Settings that offer waiver-funded services must meet five required primary characteristics outlined by the Centers for Medicare and Medicaid Services.
This applies to residential and non-residential settings, including facility-based employment and day programs.
The setting is integrated in and supports the person accessing services in having full access to the greater community.
This includes opportunities to
The setting is selected by the person from among non-disability specific settings.
The setting ensures individual's rights of privacy, dignity and respect, and freedom from coercion.
The setting optimizes, but does not regiment, individual initiative, autonomy and independence in making life choices.
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.
See the criteria for demonstrating home and community-based characteristics that CMS has established for each type of setting.