Home and Community-Based Services
What Are Home and Community-Based Services?
Home and Community-Based Services (HCBS) are long-term services & supports provided in home and community-based settings, as recognized under the federal Medicaid (Medi-Cal) Program. These services can be a combination of standard medical services and non-medical services. Standard services can include, but are not limited to, case management (i.e. supports and service coordination), homemaker, home health aide, personal care, adult day health services, habilitation (both day and residential), and respite care. States can also propose “other” types of services that may assist in diverting and/or transitioning individuals from institutional settings into their homes and community.
What are Home and Community-Based Settings?
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 Home and Community-Based Services (HCBS) rules ensure that people with disabilities have full access to, and enjoy the benefits of, community living through long-term services and supports in the most integrated settings of their choosing. The new rules explain what these settings should be like.
Home and Community-Based Setting Rule
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.
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.
All services in every state must follow the new rules by March 2022. After March 2022, 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 2022 deadline the work must begin now.
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 individuals’ 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’s service and supports and what is important to them.
What does that mean to Service Providers?
If you are a Service Provider who provides services to multiple consumers in the same location, we have to make sure these services do not isolate individuals from the community. 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.
HCBS Training and Information
For more information, resources or updates on the federal Centers for Medicare & Medicaid Services (CMS) regulations (or rules) for Home and Community-Based Services (HCBS), click here. For questions, or information on future meetings, email HCBSregs@dds.ca.gov. If you wish to be notified when updates are made to this page, please email HCBSregs@dds.ca.gov and ask to be included on the notification list. Materials and recorded webinars and/or presentations will be posted on DDS’ website and are available by clicking here.
HCBS Final Rule Compliance Information
In accordance with Welfare and Institutions Code section 4519.2(b), each regional center shall post Home and Community-Based Services (HCBS) Final Rule compliance information on its website, and shall update the information no less frequently than every six months. The below compliance information is based on provider self-assessment data.
Minimum Wage Increase – January 1, 2020
Effective January 1, 2019, due to the implementation of Senate Bill (SB) 3, the minimum wage in California will increase from $12.00 to $13.00 per hour for employers with 26 or more employees and from $11.00 to $12.00 per hour for employers with 25 or fewer employees. As authorized by the current State budget and Welfare & Institutions (W&I) Code sections 4681.6(b), 4691.6(f) and (g), and 4691.9(b), many vendors will either receive, or be eligible to request, a rate increase if necessary to adjust employees’ pay to comply with the new minimum wage.
General information about the increase in minimum wage, as well as detailed instructions and a workbook for submitting rate adjustment requests to the Department, can be found at the following website: www.dds.ca.gov/rc/vendor-provider/minimum-wage/.
Which Providers/ Services Are Eligible?
All providers of services with rates established in the following ways may be eligible for a rate adjustment:
- Rates set by DDS;
- Rates set by regional centers through negotiation;
- Rates established in Regulation.
How Will Rates Be Adjusted?
Providers with Rates set by DDS
Vendors may begin submitting requests to the Department, with a copy to the vendoring regional center. However, all rate adjustment requests must be received by the Department no later than March 1, 2020.
- Community-Based Day, In-Home Respite Agencies, and Work Activity Programs, may request a rate adjustment from the Department if any employee is paid less than the new minimum wage.
- Community Care Facilities – The updated Alternative Residential Model (ARM) rate schedule, effective January 1, 2020 – Community Care Facilities Rates. Providers with ARM rates do not need to submit rate adjustment requests.
Providers with Rates Set By Regionals Through Negotiation
Vendors should submit rate adjustment requests to the vendoring regional center by March 1, 2020. By April 30, 2020, regional centers must provide the Department information on all rate adjustments negotiated with vendors. The Department will follow up with regional centers on the process for reporting the needed information.
- Rates for a variety of services are set through negotiation between providers and regional centers. Providers with rates set in this manner may negotiate a rate adjustment with the regional center, if applicable to the new minimum wage increase. Providers should contact their local regional center for more information on submitting rate adjustment requests.
Rates Established in Regulation
- For updated rates established in regulations please refer to the vendor rates page.
Service Providers with Other Rates:
- Alternative Residential Model (ARM) Rates – Enclosed in the DDS letter by clicking here.
- Community-Based Day Program and In-Home Respite Agencies –Enclosed in the DDS letter by clicking here.
- In-Home Respite Worker (service code 864) – The new rate is $17.03 per consumer hour.
- Non-Mobile Supplemental Staffing (Pursuant to Title 17, Section 57530 of the California Code of Regulations) – The new rate for service codes 505 and 525 is $1.56 per consumer hour. The new rate for service codes 510 and 515 is $1.68 per consumer hour.
- Participant-Directed Community-Based Training Services (service code 475) – The new rate is $16.22 per consumer hour.
- Voucher and Participant-Directed Respite (service code 420 and 465) – The new rate is $17.03 per consumer hour.
- Work Activity and Supported Employment Rates – Enclosed in the DDS letter by clicking here.
If you have any questions in regarding to this correspondence, please contact Yasir Ali, Chief Rates and Fiscal Support Section, at (926) 654-2302 or email@example.com .
Employee Sick leave
Recent legislation, Assembly Bill (AB) 1522, entitles employees who work on or after July 1, 2015, and who work 30 or more days within a year, to accrue sick leave at a rate of one hour for every 30 hours worked. If your agency is NOT providing a minimum of 24 hours or three paid sick days annually, you may submit a request to DDS and WRC for a rate adjustment.
ONLY WRC VENDORS WHO DO NOT PROVIDE A MINIMUM OF 24 HOURS OR THREE DAYS OF SICK LEAVE FOR THEIR EMPLOYEES ARE ELIGIBLE TO COMPLETE THESE FORMS.
A letter from DDS click here explains the two (2) processes that have been developed. Rate Adjustments for the 24 hour Sick Leave for rates set by DDS will be sent directly to DDS. Negotiated/Median Rates will be sent directly to Westside Regional Center. If you provide multiple services that have employees who currently do not receive paid sick leave, you must submit this form for each service that you provide. [Vendor number and service code(s)]. Please look carefully at the links below to verify which process covers your service(s).
- Rates established by DDS: ARM Level Residential Facilities (905, 910, 915, 920) – DDS has already adjusted these rates. Day Programs (505, 510, 515, 520, 525, 805, 954) In-Home Respite Care (862) Please go to the following link to download the 2015 Employee Sick Leave Adjustment Request Workbook: http://www.dds.ca.gov/SickLeave/
- For all other services, please download the form here, Employee Sick Leave Worksheet WRC. YOU MUST CLICK ON “ENABLE CONTENT” before you can enter your information. You must also provide copies of your PAYROLL REGISTERS AND WORKERS COMPENSATION INVOICES WITH THIS FORM. Please return to WRC. The form can be sent directly to WRC by hitting the SUBMIT button. Please email copies of your payroll registers and worker’s comp invoice (include your vendor number) to: firstname.lastname@example.org.
Rate adjustments cannot be completed without copies of these documents. If you have any questions, please contact the Director of Community Services Mary Lou Weise-Stusser, MA at 310-258-4042.