Can You Have Cameras In HCBS Settings?

by | Sep 11, 2026

September 11th, 2026

Cameras in HCBS Settings Update:

HHSC Regulatory stated that at this time it is not citing HCS providers for use of cameras EXCEPT when there is a preponderance of evidence of a rights violation in which case it is sent to CAPM.
Regulatory is waiting on the draft letter and interpretation being prepared by the Medicaid and CHIP Services department to determine if it (Regulatory) needs to change it’s current protocol/practice with regard to cameras.  
 
HHSC reiterated that it plans to prepare an Information Letter about the use of cameras; when such will be issued is not known.  HHSC added that CMS requires states to include in their 1915 (c) waiver contracts information about use of cameras.  This includes whether cameras are used by providers for remote monitoring and whether they permit camera use controlled by families (not by the provider).  HHSC did not state when it plans to submit an amendment to its waiver contract.  
 An Information letter on the use of cameras remains pending.

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.