Protecting Home and Community-Based Services Through Communication, Policy, and Technology Levers
National Speech-Language-Hearing Month
May is National Speech-Language-Hearing Month, recognizing individuals with communication disorders and the professionals who support them. It also highlights the importance of clear communication within systems such as Medicaid-funded home and community-based services (HCBS), where effective communication is essential to delivering and sustaining care.
Why Communication Matters in HCBS
HCBS programs operate within a complex regulatory environment, supported by federal oversight and state implementation. Clear, consistent communication helps ensure program integrity, builds trust with beneficiaries, and supports long-term sustainability.
Research from the Council on Quality and Leadership shows that speech-language-hearing (SLH) therapies can significantly improve autonomy, participation, and daily living outcomes, especially individuals with developmental disabilities (IDD), to improve participation in life and enjoy greater autonomy and self-determination in daily living.
When communication is unclear or inconsistent, agencies often must spend additional time and resources addressing confusion, correcting misinformation, and rebuilding trust. Over time, this can make future engagement even more challenging.
HCBS Access Rule: Key Strategic Drivers, Deliberations, and Decisions
HCBS programs continue to evolve in response to federal guidance. Recent updates to HCBS Access Rules, imposed by the Centers for Medicare & Medicaid Services, requires states to reassess how they evaluate eligibility, needs, and service planning through tools like functional assessments and person-centered service plans (PCSP).
HCBS Access Rule reporting is slated to start as early as 2027, so states must ensure their systems can capture, analyze, and report data in a compliant and accessible way. While specific requirements are still developing, the direction is clear: increased transparency, stronger data standards, and more rigorous oversight.
As these changes unfold, proactive communication becomes even more important. Clearly explaining what is changing, why it matters, and how it impacts individuals can improve program adoption.
The Growing Role of Technology
In addition to policy changes, technology is playing a larger role in how HCBS programs operate. Some states are beginning to incorporate algorithmic tools to support decisions around level-of-care determinations, budgeting, and reimbursement models.
For structured processes, these tools can help improve efficiency and consistency. However, for more complex or individualized decisions, algorithms can introduce challenges, including unintended bias or outcomes that don’t fully reflect a person’s needs. For this reason, technology should support, not replace, human decision-making. States should ensure that:
- Clinical reviewers remain involved in final determinations.
- Policies include clear guidance on how to use tools.
- Exception and appeal processes are readily available.
Just as important is how these tools are communicated. Transparency around how decisions are made can help build trust and reduce resistance to change.
Supporting HCBS Program Strategy and Implementation
Navigating HCBS policy changes, communication challenges, and technology adoption requires both technical expertise and practical implementation experience. Myers and Stauffer supports states implementing federal rule changes necessary for HCBS programs. If you are interested in more information on strategies to implement technology to augment your current HCBS decision-making processes, contact our team.
Director
Health Care Manager
