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HCBS Advocates Toolkit

ASAN Toolkit on Improving Home and Community-Based Services (HCBS)

ASAN has published a toolkit for advocates, families and administrators on how to ensure that people with disabilities receive Medicaid-funded Home and Community-Based Services in integrated settings that offer full access to the community.

Home and community-based services are an important source of support for many people with disabilities who need help to live in the community. But so far, many of these services have been provided in restrictive or group settings, instead of people’s own homes, communities, or integrated workplaces.

In January, the Centers for Medicare and Medicaid Services (CMS) announced a new rule that may help people get the services they need in truly integrated settings. The new rule sets forth standards for the settings where people receive home and community-based services, including standards for privacy, choice, integration, and access to jobs in the community. Each state must write a five-year plan for how it will change its home and community-based services programs to meet these new standards.

The new rule is the result of several years of conversations between CMS and the disability rights community. In 2011, ASAN worked with Self Advocates Becoming Empowered (SABE) and the National Youth Leadership Network to publish a report on which types of settings people with disabilities believe give them actual, meaningful opportunities to participate in the community.

ASAN’s new toolkit includes:

  • A Resource for Advocates and their Families explaining what the new rule means and how to make their voices heard as their states make plans to comply with the new rule. The resource includes scripts for writing to state Medicaid agencies about how they’d like their state’s HCBS program to change.
  • A Resource for State Administrators and Professionals on how to come into compliance with the new rule. This resource includes detailed guidance on the implications of the new rule, suggestions for elements to be included in the transition plan, and examples of useful tools and questionnaires for assessing provider compliance.
  • A Research Brief explaining how scattered-site supported housing can help states meet the integration and choice standards in the New Rule.
  • A Fact Sheet on integrated housing for people with disabilities.

ASAN’s toolkit on home and community-based services is the third of four toolkits for advocates on health care issues facing the disability community. These toolkits were made possible by funding from the Special Hope Foundation.

We hope that you find our toolkit useful and distribute it widely. Please send any concerns, feedback, or comments on how you plan to use the toolkit to ASAN’s Director of Public Policy, Samantha Crane, at



Thanks to generous support from:

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