Home and Community-Based Services Waivers


The purpose of this webpage is to communicate key materials related to the Centers for Medicare & Medicaid Services (CMS) final rule for Medicaid home and community-based services (HCBS) waivers.


CMS published regulations in the Federal Register effective March 17, 2014, which, among other things, changed the definition of HCBS settings for the 1915(c) and 1915(i) Medicaid HCBS waivers. More information on the CMS rule and requirements can be found on the CMS website.

HCBS Activity Update, April 2018 (PDF)

The transition period has been extended for compliance with the HCBS settings rule. CMS extended the transition period (PDF) for states to demonstrate compliance with the home and community-based settings criteria until March 17, 2022. This extension will allow more time for settings to come into compliance with the provisions of the rule and give time for CMS to clarify some of the policies and procedures of the rule. At this point, the Department of Health Services (DHS) will continue to move forward with determining compliance of residential and non-residential settings so that providers that are compliant can be assured they meet the requirements, and providers that do not meet compliance will have time to remediate any deficiency.

Frequently Asked Questions

Frequently Asked Questions About the HCBS Settings Rule

Frequently Asked Questions About Door Locks in Adult Long-Term Care Residential Settings, P-01817 (PDF)

Statewide Transition Plan

DHS is required to develop a statewide transition plan to address how the Department will ensure compliance with the March 17, 2014, HCBS setting rule. These rules allow for a transition plan for states to come into compliance.

Statewide Transition Plan for Compliance with the Medicaid Home and Community-Based Setting Requirement, P-01839 (PDF) - Submitted to CMS on 6/30/17; includes DHS responses to comments received during the March 1-April 3, 2017, public review period.

Prior Versions of Statewide Transition Plan

Waiver-Specific Transition Plans

DHS is required to develop a transition plan for each of its waivers. The waiver-specific transition plans detail how each waiver will ensure compliance with the new definition of the HCBS waiver settings.

Last Revised: June 4, 2018