What is the HCBS Final Rule? How Does it Affect the Self-Determination Program?

A man in a wheelchair sits at a table in a cafe

Here in California, we have a law called the Lanterman Act that provides people with intellectual and developmental disabilities with many important services. Many of these services are paid for with money from state and federal Centers for Medicaid and Medicare Services.

That means that California disability resources like the Self-Determination Program – and the services it provides – must comply with everything the HCBS Final Rule says. But what is HCBS, anyway, and what does this “Final Rule” have to say?

What is the HCBS Final Rule?

The HCBS Final Rule is a set of laws created by the Centers for Medicare & Medicaid Services (CMS). It was published in March 2014, and all states were required to implement its changes by 2023.

The Final Rule applies to programs that are considered Home and Community-Based Services (HCBS). 

These services support individuals with developmental disabilities and help them access vital resources like housing, medical care, and more. Another thing the Rule establishes is criteria that all settings eligible for reimbursement through Medicaid HCBS programs must meet. 

Why does the HCBS Final Rule exist?

The goal of the HCBS Final Rule has always been to improve the quality of life for individuals receiving long-term support services

One key idea it discusses is person-centered planning requirements. Services and supports need to be tailored to each person’s goals, needs, and preferences. The process of finding and choosing them should be driven by the person, not their doctors or family.

The Rule also aims to:

  • Create as many opportunities and choices for individuals as possible
  • Ensure individuals get the opportunity to work and spend time with others in their community
  • Protect the rights of individuals with disabilities
  • Support full integration into an individual’s community

What Does the HCBS Final Rule Tell Us?

HCBS Final Rule requirements state that an individual with a disability(ies) receiving support services must be given the chance to:

  • Spend time in and be a part of their community
  • Work alongside others, particularly those who do not have disabilities
  • Have choices about services and who provides them
  • Have control of their own schedule and supports

On top of the requirements listed above, residential settings have some special rules to follow. Individuals with disabilities in these places must have:

  • Choices about their roommates
  • Privacy in their room, including a lock on their door
  • Control of the activities they do
  • The ability to have visitors of their choosing at any time
  • A lease or rental agreement that protects you from eviction
  • The freedom to decorate your space however you want

The HCBS Final Rule and Self-Determination Program

Thanks to the HCBS Final Rule, places where people receive services in California have to ensure their setting is up to par. If it isn’t, they won’t be able to qualify for federal funding under Medicaid (which is called “Medi-Cal” in California). 

This is good news for all Regional Center consumers in the state. The core principle of the HCBS Final Rule, person-centered planning, has been implemented into key resources like the Self-Determination Program (SDP). The SDP gives individuals with disabilities more control over the support they access and allows them to make choices based on their goals. 

However, this also means that all services an SDP participant picks need to comply with the HCBS Final Rule. We don’t see this as a downside, though – it just means you only get to choose from the best of the best!

Bring Self-Determination to Life with NeuroNav

If you live in California, you may be eligible to receive services and support protected by the HCBS Final Rule. The first step is to become a Regional Center client. From there, you can express your interest in the Self-Determination Program and other specific services that fit your needs.

Already a Regional Center client or a future SDP participant? NeuroNav Independent Facilitators can help you ease into the program, navigate the person-centered planning process, and start pursuing the things you want. Schedule a free consultation today to learn more.

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