​​​​​​​​​​HCBS Statewide Transition Plan

The California Department of Health Care Services (DHCS) submitted the revised Statewide Transition Plan (STP) to the Centers for Medicare & Medicaid Services (CMS) on November 23, 2016.  The STP describes how the State will come into compliance with new Federal Home and Community-Based (HCB) Settings Final Rule that became effective March 17, 2014.  These regulations are CMS 2249-F and CMS 2296-F, which affect 1115, 1915(c), 1915(i) and 1915(k) Home and Community-Based Services (HCBS) waivers and State Plan programs. All 115, 1915(c), 1915(i) and 1915(k) HCBS waivers and State Plan programs must be in full compliance with the new federal rules by the new extended date of March 17, 2023. CMS issued guidance to states on July 14, 2020, indicating that the transition period for ensuring compliance with the HCBS Final Rule was extended in response to the COVID-19 pandemic. See the Federal Policy Guidance.
DHCS has worked with partner agencies, including the Department of Developmental Services (DDS), the California Department of Aging (CDA), the California Department of Public Health (CDPH), California Department of Social Services (CDSS), Stakeholders, and other entities to develop the revised STP and attachments.  DHCS is committed to working with partner agencies and stakeholders throughout the transition period.
Below is California's revised Statewide Transition Plan (STP) that describes the State's current efforts and proposed actions to ensure Home and Community-Based Service (HCB) providers achieve compliance with the federal HCB settings rule. CMS granted initial approval of California's STP on February 23, 2018.

As required under the American Recovery and Reinvestment Act of 2009 (ARRA), DHCS seeks advice from designees of Indian Health Programs, and Urban Indian Organizations on Medi-Cal matters having a direct effect on Indians, Indian Health Programs, or Urban Indian Organizations. The STP was submitted for tribal review on October 7, 2022. The public comment period will be held October 14, 2022 through November 13, 2022, with the intention of submitting the STP to CMS for final approval following the notice period. For more information on the CBAS STP, please visit the CBAS STP landing page.

Public comments should be submitted through the following routes:

  • By Email:             STP@dhcs.ca.gov subject line “STP Public Comment"
  • By US Mail:         Department of  Health Care Services

​Integrated Systems of Care Division
1501 Capitol Avenue, MS 4502​​
P.O. Box 997437
Sacramento, CA 95899-7413

California DHCS Heightened Scrutiny Settings Packets

The California Department of Health Care Services (DHCS) has posted the following HCBS Settings Final Rule documents for public comment:

  • Heightened Scrutiny summary sheets for facilities that may have an isolating effect for residents.​
  • The public comment period will be from July 29, 2022 to August 28​, 2022

Follow the link to view the Heightened Scrutiny Setting Packets​ and Leave Comments

Public Comment Periods

DHCS conducted public comment periods for stakeholder feedback on the STP and On-Site Assessment and Provider Self-Survey Tools: ​​
  • Final STP Comment Period October 14, 2022 through November 13, 2022
  • Heightened Scrutiny Setting Comment Period July 29, 2022 through August 8, 2022
  • Statewide Conference Call, September 27, 2016
  • Draft STP Comment Period, August 29, 2016, through September 29, 2016
  • Final STP, On-Site Assessment, and Provider Self-Survey Tools Stakeholder Conference Call, August 20, 2015 
  • Draft STP, On-Site Assessment, and Provider Self-Survey Tools Stakeholder Conference Call, July 13, 2015
  • Draft STP Public Comment Period, July 2, 2015, through July 31, 2015
  • On-Site Assessment and Provider Self-Survey Tools Public Comment Period, May 22, 2015, through June 30, 2015
  • Stakeholder Conference Call, December 2, 2014
  • Draft STP Public Comment Period November 7, 2014, through December 8, 2014
  • Stakeholder Conference Call, October 21, 2014
  • Draft STP Public Comment Period September 19, 2014, through October 20, 2014


Additional Links

HCB Settings Rule:

HCBS Training

For more information regarding the new Federal HCBS setting requirements, please visit:

Medicaid.gov Home and Community-Based Services website

​If you have additional questions or comments regarding the Statewide Transition Plan, please email STP@dhcs.ca.gov
Last modified date: 11/22/2022 3:16 PM