HCBS Settings Rule 101

The HCBS Settings Rule is a federal regulation enacted in 2014 (Home & Community Based Services Final Regulation | Medicaid). It works to ensure that people who receive supports through Medicaid's HCBS waiver programs have full access to community living and can receive services in the most integrated setting. It encourages individuals' autonomy to make choices and to control the decisions in their lives. The rule prioritizes a person-centered planning process led by the individuals that reflects their own preferences and goals.

All services and supports funded through an HCBS waiver must comply with the HCBS Settings Rule including the three waivers managed by the Division of Developmental Disabilities. Rights laid out in the rule include the right to privacy and to control personal resources, the right to be treated with dignity and, respect, to be freed from coercion and restraint, the right to decide what and when to eat, the right to have visitors of their choosing, and the right to lock doors, among others.

11 Categories for the HCBS Settings Compliance Requirements is a list of the rights individuals have through the HCBS Settings Rule with a brief explanation of each.

Illinois created a Statewide Transition Plan | HFS (illinois.gov) that reflects the State's efforts to ensure provider owned or controlled sites are compliant with the HCBS Settings Rule. The Division of Developmental Disabilities spent two years validating more than 2,100 provider owned or controlled sites, reviewing site evidence for all sites and holding site visits to more than 500 sites. More than 1,200 sites were identified as needing compliance action plans (CAPs), and DDD reviewed completed CAPs through a quality assurance process.

Ongoing compliance occurs through continued quality assurance reviews of CAPs, reviews by the Bureau of Quality Management and surveys by the Bureau of Accreditation, Licensing and Certification. New providers and all new provider controlled sites are reviewed within the first six months for initial compliance with the HCBS Settings Rule as well. For more information on the initial validation process of provider controlled sites, quality assurance reviews and validations for new sites, please review the HCBS Settings Rule Compliance page (IDHS: Division of Developmental Disabilities HCBS Settings Rule Compliance (state.il.us) - can we change the name to HCBS Settings Rule Compliance - Provider Page.