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  • Writer's pictureTogether for Choice

Together for Choice Welcomes New CMS Guidance on HCBS Settings

Updated: Jun 26

CHICAGO, March 26, 2019 /PRNewswire/ -- Together for Choice (TFC) issued the following statement in response to the Centers for Medicare & Medicaid Services' (CMS) issuance of new guidance relating to the settings in which individuals receiving Medicaid home- and community-based services (HCBS) may live and/or receive services:

"CMS's guidance will make it easier for individuals with intellectual and developmental disabilities to continue to live and receive services in settings that they choose for themselves and that best meet their needs.  Personal autonomy has been a hallmark of the disability rights movement, and this guidance is a step in the right direction to ensuring individuals and their legal guardians have the right to choose where to live and receive services.

"TFC thanks CMS — and in particular Administrator Seema Verma, Deputy Administrator Chris Traylor, Group Director Michael Nardone, Ralph Lollar and Melissa Harris — for their leadership and continued engagement with stakeholders on this issue."

The guidance, issued on Friday, March 22nd, supersedes and replaces prior guidance on the criteria of an isolating setting, which presumed disability-specific settings to have the qualities of an institution regardless of the quality and types of services provided by the setting.  The previous guidance threatened to force individuals with intellectual and developmental disabilities to leave the community they have chosen in which they had lived and/or received services for years, and it would have substantially limited the choices available to them.  In contrast, the new guidance is outcome-oriented based on choice and person-centered plan.

While TFC applauds the new guidance, it urges CMS to take further steps to maximize choice for individuals with intellectual and developmental disabilities. 

Scott Mendel, Chairman of TFC, stated: "In addition to this guidance, we ask CMS to amend the Settings Rule to eliminate the 'heightened scrutiny' process altogether. 

This ill-defined process adds unnecessary administrative costs, confusion and uncertainty.  If a setting otherwise meets all the robust requirements in the Settings Rule, there is no need for it to be subjected to 'heightened scrutiny.'"  Mendel added: "We also request that CMS expressly clarify that settings specifically designed for individuals with disabilities should be treated no differently than, and be subject to the same standards as, other settings in which individuals live and/or receive Medicaid HCBS.  It is critical that the individual and his or her family choose where to live and receive services based on individual needs and preferences, rather than have the government dictate such choices."

About Together for Choice

TFC is a non-profit organization with a mission to unite to protect and advance the rights of individuals with intellectual and developmental disabilities.  For more information about TFC, please visit

SOURCE Together for Choice

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