The Home and Community-Based Services (HCBS) rules make sure that individuals with disabilities have full access to community life and can benefit from it by receiving long-term services and support in the settings that they find to be the most integrated. The HCBS Federal Requirement 2 emphasizes the right of individuals to select their preferred setting for care and support. By understanding and embracing this important aspect of HCBS, we empower giving individuals the best possible care. 

All Medicaid HCBS-funded residential and non-residential settings must abide by the rules. It covers places like group homes, day programs, job opportunities, and other independent living arrangements.

What Is IPP?

Person-centered individual program planning helps in the capacity and capability development of people with developmental disabilities and their families. This planning process involves a team of individuals, including the person with a developmental disability, their family (where appropriate), regional center representative(s), and others. It is not a single event or meeting.

The team helps the individual create a description of their current circumstances, preferred home, friends with whom to socialize, and preferred daily activities, including preferred occupations, as part of the planning process. Based on the person's talents, capabilities, interests, lifestyle, and cultural background, this description is created as a preferred future.

The planning team decides what actions must be taken, by whom, and how the individual is to start their preferred future. The Individual Program Plan (IPP) is a document that serves as a record of the decisions the planning team makes.

The Lanterman Developmental Disabilities Act

The Lanterman Developmental Disabilities Act mandates that everyone receiving services from a regional center older than three have an Individual Program Plan (IPP). An IPP outlines the goals the client is aiming toward, who will deliver the services or support, and if there is a fee involved, who will fund it.

The law was amended in 1992 to make IPP development more client-centered. This strategy, known as person-centered planning, aims to identify, plan for, and work toward the preferred future of the individual with developmental disabilities.

The Service Coordinator (SC) writes the IPP that outlines the goals and objectives to concentrate on, identifies the services and supports required to carry out the IPP's objectives, and keeps track of the client's needs and preferences to ensure that they are provided with the services and supports they need.

Provider Concepts

The Department will be informed as soon as it receives any submitted concepts from service providers that want to apply for funding through regional centers. Although the Department will finally approve funding requests, regional centers must provide recommendations. Projects that take several years need more finance or meet some, but not all, of the HCBS regulations, will be considered.

Need for Services

Before a service is provided, the Regional Center must assess that it is necessary and related to the person's disability. It implies that you might be asked for information by the Regional Center, including but not restricted to:

• A copy of an Individualized Education Plan (IEP), notably for Social Skills Training (SST) and Adaptive Skills Training (AST) referrals for educational advocacy.

• Details on In-Home Supportive Services (IHSS) hours, in particular protective supervision and details about any requests for further respite or personal assistance time.

• Information on extenuating circumstances (for example, if a request for extended respite is made owing to a caregiver's medical issues, the Regional Center may need information addressing the caregiver's limitation.s)

• information on how the services will be used.

• Information about the specific issues that a service might address.

HCBS Infrastructure Improvements 

Participating states may prioritize building infrastructure to assess and expand the availability of home settings that are not specific to disabilities or controlled by providers, benefiting individuals receiving HCBS.

States could pursue inclusionary zoning requirements and other sorts of incentives to accelerate partnerships with state and local housing organizations and increase the supply of housing stock that is suited for lifelong use.

Housing that meets the "qualified residence" criteria for Money Follows the Person and the new Section 811 program could be the target of resources. Additionally, participating states could be permitted to provide a minimal rental assistance benefit to people moving from congregate residentials to community-based housing (in compliance with the MFP-qualified residence standard). This rental assistance benefit cannot cover the cost difference between Medicaid and the individual's current and previous service setting.

Conclusion

HCBS Federal Requirement 2 is important in granting individuals with disabilities the freedom to choose their preferred settings for care and support. By prioritizing person-centered planning, involving service coordinators and regional centers, and assessing the necessity of services, we can make individual lives better. Furthermore, by improving HCBS infrastructure and expanding the availability of inclusive home settings, we can ensure that individuals receive the personalized care they deserve.

HCBS has other Federal Settings Rules made to make the lives of individuals better in their chosen care setting. These rules are essential to know to provide the highest quality of care and support to individuals receiving HCBS.

Read more about the different HCBS rules in Ca Care Association’s Care News Section.