The Home and Community-Based Settings Rule Attempts to Usher In Long Overdue Higher Standards

For nearly 35 years, the federal Medicaid program has given states the opportunity to provide services and supports outside of institutions to individuals with disabilities who would otherwise be eligible for institutional care.  Despite the fact that entitlement to institutional care remains a feature of the modern-day Medicaid program, many state Medicaid agencies have reached a point where they serve far more people with disabilities in non-institutional services (called “home and community services” or “HCBS”) than are served in institutional settings.  Spending patterns have followed, despite the fact that the per-person cost of institutional care rises exponentially as states reduce the numbers of people served in these settings. There is irrefutable and long-standing evidence demonstrating that, on the whole, serving individuals with disabilities in home and community based services and settings costs less than serving those same individuals in institutional settings. Read more…