New federal regulations have established first-time standards for when settings qualify as “community-based” for the purposes of Medicaid-funded Home and Community-Based Services (HCBS). Each state is charged with developing a transition plan to meet these standards. These plans will have a huge impact on older adults receiving Medicaid-funded HCBS in assisted living, adult day services, and other settings.

Consumers and their advocates must be heard in the states’ transition planning processes. Justice in Aging’s new issue brief provides policy recommendations for consideration by states and stakeholders. The transition plans must confront and answer many important questions.

• What service models are eligible for payment?
• Should services in assisted living facilities be covered?
• What about adult day care programs?
• Does the size of these programs matter?
• And should programs be allowed to be “secure”, i.e., locked, if they care for persons with dementia?

The recommendations address (among other things) how to assess settings for compliance, judging whether a setting is integrated with the community, protecting consumers from eviction, and applying the regulations when consumers have dementia.