Illinois HCBS Site Validation Survey

Instructions for Completing the HCBS Settings Pre-Screen Survey

HCBS Settings Requirements

This HCBS Settings Pre-Screening survey is a part of the HCBS settings rule validation process required by the Centers for Medicare and Medicaid Services. The state must validate all sites receiving HCBS waiver funding by March 17, 2023. Following this pre-screen, sites will be notified if they will receive onsite or desk validation process and will be asked to provide policy and supporting evidence of compliance with the HCBS Settings Rule. To learn more about the Settings Rule, please see Division of Developmental Disabilities HCBS Settings Rule Compliance. To learn more about the HCBS Settings Rule, including reading the Rule language, please see Home & Community Based Services Final Regulation.

Prong 3 Pre-Screening Survey and Evidence Collection

Thank you for filling out the previous survey identifying Prong 1 and Prong 2 category sites. The HCBS Settings Pre-Screening Survey is focused on identifying sites that have isolating characteristics.

For sites that answer any of the pre-screen questions 1-10 yes, IDHS staff will reach out to schedule an onsite validation process to confirm compliance with the HCBS settings requirements. You will be contacted following the survey to schedule an onsite visit and be given the required documentation requests.

For sites that answer all of the pre-screen questions 1-10 no, IDHS staff will reach out to request documentation that confirms compliance with the HCBS settings requirements electronically. These documents will be reviewed by IDHS staff. If there are any questions, IDHS staff will reach out for additional information and possibly an onsite visit. If a site is found to be isolating, an additional compliance action plan will developed. Otherwise, the site will be found to be in compliance and will move to ongoing validation during regular monitoring reviews/surveys.

If you have questions with this survey, please contact the Division at

Pre-Screening Questions for Each Site

Please provide this pre-screening information:

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Please respond yes or no to these characteristics of a site for one site at a time only. When you have completed the 10 questions for one site, you will have an opportunity to complete the survey for additional sites.