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AARP AARP States Advocacy

New Rules about Home and Community Based (HCB) Settings

Adult Mother & Daughter
A grown woman and her senior mother. Focus is on the adult daughter.
Lisa F. Young

Right now the Department of Health Care Services (DHCS), the California Department of Aging (CDA) and the Department of Developmental Services (DDS) are creating a plan that will make BIG changes to how services are provided to people with disabilities, the elderly, and families. Without your input, these changes may not be strong enough to make lives better!

New federal rules say that community settings (including assisted living and group homes & day and work programs) must give people choice, privacy, and independence. People also have a right to have a say in their planning and to be included into their communities.  

What Do the New Rules Say?

The new federal rules say that HCB settings and services:

  • Must be integrated in and support full access to the greater community;
  • Are selected by the person from among setting and service options;
  • Make sure peoples' rights to privacy, dignity, and respect, and freedom from coercion and restraint are protected;
  • Maximize support of peoples autonomy and independence in making life choices; and
  • Support choice regarding services people get and who provides them.

Are There Rules About Group Homes and Assisted Living?

Yes. If the provider owns or controls the setting, then the provider must make sure that people who live there:

  • Have a lease or other legally enforceable agreement providing similar protections;
  • Have privacy in their unit including lockable doors, choice of roommates and freedom to furnish or decorate the unit;
  • Can control their own schedule including access to food at any time;
  • Can have visitors at any time; and that
  • The setting is physically accessible.

(Any exceptions must be justified by individual need and be in the person's IPP or care plan).

Which Settings Are Not Covered by the New Rules?

  • Settings and services that are not HCBS settings: nursing facilities, IMDs, ICF-DDs, and hospitals.
  • Some places that people live are “presumed to have institutional qualities”, and the State must show that they are in fact HCB. These are:
  • in a publicly-owned or privately owned facility that provides inpatient treatment;
  • on the grounds of, or immediately adjacent to, a public institution; or
  • that have the effect of isolating people receiving Medicaid-funded HCBS from the broader community.

The State needs to hear your stories, examples and input about the quality of the services that people with disabilities are getting and if their rights are being respected. Please visit the Disability Rights California website to learn how you can take action. There's only a little time, so help now!

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