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 rule went into effect in March 2014, and states originally had five years - until March 2019 - to ensure that their HCBS settings were compliant with the rule. In May 2017, CMS issued an Informational Bulletin extending the transition period for statewide compliance with the HCBS Settings Final Rule by three years, to March 2022. In July 2020, CMS issued a State Medicaid Director Letter extending the transition period by another year, to March 2023. Providers need to demonstrate compliance well before the end of the transition period in order to allow time for individuals at noncompliant settings to transition to other settings or funding sources.
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
Colorado Statewide Transition Plan
The Department has 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 outlines the Department's process and timelines for working with interested parties to implement requirements of the rule for all home-and-community-based services.
Current version of STP - December 2016
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_STP.PublicComment@state.co.us.
Waiver-specific transition plans are included in Colorado's affected HCBS waivers.
- Systemic Assessment Crosswalk
Under the STP, the Department has 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
- Individual/Family/Advocate (IFA) Survey
The Department is conducting 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 Department will keep the IFA Survey open for individuals and their families/advocates to take as often as they like, through at least the end of the transition period.
Participate in IFA Survey
Language Online Survey Paper Survey English
Complete and submit using your
computer or electronic device
Complete and submit using paper and U.S. mail - see instructions below for sending
Completar y enviar utilizando su computadora
o dispositivo electrónico
Paper survey for individuals - (encuesta para personas que reciben servicios)
Paper survey for family and friends - (encuesta para familiares y amigos de personas que reciben servicios)
Paper survey for advocates - (encuesta para abogados que representan a personas que reciben servicios)
Complete y envíe utilizando papel y correo de los Estados Unidos - vea las instrucciones a continuación para enviar
Заполните и отправьте с помощью своего компьютера или электронного устройства
Paper survey for individuals - (Опрос для представителей лиц, получающих услуги по программе Medicaid)
Paper survey for family and friends -(Опрос для представителей лиц, получающих услsуги по программе Medicaid)
Paper survey for advocates - (Опрос для представителей лиц, получающих услуги по программе Medicaid)
Заполните и отправьте с помощью бумаги и почты США - см. Инструкции ниже для отправки
To request that a hard copy of the survey be mailed to you, and/or to submit a completed hard-copy survey, contact:
Mail/In Person: 1570 Grant Street, Denver, CO 80203, Attention: Statewide Transition Plan Team
Fax: 303-866-3991, Attention: Statewide Transition Plan Team
Phone: Lori Thompson, 303-866-5142 or Kyra Acuna, 303-866-5666
- Stakeholder Engagement
The Department’s proposed codification of the HCBS Settings Final Rule is currently open for public comment.
Public Rule Review Meeting – September 20, 2021
Medical Services Board Initial Approval - October 8, 2021
Medical Services Board Final Adoption - November 12, 2021
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 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.
The Department hosted a series of open meetings in summer-fall 2020 to continue the development of the Draft Rule that will codify 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.
- Workgroup Meeting Minutes
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_STP.PublicComment@state.co.us.
- Correspondence between the Department and CMS
- Statewide Transition Plan Quarterly Update to CMS - Quarter ending September 30, 2021
- Heightened Scrutiny Submission - August 2021
- Statewide Transition Plan Quarterly Update to CMS - Quarter ending June 30, 2021
- Statewide Transition Plan Quarterly Update to CMS - Quarter ending March 31, 2021
- Statewide Transition Plan Quarterly Update to CMS - Quarter ending December 31, 2020
- Statewide Transition Plan Quarterly Update to CMS - Quarter ending September 30, 2020
- Email to CMS - regarding HCBS Settings Rule Milestones - September 2020
- Statewide Transition Plan Quarterly Update to CMS - Quarter ending June30, 2020
- Statewide Transition Plan Quarterly Update to CMS - Quarter ending March 31, 2020
- HCBS Settings Final Rule Milestones Cover Email to CMS - February 6, 2020
To request a copy of older correspondence between the Department and CMS, please contact HCPF_STP.PublicComment@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.
- Nonresidential PTP - Google Cloud Platform Template - July 2020
- Children's Residential PTP - Google Cloud Platform Template - July 2020
- HCBS Settings Final Rule - Provider Transition Plan User Manual for Google Cloud - June 2020
- Adult Residential PTP - G-Suite Template - December 2018
- HCBS Settings Final Rule - Provider Transition Plan (PTP) User Manual - November 2018
To request a copy of older versions of the PTP templates and/or the provider scorecards that preceded them, please contact HCPF_STP.PublicComment@state.co.us.
- Heightened Scrutiny
Documents for review by CMS
- Heightened Scrutiny Submission - August 2021
- Summary Sheets:
HS-039 - closed
Public comment opportunity
The Department’s heightened scrutiny determinations were open for public comment from June 10, 2021 through July 10, 2021. The Department has reviewed and addressed the comments received during and after the public comment period, as set out in the updated summary sheet links above. CMS will make final determinations regarding these settings.
Documents for review by members of the public
- Informational Memo
- HCBS Settings Final Rule Heightened Scrutiny Determinations Fact Sheet
- HCBS Settings Final Rule Site-Specific Assessment and Heightened Scrutiny Process
- List of Settings
- Summary Sheets:
- Training Materials Presented by the Department
- Individual Rights & Rights Modification - Members - June 2021
- Individual Rights & Rights Modification - Families & Guardians - June 2021
- Individual Rights & Rights Modification - Providers & Case Management Agencies - June 2021
- Rights Modification Documentation TA Call - Webinar Recording - January 13, 2021
- Rights Modification Training - January 2019
- Residency Agreements and the HCBS Final Rule Training - May 2016
- Attachment 1 - Code Enforcement and Health Department Roster
- Attachment 2 - Reasonable Accommodation Information Sheet
- Attachment 3 - Fair Housing-Reasonable Accommodations
- Attachment 4 - Fair Housing-Reasonable Modifications
- Attachment 5 - Warranty of Habitability
- Attachment 6 - Rental Property Condition Checklist
- Attachment 7 - Mutual Rescission of Lease Sample Letter - Note: If a provider has a document along these lines, if must be in plain language, which is not demonstrated in the sample.
- Attachment 8 - Colorado Section 8 Housing Programs Administrative Plan
- Attachment 10 - Landlord and Tenant Rights
- Balancing Individual Rights and Provider Liability Training - April 2016
- Understanding Guardianship and the HCBS Settings Final Rule Training - March 2016
- HCBS Settings Final Rule Non-Residential Settings Training - February 2016
- HCBS Settings Final Rule Residential Settings Training - January 2016
- Person-Centeredness and the HCBS Requirements - October 2015
- HCBS Settings Final Rule and Provider Assessment Training - September 2015
- Additional Departmental Guidance
Operational Memo 21-066 - HCBS Settings Final Rule - Use of Updated Documents - September 24, 2021
- Informed Consent Template - March 2021
Operational Memo 20-103 - Rights Modifications Documentation - December 21, 2020
- BUS Screenshots and Data Entry for Rights Modification Screens
- BUS Screenshots for Log Notes
- Informed Consent Template
Informational Memo 20-34 - HCBS Settings Final Rule - Milestone Update 3 - September 1, 2020
- CO Milestones Update Schedule - September 1, 2020
Responses to Frequently Asked Questions (FAQs)
- Part IV: Employment-Related Services - April 2019
- Part III: Leases and Residential Agreements - November 2018
- Part II: Follow-Up on General Questions - June 2018
- Part I: General Questions - January 2018
To request a copy of guidance materials that are no longer available online, please contact HCPF_STP.PublicComment@state.co.us.