Honolulu, Hawaiʻi – The Hawaiʻi State Department of Health (DOH), in conjunction with the Department of Human Services (DHS) Med-QUEST Division, is notifying the public of its intent to request an amendment to the Home and Community Based Services (HCBS) Waiver for Individuals with Intellectual and Developmental Disabilities (I/DD Waiver). This request will be submitted to the Centers for Medicare & Medicaid Services (CMS) under Section 1915(c) of the Social Security Act.
The purpose of the proposed amendments is to provide individuals with developmental or intellectual disabilities who meet institutional level of care the option to live in their own homes or in the community with appropriate and quality supports designed to promote health, safety, and independence. The State is currently seeking public input on these proposed changes.
Overview of Proposed Amendments: The core of this amendment involves implementing a rate increase for specific Waiver services. These increases are based on a provider rate study conducted in 2024 and recent increases in Hawaiʻi’s minimum wage. The services slated for rate increases include:
- Personal Assistance/Habilitation (PAB)
- Residential Habilitation (ResHab)
- Additional Residential Supports (ARS)
- Adult Day Health (ADH)
- Community Learning Service (CLS)
- Community Navigator (CN)
- Discovery and Career Planning (DCP)
- Individual Employment Supports (IES)
- Respite
- Chore
- Non-Medical Transportation (NMT)
- Private Duty Nursing (PDN)
- Training and Consultation (T&C)
In addition, the ranges within Individual Supports Budgets will be revised to correspond with these increased service rates, aiming to ensure participants can continue to access the same amount of services. The maximum cost for Vehicle Modification (VM) services is also proposed to increase, based on an analysis of rising costs over the past two years.
Public Comment Submission Process: As mandated by federal regulations, the State must allow for public input on any changes to the waiver’s services or operation for a minimum of 30 days.
Comments will be accepted for consideration from the date this notice is published through September 2, 2025. Individuals may submit written comments via two methods:
- By email: doh.dddcrb@doh.hawaii.gov (Please identify “Waiver Amendment” in the subject line).
- By mail: Department of Health, Developmental Disabilities Division Attention: Community Resources Branch 3627 Kilauea Avenue, Room 411 Honolulu, Hawaiʻi 96816
A copy of the 1915(c) I/DD Waiver is available for public viewing online at https://medquest.hawaii.gov/en.html (under “Featured News”) and https://health.hawaii.gov/ddd/. A printed copy and special accommodations (interpreter, large print, or taped materials) can be arranged by contacting the DDD Community Resources Branch at (808) 733-2135, no later than seven working days before the comment period ends.
All comments and requests for a public hearing (which must state the nature of issues and meet HAR requirements) received by the September 2 deadline will be considered in the final determination. The Director of Health may hold a public hearing if a significant degree of public interest is found, with notice provided at least 30 days prior.