What is today's Direct Support News focus?

The Nov. 6, 2026 edition leads with CMS's CARE proposed rule for ICFs/IID and KFF's analysis of Section 1115 budget-neutrality changes, then rounds up SSA's paper-check phaseout, HCBS sector pressures, Alabama's CWP comment deadline and home-care groups' midterm outlook.

Why does the Social Security paper-check change matter for direct support?

Many people who receive DSP supports also get SSI or Social Security Disability Insurance. SSA plans to finish moving remaining paper-check beneficiaries to electronic payments by the end of 2026, so agencies and families should help people set up direct deposit or Direct Express if they still get checks by mail.

Is Alabama's Community Waiver Program comment period still open?

Federal comments on Alabama's five-year CWP renewal close Nov. 6, 2026. The request would extend the demonstration toward 2031 and drop Group 5 authority while the state considers consolidating its intellectual-disability waivers.

Today in Direct Support: November 6, 2026

The Nov. 6, 2026 DSN digest: CMS's CARE rule for ICFs/IID, KFF on 1115 budget neutrality, and SSA's paper-check phaseout. Also: HCBS sector squeeze, Alabama CWP comments due today, and home-care groups on the midterm flip.

digest · policy · cms · icf-iid · 1115 · hcbs · ssi · alabama · workforce

Martin Falbisoner, Wikimedia Commons, CC BY-SA 3.0

Direct Support News desk · November 6, 2026 · Updated November 6, 2026 · 2 min read

Today's deep dives: CMS's CARE proposed rule would trim ICF/IID payment-transparency reports and drop COVID staff educate-and-offer rules, and KFF warns new 1115 budget-neutrality rules may squeeze HCBS demonstration renewals in 2027. Here is the rest of today's news.

Social Security aims to finish the paper-check phaseout this year People still getting Social Security or SSI by mail need to switch to direct deposit or a Direct Express debit card. Federal law and Executive Order 14247 required electronic federal benefit payments as of Sept. 30, 2025; SSA says it plans to complete the transition by the end of 2026, with rare Treasury waivers. Sources: Disability Scoop, Social Security Administration

HCBS providers describe a squeeze of policy upheaval and short staffing Home Health Care News's Nov. 3 state-of-the-sector piece says Medicaid funding pressure, the 80/20 wage rule, immigration enforcement and nurse competition are all hitting HCBS agencies at once. Executives told the outlet retention now depends as much on authorized hours as on wages. Source: Home Health Care News

Alabama CWP federal comments close today CMS's federal comment window on Alabama's five-year Community Waiver Program renewal ends Nov. 6, 2026. The state would drop little-used Group 5 authority and keep the demonstration running while it weighs consolidating its intellectual-disability waivers; the renewal is an early test of statutory 1115 budget neutrality. Source: Direct Support News (primary: Medicaid.gov CWP page / Oct. 7 bulletin)

Home-based care groups size up a Democratic Congress Trade groups told Home Health Care News the midterm flip could revive interest in the Senate Finance Democrats' home-care RFI and in protecting Medicaid HCBS from further cuts, while Medicare payment rates still run through CMS rulemaking and a presidential veto remains a limit. Source: Home Health Care News

ACL sets a 2027 Senior Nutrition Program theme ACL announced the 2027 theme for the nationwide Senior Nutrition Program network of about 5,000 local providers as the program marks 55 years. The item is aging-services focused but sits in the same ACL news cycle as recent disability research awards. Source: ACL

Common questions

What is today's Direct Support News focus?: The Nov. 6, 2026 edition leads with CMS's CARE proposed rule for ICFs/IID and KFF's analysis of Section 1115 budget-neutrality changes, then rounds up SSA's paper-check phaseout, HCBS sector pressures, Alabama's CWP comment deadline and home-care groups' midterm outlook.
Why does the Social Security paper-check change matter for direct support?: Many people who receive DSP supports also get SSI or Social Security Disability Insurance. SSA plans to finish moving remaining paper-check beneficiaries to electronic payments by the end of 2026, so agencies and families should help people set up direct deposit or Direct Express if they still get checks by mail.
Is Alabama's Community Waiver Program comment period still open?: Federal comments on Alabama's five-year CWP renewal close Nov. 6, 2026. The request would extend the demonstration toward 2031 and drop Group 5 authority while the state considers consolidating its intellectual-disability waivers.