Waiver Redesign Monthly Updates

December 2025 

  • Workgroups are determining which ideas from the waiver report can get federal approval and how much money those ideas will need. We plan to share what we find by posting it on this webpage in a future update. 
  • CMS (Centers for Medicare & Medicaid Services) said we cannot combine (bundle) very different provider types into one service when different rules apply to different people.   
  • Listening sessions continued (many are meeting monthly) with the community groups and topics listed in the stay in touch section of the waiver redesign page. The team is organizing feedback to see shared priorities among people with lived experience, families, and providers.
  • The Community Collaboration listening sessions will pause starting January 2026 so we can focus on service design. We will start sessions again when we have new updates to share. The service design workgroup will continue to use feedback from the listening sessions we have had. 

November 2025 

  • We are collecting data to learn how many people use each waiver service and the cost. This helps us plan funding for the redesign. Plans may change if funding is not available.  
  • We asked CMS about service bundling. We asked if one service can have different rules based on provider type.  
  • Listening sessions continued (many are meeting monthly) with the community groups and topics listed in the stay in touch section of the waiver redesign page. The team is organizing feedback to see shared priorities among people with lived experience, families, and providers. The service design workgroup is using feedback from the community sessions. 

October 2025 

  • A project manager was assigned to help with documentation and advice.  
  • Workgroups are planning how much time and resources are needed to update systems for the redesign.  
  • Timeline change: Moving from five waivers to two will not begin in September 2027 as first hoped. An updated timeline will be shared soon. 
  • Project risk: We need more funding and staff to recruit and contract providers for new services. We want a strong and diverse provider network.  
  • Listening sessions continued (many are meeting monthly) with the community groups and topic listed in the stay in touch section of the waiver redesign page. The team is organizing feedback to see shared priorities among people with lived experience, families, and providers.  
  • The service design workgroup started meeting and is using feedback from the community sessions. 

September 2025 

  • CMS said we can only combine (bundle) services that are closely related. We must show that bundling improves quality, reduces cost, and keeps choice for participants. Services that are very different (for example, assistive technology and waiver transportation) cannot be combined.  
  • Transition plan: When waivers change, the move will take about 12 months. It will start at a person’s annual assessment or by request. We cannot change everyone at once. The Person-Centered Service Plan in the CARE assessment tool cannot fill in all service amounts automatically.  
  • Listening sessions continued (many are meeting monthly) with the community groups listed in the stay in touch section of the waiver redesign page.  
  • The National Core Indicators survey in-person survey was completed. Results will help guide the waiver redesign.   
  • Service design: We reviewed service plans after removing some prior approvals for assistive technology and specialized equipment under $550. This data will help design goods in the waivers. 

August 2025 

  • Workgroups met. Listening sessions began (many are monthly) with the community groups and topic listed in the stay in touch section of the waiver redesign page.  
  • We asked CMS (Centers for Medicare & Medicaid Services) for clear rules on bundling services such as assistive technology, specialized equipment, transportation, and more. CMS pointed to the HCBS technical guide that limits bundling. Talks with CMS are ongoing. 

July 2025 

  • Provider rate increases started on July 1, 2025, for:  
  • Waiver redesign workgroups began. We set up expert meetings to study system changes, resources, and service changes.  
  • We drafted the Waiver Redesign webpage to share updates and ask the public for feedback.