Home and Community Based Services Rules
Medicaid Home and Community Based Services (HCBS) went into effect Friday, July 01, 2016. The Medicaid HCBS rules are contained in the Medicaid Enhanced rules in IDAPA 16.03.10 and the Consumer-Directed Services rules in IDAPA 16.03.13 which are published on the Idaho Department of Administration Website. A direct link to these two sections of rules is posted on this page, under the “What’s New” section.
The Medicaid HCBS rules implement requirements to ensure that individuals receiving Medicaid Home and Community Based Services are integrated in and supported to gain full access to their community. Idaho Medicaid is currently working with stakeholders to establish a resource toolkit that will assist Idaho providers of Medicaid HCBS services to come into compliance with the new HCBS IDAPA rules.
Home and Community Based Settings
The Department of Health and Human Services’ Centers for Medicare and Medicaid Services (CMS) published regulations in the Federal Register on January 16, 2014, which became effective on March 17, 2014, implementing new requirements for Medicaid’s 1915(c), 1915(i), and 1915(k) Home and Community-Based Services (HCBS) waivers. The purpose of the regulation is to ensure that individuals receive Medicaid HCBS in settings that are integrated in and support full access to the greater community and that the individual’s role in service planning is optimized. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services in the community to the same degree as individuals who do not receive HCBS.
CMS expects all states to develop a HCBS transition plan that provides an assessment of potential gaps in compliance with the new regulation, as well as strategies and timelines for becoming compliant with the rule’s requirements. CMS further requires that states seek input from the public in the development of this transition plan.
Idaho has completed its’ fourth version of the state plan. This plan sets forth the actions Idaho will take to operate all applicable HCBS programs in compliance with the final rules. It is Idaho’s effort to comply/demonstrate compliance with the regulations around Home and Community Based (HCB) setting requirements. To access the updated Idaho Transition Plan, please go to Resources in the right hand column, Idaho Transition Plan – Version 4.