Illinois is going to have many positive changes to bring its Home & Community Based Housing into
compliance with these new innovative rules.

The final rule requires that all home and community-based settings meet certain qualifications.
These include:
• The setting is integrated in and supports full access to the greater community;
• Is selected by the individual from among setting options;
• Ensures individual rights of privacy, dignity and respect, and freedom from coercion and
• Optimizes autonomy and independence in making life choices; and
• Facilitates choice regarding services and who provides them.

The final rule also includes additional requirements for provider-owned or controlled home and
community-based residential settings.
These requirements include:
• The individual has a lease or other legally enforceable agreement providing similar
protections; • The individual has privacy in their unit including lockable doors, choice of roommates
and freedom to furnish or decorate the unit;
• The individual controls his/her own schedule including access to food at any time;
• The individual can have visitors at any time; and
• The setting is physically accessible.

Any modification to these additional requirements for provider-owned home and community-based
residential settings must be supported by a specific assessed need and justified in the person-
centered service plan.

See links below for more details.


Medicaid / Home and community-based setting

The Centers for Medicare and Medicaid Services (CMS) released its long-awaited final rule that
defines home and community-based setting.  The definition pertains to home and community-
based settings across all Medicaid home and community-based services (HCBS) authorities:
section 1915(k) Community First Choice, section 1915(i) State plan HCBS, and section 1915(c)
HCBS Waivers.  Until the final rule is published in the Federal Register on January 16, a
pre-publication version is available.  The rule will become effective March 17, 2014.  CMS
has developed a website to provide information about the new rule, including an
informational bulletin, a summary of key provisions in the new HCBS definition, fact sheets,
questions and answers, and other related resources. CMS will be holding a series of
informational webinars over the next several weeks. The dates for these webinars can be found
on the website.

For currently approved 1915(c) waivers and 1915(i) state plans, states will need to evaluate
the settings currently in their 1915(c) waivers and 1915(i) state plan programs and, if there are
settings that do not meet the final regulation’s home and community-based settings requirements,
work with CMS to develop a plan to bring their program into compliance. The public will have an
opportunity to provide input on states’ transition plans. States will have up to one year to bring
their HCBS settings into compliance.

Tony Paulauski
Executive Director
The Arc of Illinois
20901 S. LaGrange Rd. Suite 209
Frankfort, IL 60423
815-464-1832 (OFFICE)
815-464-1832 (CELL)