Home and Community Based Settings (HCBS) Rules - Residential and Day Programs - Rule 7

In a provider-owned or controlled home and community-based residential settings, the following additional requirements must be met:

a. The individual has a lease or other legally enforceable agreement providing
similar protections

b. The individual has privacy in their sleeping or living unit including

• Lockable doors by the individual with only appropriate staff having keys to the
  doors
• Individual sharing units have a choice of roommates in that setting
• Freedom to furnish or decorate the unit within the lease or agreement

c. The individual has freedom and support to control his/her own schedules and activities including     access to food at any time

d. The individual can have visitors at any time

e. The setting is physically accessible

Rule 7 in Practice - Residential

1. Do individuals have access to a key to their bedroom/unit?
2. Are individuals allowed to decorate their own room including moving furniture and hanging up items on the walls?
3. Do individuals get to choose their roommates?
4. Do individuals have access to a key/code to the front door/entrance of their home/setting?
5. Do individuals have a choice in what time they want to eat?
6. Do individuals have an opportunity to buy their own food/snacks/drinks?
7. Are individuals free from restrictions (visiting hours) on when they can have family and friends to visit?
8. Do individuals, or representative, have a written agreement in place providing protections to address termination of residency agreement and due process and appeals?

Summary

1. Rules are basic rights afforded to all members
2. Its not just about the location of where the services are
provided, but its about the individual’s experience and
outcomes
3. Rights may be limited, on a case-by-case basis, if they
jeopardize the health and safety of the member and/or
others
- Must be documented in the service plan

- Strategies developed and monitored to restore rights

For more information visit Medicaid.gov

Visit the AHCCCS Home and Community Based Settings Rules webpage

To see the AHCCCS Home and Community Based Services provider training click Here