The Disability Law Center released a report, titled HCBS Settings Rule: Evaluating Utah’s Transition Process An Opportunity for Inclusion, which details the results of a year-long assessment of the State’s efforts to comply with the new federal Home and Community-Based Settings regulations.
In 2014, the Centers for Medicare and Medicaid Services issued a final rule to define and describe the requirements for Home and Community-Based Settings. The purpose of the rule is to enhance the overall quality of the programs, add protections for individuals receiving services, and carry out the Centers for Medicare and Medicaid Services’s intent that individuals receiving Home and Community-Based Settings services have full access to the benefits of community living and are able to receive services in the most integrated setting.
These services support people with disabilities who want to remain at home or in their community rather than receive services in an institution. Because these services are an alternative to institutional care, it is critical that these services give individuals real opportunities to live, work, and play in the community. The purpose of this overhaul is to allow states time to ensure that home and community-based services are not being delivered in a way that isolates people with disabilities from the broader community. States have been given five years to evaluate settings and fully resolve areas of noncompliance.
Despite knowing about this process for more than two years, Utah has yet to identify, let alone remediate, any areas of concerns. The Disability Law Center conducted its own survey to determine the state and service system’s current level of compliance. Using a stratified random sample of service providers, staff from the Disability Law Center found that approximately 20 percent of settings identified may actually isolate individuals from the broader community rather than support individuals to live independently. These results are troubling given that full compliance is required by 2019. It is the state’s responsibility to help providers understand the new requirements and assist them in coming in to compliance. The results of the Disability Law Center report indicate that many service providers will need to make significant changes in order to be compliant. Without meaningful direction from the state detailing a path to compliance, these providers and the people with disabilities who rely on them, may run out of time. This means that people with disabilities who rely on these models could be without services in 2019 if appropriate action is not taken soon.
Additionally, the results of the Disability Law Center survey indicate that service providers who are not currently compliant would readily accept assistance from Utah; however, most providers felt there was not sufficient information from the state about the specific changes that will be made or how providers will be impacted. As 2019 quickly approaches, the Disability Law Center is urging Utah to take immediate action to ensure no services are lost and to thoughtfully consider the results of the center’s findings. If immediate action is taken, there is still time within the transition process to ensure compliance with the new settings rule and improve the quality of our home and community-based service system.
