The federal Center for Medicare and Medicaid have issued regulations that define the settings in which states are allowed to pay for Medicaid Home and Community-Based Services (HCBS). The purpose of these regulations is to ensure that individuals receive Medicaid HCBS in settings that are integrated in and support full access to the greater community. This includes opportunities to seek employment and work in competitive and integrated settings, engage in community life, control personal resources, and receive services in the community, to the same degree as individuals who do not receive services from a Medicaid waiver.
The new federal rules that all states will need to follow means that:
- The setting must be integrated in and supports full access to the greater community;
- The setting must be selected by the individual from among setting options; Each individual has a right to privacy, to be treated with dignity and respect, and is free from bullying and restraints;
- Each individual is supported in making life choices; and
- Each individual is given choice regarding services and who provides them.