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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’ second submission of the state plan to CMS. 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 3.

Home and Community Based Settings Proposed Rules


Medicaid Home and Community Based Services (HCBS) settings proposed rules have completed the negotiated rule making process and have been published in the October 7, 2015 Bulletin by the Division of Administrative Procedures. The proposed HCBS rule changes are necessary to move Idaho’s Home and Community Based Services provision into full compliance with law previously passed by the Center for Medicare and Medicaid Services (CMS). These proposed rules will affect certified family home providers, residential assisted living facilities, residential habilitation agencies, and those providing services to Medicaid participants in adult day health centers, developmental disability agencies, supported employment, partial care services, and providers delivering services as support brokers and targeted service coordinators.

The HCBS proposed rule docket has been uploaded to the this page under the “What’s New” section. With the publication of these rules , anyone may submit written comments regarding this proposed rule docket to on or before Wednesday, October 28, 2015.  Public hearings have also been scheduled concerning this rule making as indicated on the rule docket. Please watch this page for further announcements on the rule promulgation process.



Ask The Program

We are interested in receiving your comments, recommendations, and questions as we work to move to full compliance with the new HCBS setting requirements. The State’s Transition Plan is posted here under What’s New.  If you have any questions or comments about the plan or the new requirements (see Final Regulation under Resources) please send us an email and we will get back to you as soon as possible.

Email the program