Helping Communities with Better Support Act
The Helping Communities with Better Support Act would expand and make more transparent how home- and community-based services (HCBS) under Medicaid are provided. It does two main things: (1) it broadens potential coverage options by allowing states to use HCBS funds to pay for services for additional individuals beyond the current target groups, subject to specific safeguards; and (2) it requires new and ongoing public reporting on HCBS waivers, so the public can see wait times, service delivery, and access metrics. The bill also directs new guidance to states to allow a temporary 60-day interim coverage period before a formal written plan of care is finalized, which could shorten gaps in care. Overall, the bill aims to improve access to home- and community-based supports for more people while increasing government transparency about how HCBS waivers operate and how quickly services are delivered.
Key Points
- 1Expands coverage options: The Secretary may approve waivers that allow a state to include as medical assistance payment for HCBS (excluding room and board) for certain individuals beyond those currently described in the waiver, if the state meets specified requirements.
- 2Safeguards for expansion: To qualify, the state must (i) show that expanding coverage would not meaningfully delay or worsen wait times for others, (ii) estimate how many additional individuals would receive services and how their service mix might differ, and (iii) provide a plan describing this impact.
- 3Increased transparency (new data to publish): Beginning Jan 1, 2028, certain information must be publicly available on the CMS website, including:
- 4- If a state limits the number of individuals served, details about waitlists, eligibility screenings, re-screening, and average wait times.
- 5- Descriptions of service types, including how long it takes from approval to starting services and the share of hours actually delivered.
- 6- Information on access to homemaker, home health aide, and personal care services, including start times after approval and actual hours delivered.
- 7Interim care plan coverage: By 2026, the Secretary must issue guidance letting states provide up to 60 days of HCBS coverage under an interim care plan for individuals eligible for HCBS, from eligibility determination until a written plan of care is finalized.
- 8Administrative timing: The bill includes a requirement that certain data be updated on at least an annual basis.