Document Type


Publication Date



Disability and Aging, Cutler Institute, USM Aging Initiative, Policy


Research staff at the Muskie School of Public Service, USM were requested to evaluate the effectiveness of the revised HCBS waiver application process from the perspective of states. This report summarizes the purpose, scope, approach and findings of the evaluation. The evaluation was designed to provide qualitative information on states' experience using the new HCBS waiver application for initial and renewal waiver applications. The evaluation examined four major issues:


: Are the waiver application components (Application, Technical Guide, Review Criteria) clearly understood and do they promote consistent interpretation?


:Do the application components address the range of waivers and options available to states and are they useful in clarifying the design of the state's waiver program


:Do the application components and processes promote efficiency of state effort?


: Do the waiver application components strengthen the waiver program? States identified four primary areas of benefit from the new waiver application process?

Overall Benefits

States identified four primary areas of benefit from the new waiver application process. They found that the waiver application:

  • Facilitated communication and coordination within the State and with CMS.
  • Clarified the expectations of CMS regarding roles and responsibilities.
  • Improved the overall consistency and accuracy of the waiver application.
  • Improved and strengthened the organization and design of the waiver programs.


The contents herein do not necessarily represent the policy of CMS and should not infer endorsement by CMS or Thomson Healthcare.

Funding Organization

This document was developed under the CMS Nati onal Quality Contract, Prime Contract No. 500-00-0021/Task Order 01, through Thomson Healthcare.



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