March 17, 2023, was the deadline for states to comply with the federal home and community-based services settings rule, which the Centers for Medicare & Medicaid Services (CMS) adopted in January 2014, according to the rule and reporting by Disability Scoop. The rule aimed to make sure Medicaid-funded settings offered real community living rather than institution-like care.
A long road to the deadline
States originally had until 2019 to comply. CMS extended that by three years in 2017, and extended it again after the COVID-19 pandemic disrupted work. Disability Scoop reported that nearly all states were on corrective action plans as the deadline arrived, giving them more time on some requirements.
Even with those plans, CMS expected certain protections to be in place by the deadline. They included privacy, dignity and respect; freedom from coercion and restraint; control over personal resources; a lease or similar agreement; lockable doors; access to food and visitors at any time; and a person-centered service plan.
Why this mattered for providers and DSPs
For residential and day providers, the rule changed daily routines, not just paperwork. Group homes had to show that people could choose roommates, keep their own schedules and have visitors when they wanted. DSPs were often the ones who put those rights into practice, from knocking before entering a room to supporting trips into the community.