Settings Characteristics

The Centers for Medicare and Medicaid Services (CMS) identified five primary characteristics required for settings where home and community based services (HCBS) are provided. The rule applies to residential and non-residential settings, including workshops and day programs, funded through HCBS waivers.

Required Settings Characteristics

1.The setting is integrated in and supports the person accessing services in having  full access to the greater community.
This includes opportunities to

a.Work in integrated settings

b.Engage in community life

c.Receive services in the community to the same degree of access as people not enrolled in waivers

2.The setting is selected by the person from among non-disability specific settings.

3.The setting ensures individual's rights of privacy, dignity and respect, and freedom from coercion.

4.The setting optimizes, but does not regiment, individual initiative, autonomy and independence in making life choices.

5.The setting facilitates individual choice regarding services and supports and who provides them.

The definition is designed to be outcome-oriented and experiential. This means a determination about whether or not a setting meets these characteristics is based upon the needs of the people receiving services there, as reflected in their person-centered plans. It is not based upon the physical location of the setting, the size of the setting, or a prescribed duration or number of community-based activities.

​Ohio's rule regarding settings (Ohio Administrative Code Section 5123:2‐9‐02) in which HCBS services may be delivered seeks to ensure that home and community-based services waivers maximize opportunities for people to access the benefits of community living and receive services in the most integrated setting.
Main points from the rule
Text needed

Settings Evaluation Tool
​This tool, developed in partnership with stakeholders, helped…

Heightened Scrutiny
​Need text

Remediation Plan
​Need text

Rental Agreements
​DODD, with a workgroup of stakeholders, developed a rule regarding settings in which HCBS services may be delivered, Ohio Administrative Code Section 5123:2‐9‐02.  This rule also includes the specific requirements for a lease or rental agreement.