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Home and Community Based Services Settings Final Rule

In 2014, the federal Centers for Medicare & Medicaid Services (CMS) published a rule requiring home- and community-based services (HCBS) to be provided in settings that meet certain criteria. The criteria ensure that HCBS participants have access to the benefits of community living and live and receive services in integrated, non-institutional settings.

The transition period under the federal rule ended on March 17, 2023. Pursuant to Colorado’s approved corrective action plan (CAP), a small group of settings is receiving additional time to demonstrate compliance with certain criteria.

The following documents and information relate to Colorado's implementation of the HCBS Settings Final Rule.

HCBS Settings Final Rule and Related CMS Guidance
Colorado Statewide Transition Plan

The Department developed a Statewide Transition Plan (STP) for bringing Colorado's home-and-community-based services into compliance with the HCBS Settings Final Rule. The STP outlined the Department's process and timelines for working with interested parties to implement requirements of the rule for all home-and-community-based services.

Documents posted for review during public comment period (March 25-May 9, 2022) 

To request a copy of prior versions of the STP, public comments on those versions, and/or the Department’s responses to those comments, please contact HCPF_HCBS_Questions@state.co.us.

Waiver-specific transition plans are included in Colorado's affected HCBS waivers.

Systemic Assessment Crosswalk

Under the STP, the Department conducted a comprehensive review of the kinds of settings in which home-and-community-based services are provided in Colorado and the state statutes, regulations, and waivers that govern the provision of home-and-community-based services in these settings. The results of this systemic review and the Department's plan for proposing changes to relevant authorities are set forth in a crosswalk.

Current version of crosswalk - December 2016

To request a copy of prior versions of the crosswalk, public comments on those versions, and/or the Department’s responses to those comments, please contact HCPF_HCBS_Questions@state.co.us.

Individual/Family/Advocate (IFA) Survey

During the transition period, the Department conducted a voluntary survey for individuals receiving home-and-community-based services, as well as their family members and advocates, to provide input on the settings where they live and/or receive such services. The IFA Survey is now closed. To provide feedback to the Department about any HCBS setting, please email us at HCPF_HCBS_Questions@state.co.us.

Stakeholder Engagement

The Department’s second batch of heightened scrutiny determinations is currently open for public comment. Please refer to the Heightened Scrutiny section of this webpage.

To view departmental issuances regarding the HCBS Settings Final Rule and other matters, please visit the Department’s Memo Series page. This page includes links to Policy Memos, Operational Memos, and Informational Memos, as well as attachments to such memos.

To receive communications regarding the implementation of the HCBS Settings Final Rule, including notices of Memo Series issuances as well as notices of upcoming trainings and meetings and other information, please visit the Department's distribution lists sign-up page. Check the box for the Long-Term Services & Supports Stakeholders list. Add your contact information and click Sign-Up.

To review back issues of these communications, please visit the Long-Term Services and Supports (LTSS) Newsletter Archive.

To join meetings and other events, please visit the Office of Community Living’s stakeholder engagement page. You can subscribe to the calendar by following the instructions on that page.

Critical Rule Updates

The Department conducted formal stakeholder engagement as part of developing critical updates to Colorado’s codification of the HCBS Settings Final Rule and other regulations, now available at 10 CCR 2505-10 sections 8.484.1, 8.500.5.B, 8.500.94.B, 8.609.4, 8.609.9, and 8.610 (updates effective March 15, 2023).

Medical Services Board Final Adoption - January 13, 2023

Medical Services Board Initial Approval - December 9, 2022

Public Rule Review Meeting – November 28, 2022

Final STP

The Department solicited public comment as part of finalizing the STP.

Additional materials relating to the public comment period are available above, under the header “Colorado Statewide Transition Plan.”

Formal Rulemaking

The Department conducted formal stakeholder engagement as part of codifying its version of the HCBS Settings Final Rule, now available at 10 CCR 2505-10 section 8.484 (excerpt containing just the new rule language) (effective January 10, 2022)

Medical Services Board Final Adoption - November 12, 2021

Medical Services Board Initial Approval - October 8, 2021

Public Rule Review Meeting – September 20, 2021

Open Meetings

The Department hosted a series of open meetings in summer-fall 2020 to continue the development of the Draft Rule that now codifies within Colorado regulations the requirements of the Settings Final Rule and an informed consent template with guidance for providers and case managers. For more information, please review this Informational Memo.

Rights Modification Stakeholder Workgroup Meetings

As announced in Informational Memo IM 19-050, the Department hosted a Rights Modification Stakeholder Workgroup to develop proposed materials regarding the rights modification process. The workgroup met five times between December 2019 and June 2020.

Initial HCBS Settings Stakeholder Workgroup Meetings

These workgroups met from November 2015 through March 2016. 

To request a copy of materials relating to these meetings, please contact HCPF_HCBS_Questions@state.co.us.

Correspondence between the Department and CMS

To request a copy of older correspondence between the Department and CMS, please contact HCPF_HCBS_Questions@state.co.us.

Site-Specific Assessments

Provider Transition Plans (PTPs)

The PTP is completed by the provider to assess its compliance with the HCBS Settings Final Rule, assess the potential application of heightened scrutiny, and set out a remedial action plan and timeline. When submitting its PTP, the provider attaches relevant evidence (e.g., leases, photographs). The completed PTP and attached evidentiary materials are subject to review and approval by the Department.

To request a copy of older versions of the PTP templates and/or the provider scorecards that preceded them, please contact HCPF_HCBS_Questions@state.co.us.

Heightened Scrutiny

Documents for review by CMS - Second Submission

The Department’s second batch of heightened scrutiny determinations was open for public comment from April 25, 2023 through May 25, 2023.

HS-053

HS-055

HS-058

HS-054

HS-056

HS-059

 HS-057
Documents for review by CMS - Initial Submission

The Department’s heightened scrutiny determinations were open for public comment from June 10, 2021, through July 10, 2021.

HS-001

HS-018

HS-036

HS-002

HS-019

HS-037

HS-003

HS-020

HS-038

HS-004

HS-021

HS-039 - closed

HS-005

HS-022

HS-040

HS-006

HS-023

HS-041

HS-007

HS-024

HS-042

HS-008

HS-025

HS-043

HS-009

HS-026

HS-044

HS-010

HS-027

HS-045

HS-011

HS-028

HS-046

HS-012

HS-029

HS-047

HS-013

HS-030

HS-048

HS-014

HS-031

HS-049

HS-015

HS-032

HS-050

HS-016

HS-033

HS-051

HS-017

HS-034

HS-052

 

HS-035

Training Materials Presented by the Department

Additional Departmental Guidance

Critical rule update - effective March 16, 2024

Critical rule updates – effective March 15, 2023 

Operational Memo 22-052 - HCBS Settings Final Rule-Individual Transition Plan (ITP) Guidance for Case Managers - Nov. 10, 2022

Operational Memo 22-052 - Home And Community-Based Services (HCBS) Settings Final Rule — Rights Modification Reminders And Training For Case Managers - Nov. 8, 2022

Informational Memo 22-031 -  HCBS Settings Final Rule - Provisional Notice Reminder for Case Managers - September 23, 2022

Community Integration Tips - September 2, 2022

Informational Memo 22-029 - HCBS Settings Final Rule - Schedule Updates - August 29, 2022

Informational Memo 22-028 - HCBS Settings Final Rule - Videos for Members - August 24, 2022

Policy Memo 22-008 - HCBS Settings Final Rule—Announcement Of FAQ Part V - July 15, 2022

Operational Memo 22-020 - Implementation of the HCBS Settings Final Rule within the Children’s Habilitation Residential Program (CHRP) - May 9, 2022

10 CCR 2505-10 section 8.484 – Colorado’s codification of the HCBS Settings Final Rule – effective January 10, 2022

Operational Memo 21-066 -  HCBS Settings Final Rule - Use of Updated Documents - September 24, 2021

Informational Memo 21-044 - HCBS Settings Final Rule - Trainings on Individual Rights and Rights Modification – July 1, 2021

Informational Memo 21-037 - HCBS Settings Final Rule - Heightened Scrutiny Determinations – June 10, 2021

Operational Memo 21-032 - Informed Consent Template for Rights Modifications - March 17, 2021

Operational Memo 20-103 - Rights Modifications Documentation - December 21, 2020

Informational Memo 20-34 - HCBS Settings Final Rule - Milestone Update 3 - September 1, 2020

Informational Memo 20-034 - HCBS Settings Final Rule - Meetings to Develop Rule and Related Materials - August 3, 2020

Informational Memo 20-025 - HCBS Settings Final Rule - PTP Training Announcement #3 - June 16, 2020

Responses to Frequently Asked Questions (FAQs)

To request a copy of guidance materials that are no longer available online, please contact HCPF_HCBS_Questions@state.co.us.

Ask a Question/Report a Concern

To ask a question about the HCBS Settings Final Rule or report a concern about possible noncompliance, you may: