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General Requirements for All Settings


Home and Community-Based Services (HCBS) Waivers provide Virginians enrolled in Medicaid long-term services and supports the option to receive community based services as an alternative to an institutional setting. Per federal regulations (42 CFR 441.301), individuals enrolled in a DD Waiver are permitted specific rights. For individuals receiving group home, sponsored residential, supported living, group day or group supported employment services in the DD Waivers the following must apply:

  • The setting must be integrated in and supports full access to the greater community. This includes opportunities to engage in community life, control personal resources, and receive services in the community, to the same degree of access as individuals not receiving Medicaid HCBS.
  • The setting must ensure an individual's rights of privacy, dignity and respect, and freedom from coercion and restraint.
  • The setting must optimize, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to, daily activities, physical environment, and with whom to interact.
  • The setting must facilitate individual choice regarding services and supports, and who provides them.

Use the information and resources provided to critically evaluate each setting’s compliance with these standards and to develop strategies to ensure individual’s rights are supported and achieved.



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