The recent announcement of the U.S. Department of Health and Human Services to delay implementation of the
Home and Community Based Services Final Rule compromises the civil rights of people with disabilities and
delays access to the freedoms that people without disabilities enjoy as a matter of course.
The new international association, the Alliance for Citizen Directed Supports, opposes HHS’s recently
announced decision to delay the implementation of the HCBS Final Rule until 2022. By delaying the
implementation of the HCBS rule and the changes in service models that will be required to meet these Federal
regulations, HHS is delaying the affirmation of peoples’ rights, denying opportunities of full citizenship and
impeding access to full and meaningful lives.
The Final Rule, CMS 2249-F – 1915(i), was originally announced by the Centers for Medicare & Medicaid
Services (CMS) in October 2014 and implementation was to be required in 2019. The rule was designed to
enhance the quality of Home and Community-Based Services and ensure that people receiving services through
these Medicaid waiver programs have full access to the benefits of community living. The regulation was
developed over five years and crafted in response to input that CMS sought from thousands of stakeholders.1 In
2014, when HHS Secretary Kathleen Sebelius announced the new rule, she described its purpose as being to
“ensure that all people participating in Medicaid home and community-based services programs have full access
to the benefits of community living.”2 Members of the Alliance for Citizen Directed Supports believe that
delaying the implementation of the HCBS Rule will result in people continuing to be isolated in service settings
thus denying their human and civil rights. We are heartened and encouraged to know that many states and
service providers are committed to continuing their efforts to comply with the rule in a timely manner but many
more will take advantage of the opportunity to delay implementation of the important changes the rule
The Alliance for Citizen Directed Supports is a recently established international organization of people with
disabilities, their family members, service providers, advocates, organizations and allies. The organization
serves as a catalyst to transform traditional service approaches and champion innovation. The Alliance for
Citizen Directed Supports is an association of people committed to self-directed supports that offer
opportunities for lives of meaning and impact. We proudly support and seek to include everyone who is
committed to ensuring that people with disabilities can exercise their rights and live fully included lives in the
communities of their choice.
For more information about the Alliance for Citizen Directed Supports contact Marian Frattarola-Saulino,
Chair, at firstname.lastname@example.org.