HCBS News 2026June26

Kierstin Reed • June 25, 2026

DHHS Hosts Quarterly Division Meeting for HCBS Providers

DHHS held the quarterly meeting for HCBS providers on the five waiver programs under DHHS on June 23rd. Slides from this meeting will be posted on the website soon. Here are a few highlights from the meeting: 

  • Name change for the Division will take place on July 1, 2026. The official new name is Division of Disability and Aging. Assisted Living Services on the Medicaid Waiver are now referred to as “Supported Residential Living”. 
  • Reminder: All AD/TBI waiver providers must have training in CPR, First Aid and Abuse, neglect and exploitation reporting requirements and prevention. Full compliance is expected within 60 days of implementation (July 1). Providers should keep records for employee certifications in their HR file. 
  • AD/TBI waiver providers will be receiving a HCBS Provider Policy Manual soon—this document will provide detailed information on aspects and requirements of service providers
  • There are changes coming on July 1st to the HCBS Fee Schedule. These will be posted on the website. 
  • Flat rates are being established for adult day health, chore, respite, LRI Personal Care, and Independence Skills Building. These rates supersede rates set on the MC-190. Personal care rates are not being impacted at this time
  • The cap on annual budgets begins July 1, 2026. Waiver services that exceed 150% ($138,657) of the average nursing facility. Beyond this, the service coordinator must submit a request for exception to the DDA clinical team.
  • Importance of program integrity- billed services must match what is authorized and delivered. Pre-authorization and post claim reviews are being completed to ensure integrity.
  • National Core Indicators results are now complete

New E-Report Finds Rural Family Caregivers Holding the Health System Together

A new e-report from LeadingAge member Lutheran Services in America, Rooted in Care: Transforming the Future for Rural Family Caregivers, highlights the essential role that rural family caregivers play in supporting older adults. This report draws upon insights from residents of North Dakota, South Dakota, Montana, and Minnesota as well as national data from Caregiving in the U.S. Nationally, one in five caregivers live in a rural community and are experiencing the erosion of the local care infrastructure. The report discusses four key challenges facing family caregivers in rural communities. Addressing Emotional & Physical Toll: Rural caregiving is intense and sustained wherein the report highlights practical pathways to bolster respite options and train family caregivers. Expand Access to Services & Infrastructure: Rural caregivers consistently face access challenges to affordable services and supports including in-home health assistance, limited broadband that restricts telehealth, and declining access to clinics and hospitals wherein the report outlines opportunities to align policies with the reality of rural infrastructure. Reducing Out-of-Pocket Costs & Strengthening Supports: Caregiving places a significant financial strain on families wherein the report shares several opportunities to reduce financial burden on family caregivers through various pathways put forth in the report. Building & Sustaining a Rural Care Workforce: Rural communities are facing a deepening workforce crisis where the report discusses home care workforce challenges — including worker shortages, inadequate training, and low wages — that were identified as a top priority for action. The report concludes by highlighting policy opportunities at both the federal and state level.

By Kierstin Reed August 13, 2026
LeadingAge Webinar on Tenant Compliance Must-Dos for Affordable Senior Housing, August 19, 2-3:15 p.m. ET. Join the LeadingAge housing community for a webinar by compliance expert Jenny DeSilva, who will review unique rules and requirements for HUD-assisted senior housing communities. Participants will receive practical guidance to stay prepared for HUD oversight while supporting older adults as they age in community. Register here . Affordable housing Weekly Recap . Here is your weekly Affordable Housing Weekly Recap
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New Guidance from IRS on No Tax on Overtime Last week, the Internal Revenue Service issued updated FAQs on the No Tax on Overtime provision under HR 1, which added a new tax deduction for qualified overtime compensation. The deduction allows individuals to deduct up to $12,500 of qualified overtime pay annually ($25,000 in the case of a joint return) but may be reduced if a taxpayer's modified adjusted gross income (MAGI) exceeds $150,000 ($300,000 for joint filers). Developed in coordination with the Department of Labor and Office of Personnel Management, the updated FAQs replace previous FAQs issued in January 2026 and provide more extensive guidance on overtime eligibility and exemptions under the Fair Labor Standards Act, reporting qualified overtime compensation, and federal income tax withholdings from wages. The FAQs also include a guidance for employers on calculating qualified overtime compensation to be paid to an employee for purposes of the deduction. This includes instructions for alternative methods of computation are used to compute overtime, which may apply to employees of certain residential care facilities. Here is your weekly Workforce Weekly Recap
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COVID “Up to Date” Definition Will Not Change
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Life Safety Update
By Kierstin Reed August 13, 2026
Life Safety Update State Fire Marshal has provided a memo regarding Personal Electrical Devices in long term care settings under the preview of the Life Safety Code. This memo clarifies that residents will be able to use personal electronics (such as lamps, laptops and phone chargers) within six feet of the bed without being in violation of Section 10.4.2.2 of the Life Safety Code. These devices no longer require a three-prong or double insulated designation. Facilities must conduct an annual visual inspection and document that devices are in proper working order and are not in need of repair. An inspection must also be conducted when a resident moves in or moves to a new room within the facility. These devices can be plugged directly into the wall or into an approved power tap (60601-1 or 1363A). Extension cords and unapproved power strips should still be avoided. We appreciate the continued follow up on this concern and the willingness of the Fire Marshal to update the understanding of the use of personal electronics in long-term care settings.
By Kierstin Reed August 13, 2026
Join Our Advocacy Movement
By Kierstin Reed August 6, 2026
Proposed Rule Rolls Back Community Reinvestment Act Obligations. Of great concern to LeadingAge and others interested in expanding and preserving the nation’s supply of affordable housing, the Department of Treasury, Office of the Comptroller of the Currency (OCC) and the Federal Deposit Insurance Corporation (FDIC) posted a joint rulemaking on July 31, 2026, amending the regulations implementing the Community Reinvestment Act (CRA) that could weaken investment in affordable housing and community development. The CRA was enacted in 1977 and requires federal banking regulators to encourage financial institutions to help meet the credit needs of the communities in which they do business, including in low and moderate-income (LMI) neighborhoods. In particular, a financial institution’s record of meeting the credit needs of its entire community is taken into account by federal regulators when evaluating the financial institution’s application for a deposit facility. Among the changes that the rule proposes for evaluating whether a financial institution is meeting its CRA requirements are: restricting the large bank service test to a bank’s “credit services” – i.e., lending – rather than deposit services; imposing a 15% cap on indirect costs that recipients of community development grants at large banks may incur; recalibrating asset thresholds for small, immediate, and large banks; and tailoring retail lending tests to focus only on a bank’s major product line(s). In particular, the recalibration of asset thresholds would likely reduce the number of banks incentivized to make loans and investments in affordable housing and community development, such as investing in the Low Income Housing Tax Credit (LIHTC). LeadingAge is concerned that this rule would further limit opportunities for affordable housing for older adults, and we will continue to work with our housing partners to coordinate a response in opposing this rule. While this rule has yet to be published in the Federal Register, there will be a 60 day comment period from the date of publication.
By Kierstin Reed August 6, 2026
Analysis: FY2027 Hospice Wage Index Final Rule
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