Home and Community Based Services (HCBS) Settings Rule Transition Initiative

Home and Community Based Services (HCBS) provide opportunities for Medicaid beneficiaries to receive services in their own home or community rather than institutions or other isolated settings. These programs serve a variety of targeted populations groups, such as people with intellectual or developmental disabilities, physical disabilities, and/or acquired brain injuries.

Federal HCBS Settings Rule

In January 2014, the federal Centers for Medicare and Medicaid Services (CMS) released a new rule regarding home and community-based services which took effect March 17, 2014. The rule requires that people who receive home and community-based services and supports funded through Medicaid must receive those services and supports in settings that meet specific standards. The standards are designed to ensure the settings are truly home and community-based.

This means that individuals receiving services in these settings have full access to the greater community and can enjoy all of the benefits of community living. The overall goal is to ensure all HCBS programs provide an experience that is distinctly different from what an institution offers (e.g. a hospital, nursing facility or intermediate care facility for people with intellectual disabilities (ICF-IID)).

The Home and Community Based Services Settings rule applies to people who receive services through the following 1915 (c) waivers: MaineCare Benefits Manual Ch. II Section 18; Section 19; Section 20; Section 21; and, Section 29.

Compliance Portal

The Maine Department of Health and Human Services (DHHS) has launched a compliance portal in which providers of HCBS will provide necessary data for the Department to review and analyze.

For HCBS settings coming into service after the November 30, 2019, please contact HCBS.DHHS@maine.gov to request a provider self-assessment to complete.

Questions?