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 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

HCBS Settings Final Rule

CMS Guidance Materials

CMS Training Materials

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

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_STP.PublicComment@state.co.us.

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

Online survey - For individuals, family, friends, and advocates

Complete and submit using your
computer or electronic device

Paper survey for individuals
Paper survey for family and friends
Paper survey for advocates

Complete and submit using paper and U.S. mail - see instructions below for sending

Spanish
(Español)

Online survey - For individuals, family, friends, and advocates

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

Russian
(русский)

Online survey - For individuals, family, friends, and advocates

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:

Email: HCPF_STP.PublicComment@state.co.us
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.

Open Meetings

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.

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

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.

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

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

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

HS-001

HS-018

HS-036

HS-002

HS-019

HS-037

HS-003

HS-020

HS-038

HS-004

HS-021

HS-039

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

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_STP.PublicComment@state.co.us.

Contact Us

HCPF_STP.PublicComment@state.co.us