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Home and Community Based Services (HCBS) Final/Settings Rule

In March 2014, the Centers for Medicare and Medicaid (CMS) adopted the Home and Community-Based (HCBS) Final Rule. The Final Rule intends to “enhance the quality of HBCS and provide additional protections to individuals that receive services…”   CMS have an implementation date of March 17, 2023, for this Rule.

The Final Rule puts into law that individuals with disabilities can and should:

  • Be included in the community.
  • Have the right to live in the same places as individuals without disabilities.
  • Work in a competitive, integrated job.

SOV DDSD Settings Rule Implementation Guidelines - State of Vermont - Department of Disabilities Aging and Independent Living (DAIL) Developmental Disabilities Services Division (DDSD) Guidance on Implementation of the HCBS Final Rule.

Locks on Doors Guidance -  Home and Community-Based Services Settings Rules. Residential Settings: Locks on Doors Privacy Guidance

Settings Rule Bill of Rights - Is a set of rules that the State and providers must follow related to Developmental Disabilities Home and Community Based Services settings and the Person-Centered Planning Process.

GMSA HCBS Settings Rule Resource:  HCBS Setting Rule Slides (

On January 10, 2014, the Centers for Medicare and Medicaid Services (CMS) issued final regulations regarding home- and community-based settings (HCBS). The rule supports enhanced quality in HCBS programs, outlines person-centered planning practices, and reflects CMS’s intent to ensure that individuals receiving services and supports have full access to the benefits of community living and are able to receive services in the most integrated setting.  INFORMATION FOR PEOPLE THAT RECEIVE SERVICES:  New Rules About How You are Assisted at Home and in the Community

The Developmental Disabilities Services Division (DDSD) has completed a systemic assessment based upon a comparison of the new Home and Community Based Services (HCBS) requirements and the various rules governing Vermont system of services.  The work plan includes a summary of the results of the assessment and the proposed steps towards remediation.    VT DDSD HCBS Assessment and Work Plan (June 6, 2016)

The Vermont Developmental Disabilities Services Division will conduct on site visits where services are provided to people and offer a voluntary survey for service recipients to complete to validate the information collected from the 2017 HCBS Provider Surveys. These provider surveys were completed in May of 2017 as a first step in the process of helping our system to fully align with the new Home & Community Based Services rules. Home and Community-Based Services Requirements: Provider Questions and Answers

An assessment team has been formed to conduct settings reviews in Vermont. Referred to as the Personal Outcome Assessment Team, members of this group are nationally credentialed in the Personal Outcome Measures (POM) interviewing system created by the Council on Quality & Leadership (CQL). The DDSD will use the POM interview results from this team as documentation to justify any decisions regarding heightened scrutiny.

Home and Community-based Setting Requirements (June 26, 2015):