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What are the Home and Community Based Services settings requirements? 


Per federal regulations (42 CFR 441.301), individuals enrolled in HCBS waivers are permitted specific rights. For individuals receiving Medicaid DD waiver services in group home, sponsored residential, supported living and/or group day settings, the setting must:

  • Be integrated in and support full access to the greater community 

  • Ensure an individual's rights of privacy, dignity and respect, and freedom from coercion and restraint 

  • Optimize, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment, and with whom to interact 

  • Facilitate individual choice regarding services and supports, and who provides them. 


Furthermore, individuals living in provider owned or operated residential settings must:

  • Have a signed lease or other legally enforceable agreement providing similar protections

  • Have access to privacy in their sleeping units including lockable doors, choice of roommates, and freedom to furnish or decorate their unit

  • Have the ability to control their daily schedules and activities and have access to food at any time 

  • Have the ability to have visitors at any time

  • Be able to physically maneuver within the residential setting (e.g., setting is physically accessible)

Home Is Where the Heart Is HCBS Policies

(Click the links in the "Contents" menu to see each policy)

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