Home and Community Based Settings (HCBS) Rules

HCBS Provider Training Logo

The purpose of the HCBS Rules is to ensure individuals receiving HCBS are integrated into their communities and have full access to the benefits of community living.

These new requirements, from the Centers for Medicare and Medicaid Services (CMS), impact individuals receiving services in residential and non-residential settings such as assisted living facilities, group homes, adult day health, day treatment and training, center-based employment programs, etc.

All service settings must come into compliance by March 2023.

For more information on the HCBS Rules and the requirements for State Medicaid programs, please visit the CMS Website.

To support providers to comply with the HCBS rules, AHCCCS, in partnership with the ALTCS Managed Care Organizations (MCOs), is offering on-line training and technical assistance sessions. These sessions will assist providers to assess, plan and align your practices with the rules so that you are prepared for the MCO’s quality monitoring visit to evaluate compliance with the HCBS Rules and, most importantly, create a more satisfying member experience.

AHCCCS recommends that Program Administrators/Managers attend as well as those person(s) in your organization who are involved with policy/procedural changes. All sessions will be held live via webinar and recordings will be posted. If you are unable to attend the live webinar, you may listen to the recording online following the instructions outlined below for each section.

Part 1 - HCBS Rules Overview

This session was previously recorded in 2020.

The session objectives included the following:

  • 1. Described the HCBS Rules including specific person-centered practices for provider compliance.
  • 2. Outlined the quality monitoring process and timeline, and
  • 3. Provided an overview of the forthcoming education and technical assistance resources available to providers.

To access the recorded training session, see below:

Downloadable (non-AV) version of the training slides: HCBS Rules Overview Training Slides

Part 2 – Provider Self-Assessment Tool Training

This session was previously recorded in 2020.

The Provider Self-Assessment Tool will be a required component of the MCO’s quality monitoring visits. This tool has been designed for providers to assess the alignment of your current practices in residential, employment and day program settings with the person-centered practices required under the HCBS Rules. The session objectives included the following:

  • 1. Familiarized participants with the tools and their intended use.
  • 2. Trained participants in how to complete self-assessment, and
  • 3. Provided an overview of the forthcoming education and technical assistance resources available to providers.

To access the recorded training session, see below:

Downloadable (non-AV) version of the training slides: Provider Self-Assessment Tool Training Slides

Part 3 – HCBS Rules Assessments Reimagined in a COVID-19 World

This session was recorded in March 2021.

The session is designed to provide a refresher on the HCBS Rules and to orient providers to changes in the quality monitoring process and tools used to assess compliance.

The session objectives included the following:

  • 1. Provide an overview of the HCBS Rules and what they look like on a day-to-day basis,
  • 2. Provide an orientation to the provider-self assessment including examples of documentation sources or evidence of compliance,
  • 3. Outline the changes to the provider assessments for compliance as a result of COVID-19,
  • 4. Provide an orientation to the new COVID-19 Transition Plan component of the provider self-assessments, and
  • 5. Present a timeline for provider compliance and health plan quality monitoring visits to assess compliance including what providers can expect when they receive a notice about the health plan’s assessment.

To access the recorded training session, see below:

Downloadable (non-AV) version of the training slides: HCBS Rules Assessments Reimagined in a COVID-19 World Training Slides

Part 4 – Implementation in Employment, Residential and Program Settings

Part four consists of four setting specific tracks representing each unique setting type that utilize a peer-to-peer, provider-to-provider approach to share and discuss specific person-centered practices that align with the HCBS Rules.

These sessions were facilitated by AHCCCS, but intended to serve as an open dialogue whereby providers who have real world experiences were able to share with their peers in the industry about changing business practices they employed to align with specific person-centered practices required by the HCBS Rules.

The session objectives included the following:

  1. Refresher on the intent of the HCBS Rules
  2. Overview of HCBS Rules in practice
  3. Overview of the quality monitoring assessment and process
  4. Facilitated brainstorming and discussion session
    1. Providers shared with peers about changing business practices they have employed to align with specific person-centered practices required by the HCBS Rules, and
    2. Providers shared some of the challenges they have experienced and brainstormed solutions with peers

HCBS Rules Implementation in a COVID-19 World – Live Interactive Training

  • DDD Day programs


  • DDD Employment programs. To access the recorded training session, see below:
  • DDD Employment programs


  • Adult Day Health Facilities. To access the recorded training session, see below:
  • Adult Day Health


  • Assisted Living Facilities. To access the recorded training session, see below:
  • Assisted Living Facilities


  • DDD Group Homes and Developmental Homes. To access the recorded training session, see below:
  • DDD Group Homes

The provider self-assessment tools are part of HCBS assessment tool suite that your health plan will use to assess compliance with the HCBS Rules The tools are being provided to assist HCBS Settings in preparing for the HCBS assessment that will be conducted by the health plan. Please do not submit these tools to AHCCCS. Your health plan will contact you when they are ready to complete your assessment with additional guidance and directions.

The HCBS assessment tool suite includes:

  • Provider self-assessment - Purpose is to gather information directly from the provider on the extent to which the provider may or may not be currently applying practices consistent with the HCBS Rules. It is important to note, the provider self-assessment includes both the documented self-assessment from the provider perspective and documentation of the health plan’s validations of the provider’s self-assessment after a joint review of the self-assessment with the provider.
  • Companion Guide – Purpose is to provide more detailed direction to assist the provider in completing the self-assessment and COVID-19 transition plan.
  • Observation tool - Purpose is to gather information by observing the location, environment and community engagement of the provider to identify characteristics that may or not be consistent with the HCBS Rules. The observation tool also includes community interviews directly from community members, who have an association with the provider, to gather information about the provider’s level of interaction with members receiving services and strategies the provider employs to maximize community engagement.
  • Member Survey - Purpose is to gather information directly from the members (or their representatives) regarding the member experience with the provider which may or may not be consistent with the HCBS Rules.

HCBS Assessment Tools

After a public comment period, AHCCCS submitted Arizona’s Systemic Assessment and Transition Plan to CMS in October 2015. The systemic assessment conducted by AHCCCS summarized Arizona’s current level of compliance for HCBS settings and was approved by CMS in September 2017.

The Transition Plan outlines strategies the State will use to make sure all HCBS settings come into compliance by March 2022. AHCCCS engaged in multiple meetings and/or correspondence with CMS, pertaining to the Transition Plan, for the period of September 2017 – February 2019. The updated Transition Plan posted below contains revisions to the Transition Plan made in response to CMS feedback during that period. In February 2019, CMS confirmed the current revisions to the Transition Plan to-date are satisfactory. CMS will not officially approve Arizona’s Systemic Assessment and Transition Plan until after the first round of site specific assessments have been completed, a public comment period is held and the State’s reports to CMS are satisfactory.

In March – May 2019, AHCCCS held a public comment period including stakeholder forums, statewide, to provide information on updates made to the Transition Plan and solicit comments that will be used to help inform the implementation of the Transition Plan.

The presentation materials and recorded presentation can be found below.

AHCCCS has created a Constant Contact email notification list to communicate updates on recent developments for the HCBS Rules. AHCCCS encourages anyone (members, families, advocates, service providers, etc.) interested in this initiative, such as opportunities for public comment, to sign up to receive communication. To subscribe, click on the sign up button below: