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Independent Living News & Policy from the National Council on Independent Living

Action Alert: Provide Input to CMS on Home and Community Based Services

Earlier this week the Centers for Medicare & Medicaid Services (CMS) issued a Request for Information (RFI) to seek public input on action the government can take to accelerate access to home and community based services (HCBS). Specifically, they are looking for input on additional reforms and policy options that will increase timeliness and quality of HCBS for Medicaid beneficiaries. The following topics were outlined in the RFI:

  1. What are the additional reforms that CMS can take to accelerate the progress of access to HCBS and achieve an appropriate balance of HCBS and institutional services in the Medicaid LTSS system to meet the needs and preferences of beneficiaries?
  2. What actions can CMS take, independently or in partnership with states and stakeholders, to ensure quality of HCBS and beneficiary health and safety?
  3. What program integrity safeguards should states have in place to ensure beneficiary safety and reduce fraud, waste, and abuse in HCBS?
  4. What specific steps could CMS take to strengthen the HCBS home care workforce, including establishing requirements, standards or procedure to ensure rates paid to home care providers are sufficient to attract enough providers to meet service needs of beneficiaries and that wages supported by those rates are sufficient to attract enough qualified home care workers?

Increasing access to HCBS is critical in our fight for community integration. The Olmstead decision historically cemented the ADA’s integration mandate by ruling that people with disabilities have a right to live in our communities, just like people without disabilities. But seventeen years later, too many of our brothers and sisters are still stuck in nursing homes.

CMS has been working to increase availability and access to HCBS for Medicaid beneficiaries, and they are now looking to their stakeholders to help them figure out how to build on their progress. It is extremely important that the disability community takes this opportunity to provide our input. In doing so, we are using our community’s experiences to help shape the future of our supports and services.

NCIL encourages you to submit comments to this RFI. NCIL committee members and staff will also be working to develop comments on behalf of NCIL, and we will send those comments out to the membership when they are available. Comments are due on January 9, 2017 at 5:00 p.m., and they must refer to file case CMS-2404-NC. Comments can be submitted online by visiting, entering the docket number CMS-2016-0168, and clicking on the “comment now” button. You can also mail your comments to: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-2404-NC, P.O. Box 8013, Baltimore, MD 21244-8013.


  1. There needs to be some home based help for seniors who are not rich but not poor enough to get on Medicaid. Caregivers need help.

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