OAAS Home and Community-Based Services Settings Rule

In January 2014, the Centers for Medicare and Medicaid Services (CMS) set regulations that define the settings in which it is permissible for states to pay for Medicaid home and community-based services (HCBS). The purpose of these regulations is to ensure that individuals receive Medicaid HCBS in settings that are integrated into and support full access to the greater community.  The Office of Aging and Adult Services (OAAS) developed a transition plan for the purpose of ensuring that the HCBS settings within the Adult Day Health Care (ADHC) and Community Choices Waivers (CCW) met the requirements of the rule.  

Under the HCBS settings rule, the setting where services are provided should have the following qualities in order to be considered a compliant setting:

• Is integrated in and supports access for the greater community;
• Provides opportunities to seek employment and work in competitive integrated settings, engage in community life and control personal resources;
• Ensures that the individual receives services in the community for the same degree of access as individuals not receiving Medicaid home and community-based services;
• Is selected by the individual from among setting options, including non-disability specific settings and an option for a private unit in a residential setting;
• Ensures an individual's rights of privacy, dignity, respect and freedom from coercion and restraint;
• Optimizes individual initiative, autonomy, and independence in making life choices; and
• Facilitates individual choice regarding services and supports and the ability to choose who provides these services and support.

On October 4, 2022, Louisiana received CMS' final approval of the Statewide Transition Plan.  The final date for OAAS compliance with the HCBS Settings Rule is March 17, 2023.

• Louisiana Statewide Transition Plan Final Approval Letter
• Louisiana Statewide Transition Plan