What Difference Will the HCBS Final Rule Make?
This document dives into the impact of the Home and Community-Based Services (HCBS) Final Rule, a game-changer for organizations funded by HCBS waivers. States must comply with this rule to access Medicaid waiver funds, but the real difference lies in how organizations embrace its purpose. The Rule aims to enhance the lives of people relying on long-term support by promoting person-centered planning and creating settings that foster community integration, employment opportunities, personal choice, and equal access to resources.
The document outlines four strategies organizations can adopt in response to the Rule: Comply, Adjust, Adopt Best Practices, and Transform through Social Innovation. Each approach varies in depth, from minimal compliance to full-scale transformation that reimagines relationships, structures, and mindsets. The Rule encourages organizations to move beyond ticking boxes and focus on creating meaningful experiences for individuals, such as living independently, working in integrated settings, and engaging in community life.
It also highlights the tension between compliance and innovation. While the Rule’s intent is developmental, its detailed specifications can distract organizations from pursuing deeper change. The document encourages readers to ask “How might we…” questions to spark creative solutions and co-create new opportunities for those supported by HCBS.
Whether you’re an advocate, policymaker, or service provider, this document offers insights into how the HCBS Final Rule can drive positive change—if organizations are willing to embrace its transformative potential. Dive in to explore strategies, challenges, and opportunities for making community-based services truly person-centered.