were not immune from the impacts of the COVID-19 pandemic. Despite this acknowledgment, CMS indicated in both the January and March 2022 webinars they will not extend the compliance date.

COVID-19 had an overwhelmingly negative impact on all levels of HCBS programming. However, new funding available under section 9817 of the American Rescue Plan Act (ARPA), provides opportunities to leverage technology and examine scopes of services included in HCBS programs. These are examples of innovative methods available to states  seeking to achieve settings compliance by March 17, 2023.

How We Can Help 

CMS is urging states to consider implementation of the HCBS settings rules as policymakers continue to refine and implement spending plans to use the increased federal funds available under ARPA. ARPA funding may be used for a wide variety of initiatives including those that will help ensure settings compliance by the end of the transition period and into the future. ARPA spending initiatives related to meeting final and ongoing compliance may include funding for the fulfillment of the five elements required for final approval, compliance monitoring, capital and structural improvements complying with the settings rule.

Myers and Stauffer is actively assisting a number of states with implementation of spending plans and providing additional technical assistance related to compliance with the HCBS settings rule. With a team of dedicated professionals with experience in HCBS programs, Myers and Stauffer is poised to offer additional supports to State teams as they work towards compliance due on March 17, 2023, while leveraging unprecedented federal support for HCBS programming.

For more information about how we can help and what we can do for you, visit our HCBS page

Contact the Contributors:

Catherine Sreckovich
Jacquelyn George, MPH, CPH
Health Care Manager