National Organizations Release Toolkit to Help Stakeholders Advocate for Strong Implementation of HCBS Settings Rule

From the Bazelon Center, January 26, 2016

The Bazelon Center for Mental Health Law, together with other disability and aging advocacy groups, today issued a toolkit to help advocates push for strong implementation of the new Home and Community Based Services (HCBS) Settings Rules in their states.  The new HCBS Settings Rules require all settings funded by Medicaid HCBS programs to, among other things, provide opportunities for participants to be integrated in and engage in community life, have access to the community, control their personal resources, and seek employment and work in competitive settings.  States have until March 2019 to transition their HCBS programs into full compliance with the new settings requirements.

For these new rules to have a real impact and move states towards more integrated and individualized services, advocates must get engaged now and push for a strong transition plan," said Alison Barkoff, Bazelon's Director of Advocacy.  All states have already submitted to CMS their initial transition plans, and CMS has provided feedback to states about needed improvements and next steps for amending and implementing their plans.  "The next several months are a critical time for advocacy because that is when states will be making important decisions about their transition plans," she said.

This new toolkit provides advocates with detailed information about the HCBS Settings Rule and provides action steps for advocates to impact implementation of the new rules in their states.  The toolkit contains three documents:  (1) The Medicaid Home and Community-Based Services Settings Rules:  What You Should Know; (2) Home and Community-Based Services Regulations Q&A: Settings Presumed to be Institutional & the Heightened Scrutiny Process, and (3) The Home and Community-Based Settings Rules:  How to Advocate for Truly Integrated Community Settings (unabridged and abridged).

The Bazelon Center developed this toolkit together with a coalition of other disability and aging advocates working together for strong implementation of the HCBS Settings Rule - the American Network of Community Options and Resources, Association of People Supporting Employment First, Association of University Centers on Disabilities, Autistic Self Advocacy Network, Coalition to Promote Self-Determination, Justice in Aging (formerly National Senior Citizens Law Center), Human Services Research Institute, National Association of Councils on Developmental Disabilities, National Consumer Voice for Quality Long Term Care, National Council on Independent Living, National Disability Rights Network, National Down Syndrome Congress, National Health Law Program, TASH, and The Arc of the United States.  The Bazelon Center's advocacy around the HCBS Settings Rule is funded in part by the generosity of the Ruderman Family Foundation (

To learn more, see and, a website with up-to-date information about the rules and states' implementation maintained by several member organizations in the coalition.

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