Monday, November 7, 2016

CMS Seeks Comments About Improving Waiver Services in Rural Areas

 Last Friday, the Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) to seek public input on additional reforms and policy options the agency can consider to accelerate access to home and community-based services (HCBS).  The provision of HCBS is critical to support individuals remaining in their communities, but there are stresses on the delivery of care in the form of home care worker recruitment and retention, program integrity challenges, state fiscal constraints, and varying quality measurement and improvement strategies. Stakeholder feedback is being sought to articulate the different perspectives across the provision of quality HCBS and to assist CMS in developing potential strategies that are responsive to those perspectives. 

HCBS provide opportunities for Medicaid beneficiaries including children with special health care needs and those living in rural areas to receive long term care services and supports in their own home or community rather than institutions or other isolated settings (more widely known in our circle as the Katie Beckett Waiver, and sometimes coupled with TEFRA).  Since the provision of HCBS services in rural areas entails a number of distinct challenges not seen in urban areas, including different workforce issues, the RFI also solicits comments on both the potential impact on access for beneficiaries living in rural areas.  It requests suggestions on ways to improve HCBS in rural areas including actions/activities that CMS or the state may take to improve the home care workforce in rural areas.

For more information on HCBS, visit

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