Dear Advocates,

We are celebrating the final Access Rule that includes many of the NACDD priorities for improving HCBS in the states! Please read our statement below and feel free to share.

NACDD Commends the Department of Health and Human Services for Improvements to HCBS Services Finalized in the “Ensuring Access to Medicaid Services” (Access Rule)

Washington, DC Washington (April 25, 2024) - The National Association of Councils on Developmental Disabilities (NACDD) commends the Department of Health and Human Services for its bold actions in the final rule for the “Ensuring Access to Medicaid Services” (Access Rule). The comprehensive scope and meaningful solutions in this rule offer a roadmap for better home and community services (HCBS) so that people with intellectual and developmental disabilities can live on their terms and in their homes, not institutions.

NACDD supported several provisions which were including in the final rule including direct care workers receiving 80% of Medicaid funds paid for HCBS, added transparency to state systems to improve access to HCBS, greater health and safety protections and quality measures, and additional requirements to ensure that the people receiving the services have more control over the types of services they receive through a robust person-centered planning process.

Jill Jacobs, Executive Director for the National Association of Councils on Developmental Disabilities, stated, “We thank the Centers for Medicare and Medicaid Services, and all of our partners at the Department of Health and Human Services, for the Access Rule that finally addresses the serious and longstanding malfunctions of the HCBS system. After years of finger-pointing and failure to produce viable solutions to the direct care worker crisis, this final rule takes the bold step of requiring 80% of Medicaid payments to states go directly to those workers to build a robust workforce. We believe providing more competitive wages for direct care professionals will help build the quality workforce necessary to get thousands of people off unconscionably long Medicaid HCBS waitlists. The rule also provides new requirements to improve HCBS systems that have lacked real accountability or grievance processes for individuals receiving HCBS when at odds with some providers over the type and quality of services they receive.”

NACDD’s primary concern with the final rule is that habilitation services are not included in the 80% minimum payment requirement. This will disproportionately impact children with intellectual and developmental disabilities who use these services. However, the final rule does include habilitation services in the reporting requirements that will provide critical information to support efforts to strengthen the direct workforce. NACDD will continue to advocate for competitive wages for workers who provide habilitative services.

Jacobs added, “Change is never easy. NACDD and the state councils on developmental disabilities pledge to work with our state and provider partners so they have the support to implement the new rule, including advocating for higher Medicaid reimbursement rates so everyone can live their best lives in the community.” For more information, please contact Erin Prangley at xxxxxx@nacdd.org