Today, the Center for Medicare and Medicaid Services (CMS) issued a State Medicaid Director letter announcing another delay in the timeline for states to fully implement the Home and Community Based Services (HCBS) Settings Rule, extending the deadline by one year to March 2023. This comes after CMS had previously extended the original March 2019 deadline by three years to March 2022.
CPR, both individually and through our work leading the HCBS Advocacy Coalition, a partnership of over 20 national disability and aging organizations, has long advocated for strong implementation of the Settings Rule. The Rule is critical to providing basic protections for people with disabilities and aging adults who receive Medicaid-funded HCBS and ensuring that everyone receiving HCBS can experience the full benefits of community living. We oppose delaying the March 2022 deadline – still over 20 months away – by another year at this time.
While CMS invokes the COVID-19 pandemic as justification for extending the deadline, we disagree. In fact, the current crisis makes the need for strong implementation of the Rule, and the provision of home and community-based services, even more clear. The COVID-19 pandemic has laid bare the risks of large congregate settings and made the Rule’s focus on more individualized supports in smaller and non-disability specific settings more important than ever.
It sends the wrong message to delay the Rule, suggesting that implementing the Settings Rule is something that should be set aside while states separately address the pandemic. Instead, states should see the Settings Rule as a critical part of their COVID-19 safety strategy and at the forefront of their reopening efforts. Strengthening HCBS is the best way to keep people with disabilities and older adults safe and out of institutional and other large congregate settings where COVID-19 outbreaks are rampant.
Read the HCBS Advocacy Coalition’s full statement on today’s announced delay here. The Coalition will be closely reviewing the new guidance and issuing further information for stakeholders. For more information about the HCBS Settings Rule and to keep updated on implementation across the country, visit www.hcbsadvocacy.org.