Home and Community-Based Services (HCBS)

Home- and Community-Based Services (HCBS) are types of person-centered care delivered in the home and community. A variety of health and human services can be provided. HCBS programs address the needs of people with functional limitations who need assistance with everyday activities, like getting dressed or bathing. HCBS are often designed to enable people to stay in their homes, rather than moving to a facility for care.

How HCBS Works

What is the Home and Community-Based Services (HCBS) New Rule?

The purpose of the rules is to ensure that individuals receive services in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services to the same degree as individuals who do not receive regional center services. It means that settings need to focus on the nature and quality of individual’s experiences and not just about the buildings where the services are delivered. Individuals have an active role in the development of their plan, the planning process is person-centered, and the plan reflects the individual service and supports and what is important to them.


What Does This Mean To Me?

If you are an individual who receives services, it means that you may have different options to choose from regarding services and service providers. There will be a focus on individuals being involved in the community; for example, shopping, attending church, dining out, employment, etc.


If you are a service provider, it means that you may need to make changes in how you operate in order to meet the new federal rules by modifying policies and program designs, where and how your service is delivered, and providing training to assure that your staff members understand the expectations of the rules.

Regional Center’s Role:

The federal government helps pay for most of the services regional centers provide to individuals with developmental disabilities. In March 2014 new federal rules became effective describing how home and community-based services are provided.


All services in every state must follow the new rules by March 2023. After March 2023, the federal government will not provide funding for services that do not meet the new rules. Assessing all services and settings and making necessary changes takes time. In order to meet the 2023 deadline SCLARC is currently developing plans and strategies with Service Providers and Stakeholders.


In Practice

Heightened Scrutiny Process: The Centers for Medicare and Medicaid Services (CMS) have released updated guidance regarding the heightened scrutiny process for home and community-based services, which can be found on the CMS website.


California drafted a Statewide Transition Plan to describe how it will move forward and ultimately achieve compliance with the new rules. Because the federal rules are new, states are being allowed some time to come into compliance. States have to assess their laws, regulations, policies, and settings where services are provided to see if they are reflective of the new rules. Each state must develop Transition Plans to describe how it will meet the new rules, how it will change the areas that do not comply, and how it will sustain the review process to assure ongoing compliance.


To view California’s current proposed statewide transition plan, please view the Department of Health Care Services webpage. To view all the Statewide Transition Plans, visit the Medicaid website here.


Home and community-based settings are places where individuals with disabilities live and spend their days; for example, licensed community care facilities and other residential settings, work activity programs, and day programs. The new rules explain what these settings should be like.

Resources & Training

Community of Practice – Home and Community Based Services (HCBS), Final Rule


SCLARC will facilitate Community of Practice. Join service providers, people who have intellectual/ developmental disabilities, family members and regional center staff to explore how Person Centered approaches align with Home and Community Based Services (HCBS) quality standards and people living their best lives.



HCBS Maintaining your Compliance:



Sure, all Remediation and Validation dates may have passed, but HCBS compliance is never ending. As you know Service providers are expected to continuously improve and maintain compliance with federal requirements, ensuring they are closely aligned with the principles of HCBS. SCLARC with the Team from ALO Consulting has made available a comprehensive training, “Maintaining Your Compliance”, where you will have an opportunity to review some sample documentation and best practices.  To help determine if this training is for you review this checklist.

South Central Los Angeles Regional Center (SCLARC) provides education, assessment, training and services in the communities of South Los Angeles, Watts, Leimert Park, Florence/Firestone, West Adams, and the cities of Bell, Bell Gardens, Compton, Cudahy, Downey, Huntington Park, Lynwood, Maywood, Vernon, South Gate, North Carson, Gardena, and Paramount.