Skip to content

Mission and Purpose

The Centers for Medicare and Medicaid (CMS) issued a new regulation (42 CFR §441.301(c)(6)) that requires that all Medicaid-funded services be provided in settings that exhibit home and community-based characteristics and do not isolate recipients. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, have full access to benefits of community living, and opportunities to receive services in the community to the same degree as people who do not receive home and community based services. 

The purpose of CMS’ new federal rule, sometimes called the “final rule,” is to make sure that states use home and community-based services waiver funding for programs that truly work to integrate people with disabilities and frail elders into the community at every opportunity. All states are required to develop transition plans outlining the process that the state and providers will undertake to comply with the settings requirements. The State of Alaska has been working with CMS and providers on a transition plan to bring Alaska into settings compliance since 2014 when the “final rule” was published. 


10/17/17- Home and Community-Based Waiver Service Regulations Signed
On October 6, Lt. Governor Byron Mallott signed regulations amendments titled Medicaid coverage and payment, home and community-based waiver services, and person-centered services and settings. These amendments become effective November 5, 2017. A link to the signed regulations and the 12 amended Conditions of Participation for waiver services has been posted on the SDS Regulations webpage here:\. Once the Conditions of Participation are effective, they will replace the current set of Conditions of Participation that are posted here: The signed regulations will remain available in PDF format until BASIS (online regulations) is updated, a few months after the regulations become effective.

7/3/17-Transition Period for Compliance with Home and Community-Based Settings Criteria
A CMS Informational Bulletin was released on May 9, 2017, indicating that the transition period for complying with home and community-based settings criteria is extended until March 17, 2022. In the Bulletin, CMS indicated that states may still choose to meet the original March 17, 2019 deadline. The State of Alaska values the person-centered transformation that will result from providers meeting the settings criteria, and acknowledges the progress made to bring Alaska’s providers into compliance. Accordingly, Alaska will retain the original March 17, 2019 deadline for settings to become compliant with the CMS home and community-based settings criteria.

Current Settings Transition Plan and CMS correspondence
Alaska Settings Status
AK HCBS Regulations

Settings Compliance Team

Left to right: Summer Wheeler, Karren Pack, Snezana Ivanoska,
Kristen Bearden.