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HCBS settings standards

According to the rule, all home and community-based setting must meet the following qualities and characteristics, or standards:

Standards that apply to all HCBS settings

  • Setting supports the person's opportunity to seek employment and work in competitive, integrated settings
  • Setting supports the person's engagement in community life
  • Setting supports the person's control of personal resources
  • Setting supports receiving services in the community to the same degree of access as individuals not receiving Medicaid HCBS
  • The person chooses setting from available setting options
  • Ensure individual rights of privacy, dignity and respect, and freedom from coercion and restraint
  • Optimize individual initiative, autonomy and independence in making life choices including daily schedule and with whom to interact
  • Facilitate individual choice regarding services and supports and who provides them

Additional standards for provider-owned or -controlled residential settings

  • The person has a lease or other legally enforceable agreement
  • Privacy in their bedroom or living unit including lockable doors
  • Choice of roommates, if shared unit
  • Freedom to furnish and decorate unit
  • Freedom and support to control schedule and activities, including access to food at any time
  • Able to have visitors at any time
  • Physically accessible

Modifications of the additional requirements must be:

  • Supported by specific assessed need
  • Justified and documented in the person-centered service plan
  • Documented in the person-centered service plan
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