May 16th, 2026
The HCBS Settings rule does not allow the use of cameras in a resident’s bedroom or other areas where privacy is expected, unless a state’s waiver application calls for it and has been approved by CMS. Some providers have expressed that they serve some individuals whose guardians “demand” the use of cameras to monitor health status (such as a person with high medical needs or seizures) or to ensure no abuse occurs. It is our understanding that HHSC intends to submit an amendment to its HCS/TxHmL waiver application to allow for the use of cameras in certain situations.
No definitive date for submission of the amendment has been provided by HHSC, nor have they indicated what regulatory staff would do during a survey if a camera was found in someone’s bedroom or other area in which privacy would be expected, even with consent and team approval of this rights restriction. We believe HHSC is working on a provider letter that will address the use of cameras.
