Home and Community Based Services-Settings Rule Implementation

The Home and Community Based Services (HCBS) Settings Rule ensures that individuals receiving services and supports through Medicaid’s HCBS programs have full access to the benefits of community living and are able to receive services in the most integrated setting. Doing so provides an opportunity to enhance the quality of HCBS and provide additional protections to individuals that receive services. UCEDDs can contribute to the authentic implementation of The Rule and collaborate with people with disabilities, families, providers, and state systems to assure ongoing compliance in a number of ways.


Links to all available documents related to Statewide Transition Plans (STP), HCBS settings corrective action plans (CAP) for compliance with the settings criteria, and Centers for Medicare & Medicaid Services (CMS) determinations of heightened scrutiny reviews. The table is updated as states and the CMS submit additional documents.

AUCD HCBS Settings Special Interest Group (SIG)
The full HCBS SIG is part of AUCD’s workplan for ACL’s Grassroots Project. It is open to anyone. The SIG meets monthly (see meeting times). During the monthly meetings opportunities for states to make public comments during hcbs waiver open comment periods and other opportunities for stakeholder involvement are discussed and work that is being done across the AUCD network is highlighted. Additionally, there are 3 working groups (stakeholder engagement, quality, knowledge translation) which are part of this SIG, are facilitated by co-chairs. Meetings for these workgroups occur outside of the larger SIG meeting.  The HCBS SIG has a steering committee which helps to decide topics and priority issues.

Register for the Monthly Meetings Here.

Reach out to Sarah Swanson and Margaux Whitehead for more information about the monthly SIG meetings and Steering Committee.

2024 Meeting Schedule: 

  • Jun 5, 2024 12:00 PM EST
  • Jul 3, 2024 12:00 PM EST
  • Aug 7, 2024 12:00 PM EST
  • Sep 4, 2024 12:00 PM EST
  • Oct 2, 2024 12:00 PM EST
  • Nov 6, 2024 12:00 PM EST
  • Dec 4, 2024 12:00 PM EST
  • Jan 1, 2025 12:00 PM EST
  • Feb 5, 2025 12:00 PM EST
  • Mar 5, 2025 12:00 PM EST
  • Apr 2, 2025 12:00 PM EST
  • May 7, 2025 12:00 PM EST
  • Jun 4, 2025 12:00 PM EST

Sarah Swanson, MPH, Family Care Enhancement Project Director and Assistant Professor at the Munroe-Meyer Institute (NE UCEDD) is supporting AUCD in coordinating and engaging the network in this current priority as an expert consultant for AUCD's UCEDD Resource Center! As CMS and ACL continue to work together to ensure DD Network and stakeholder feedback is received on State Transition Plans related to the HCBS Settings Rule (and specifically the sites identified for heightened scrutiny visits), keep an eye out for outreach from Sarah Swanson should a heightened scrutiny visit be planned in your state. You can reach out to Sarah directly via [email protected] with any questions.

Equity, Diversity and Inclusion

The DD Act requires that its programs are carried out in a culturally competent manner; that people with disabilities and their families participate in the design of and have access to needed community services, individualized supports, and other forms of assistance; and people from minority backgrounds are fully included in all activities. The national network of UCEDDs provides one platform and the infrastructure for systematically reducing disparities and promoting equity, diversity, and inclusion. In 2019, an Equity, Diversity & Inclusion (ED&I) Action Plan was developed by a project team with members at Georgia State University (GSU), the University of Southern California (USC), and Georgetown University UCEDDs to help address this need.

Guiding principles for the ED&I Action Plan are organized by the three global areas addressed in the plan: Workforce Diversity, Cultural and Linguistic Competence, and systems change activities designed to achieve Local and State Impact (slide with image from page 17 of the plan). The plan is offered as a guide to assist UCEDDs in determining appropriate next steps based on the specific needs and resources of the UCEDD.

Three years into the implementation of this action plan across the network and within AUCD, great progress has been made including the development of an Equity, Diversity and Inclusion hub as a central repository for relevant existing resources in the network and a multi-year coaching and implementation effort to support UCEDDS in taking meaningful steps forward to advance priority areas.

We are now looking to engage the UCEDD network in a conversation around a potential new data point demonstrating the participation of individuals with disabilities, including I/DD, from historically underrepresented communities who participate in the development, implementation, or evaluation of a UCEDD project.


Ashley Ogbonna-Salmon, MPH, Diversity, Equity, and Inclusion Research Associate at the Center for Leadership in Disability at Georgia State University (GA UCEDD) is consulting with the UCEDD Resource Center to inform and engage UCEDD Directors, Data Coordinators and program staff on the aforementioned proposed UCEDD performance measure related to equity, and to support our efforts to assist the network in measure the impact of equity, diversity, and inclusion activities. Her work will include addressing data literacy across the network. You can reach out to Ashley directly via [email protected] with any questions.

Darien Todd, Georgia State University’s Community Advocate Specialist, will be working alongside Ashley on this initiative. His work will be focused on the meaningful inclusion and participation of people with intellectual and developmental disabilities in network activities. You can reach Darien at [email protected].  


The UCEDD Resource Center identifies and tracks emerging needs and trends within the UCEDD network and the disability community. These needs at trends are regularly reviewed with our Project Advisory Committee and OIDD for planning and prioritization throughout the year.