Home and Community Based Settings (HCBS) Rules

HCBS Provider Training Logo

The purpose of the HCBS Rules is to ensure individuals receiving HCBS are integrated into their communities and have full access to the benefits of community living.

These new requirements, from the Centers for Medicare and Medicaid Services (CMS), impact individuals receiving services in residential and non-residential settings such as assisted living facilities, group homes, adult day health, day treatment and training, center-based employment programs, etc.

All service settings must come into compliance by March 2022.

For more information on the HCBS Rules and the requirements for State Medicaid programs, please visit the CMS Website.

To support providers to comply with the HCBS rules, AHCCCS, in partnership with the ALTCS Managed Care Organizations (MCOs), is offering a three-part series of on-line training and technical assistance sessions. These sessions will assist providers to assess, plan and align your practices with the rules so that you are prepared for the MCO’s quality monitoring visit to evaluate compliance with the HCBS Rules and, most importantly, create a more satisfying member experience.

Providers are expected to participate in both Sessions 1 and 2 and at least one part of Session 3. AHCCCS recommends that Program Administrators/Managers attend as well as those person(s) in your organization who are involved with policy/procedural changes. All sessions will be held live via webinar and recordings will be posted. If you are unable to attend the live webinar, you may listen to the recording online following the instructions outlined below for each section.

Session 1 - HCBS Rules Overview

The session objectives included the following:

  • 1. Described the HCBS Rules including specific person-centered practices for provider compliance.
  • 2. Outlined the quality monitoring process and timeline.
  • 3. Provided an overview of the forthcoming education and technical assistance resources available to providers.

To access the recorded training session, see below:

To access the Power Point slides only, click here.

Session 2 – Provider Self-Assessment Tool Training

The Provider Self-Assessment Tool will be a required component of the MCO’s quality monitoring visits beginning in 2020. This tool has been designed for providers to assess the alignment of your current practices in residential, employment and day program settings with the person-centered practices required under the HCBS Rules. For reference, the tools are posted under the Provider Toolkit tab. The session objectives included the following:

  • 1. Familiarized participants with the tools and their intended use.
  • 2. Trained participants in how to complete self-assessment.
  • 3. Provided an overview of the forthcoming education and technical assistance resources available to providers.

To access the recorded training session, see below:

To access the Power Point slides only, click here.

Session 3 – Implementation in Employment, Residential and Program Settings

Part 3 consists of four setting specific tracks representing each unique setting type that utilize a peer-to-peer, provider-to-provider approach to share and discuss specific person-centered practices that align with the HCBS Rules.

Each session will be led by a panel of providers who have real world experiences to share about changing business practices they employed to align with specific person-centered practices required by the HCBS Rules. The sessions are also intended to be an open dialogue whereby all provider participants can brainstorm and share information with their peers in the industry. More information on dates of these sessions and how to register is forthcoming.

The AHCCCS Person Centered Planning Advisory workgroup was established in August 2017 in order to gather feedback from key stakeholders to ensure a successful transition and implementation of the Federal HCBS regulations regarding person-centered service planning. The multi-stakeholder workgroup was comprised of interested members/ families members, service providers, advisory groups, and MCO/Tribal Contractors. Throughout the process, we worked to gather feedback regarding policies and procedures, case management forms, and trainings.

The workgroup was also primarily responsible for developing a uniform person-centered service planning process. In developing what is now known as the AHCCCS Assessment and Service Plan, the goal was to ensure a standardized method for assessing and documenting discussions with members during assessment and service planning meetings. The idea being that it’s not about the form itself, rather it’s about documenting the discussion.

The new standards will support the successful implementation and monitoring of the State’s compliance with the HCBS Rules on an individual member level. The development of the standards is currently underway and estimated to be completed by September 2020.

The updated Person Centered Service Plan is posted at this link along with directions on how to submit public comments. The public comment period will be open until August 8, 2020. Public comments will be utilized to help inform and changes needed to the PCSP.

After a public comment period, AHCCCS submitted Arizona’s Systemic Assessment and Transition Plan to CMS in October 2015. The systemic assessment conducted by AHCCCS summarized Arizona’s current level of compliance for HCBS settings and was approved by CMS in September 2017.

The Transition Plan outlines strategies the State will use to make sure all HCBS settings come into compliance by March 2022. AHCCCS engaged in multiple meetings and/or correspondence with CMS, pertaining to the Transition Plan, for the period of September 2017 – February 2019. The updated Transition Plan posted below contains revisions to the Transition Plan made in response to CMS feedback during that period. In February 2019, CMS confirmed the current revisions to the Transition Plan to-date are satisfactory. CMS will not officially approve Arizona’s Systemic Assessment and Transition Plan until after the first round of site specific assessments have been completed, a public comment period is held and the State’s reports to CMS are satisfactory.

In March – May 2019, AHCCCS held a public comment period including stakeholder forums, statewide, to provide information on updates made to the Transition Plan and solicit comments that will be used to help inform the implementation of the Transition Plan.

The presentation materials and recorded presentation can be found below.

AHCCCS has created a Constant Contact email notification list to communicate updates on recent developments for the HCBS Rules. AHCCCS encourages anyone (members, families, advocates, service providers, etc.) interested in this initiative, such as opportunities for public comment, to sign up to receive communication. To subscribe, click on the sign up button below: